Miller Melissa K, Wickliffe Joi, Jahnke Sara, Linebarger Jennifer, Humiston Sharon G
Division of Emergency and Urgent Care, Department of Pediatrics, Children's Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO, 64108, USA,
J Community Health. 2014 Oct;39(5):835-41. doi: 10.1007/s10900-014-9858-2.
While the human papillomavirus (HPV) vaccine has potential to protect against the majority of HPV-associated cancers, vaccination rates in the United States remain low. Racial/ethnic and economic disparities exist for HPV vaccination completion rates. We conducted a mixed-methods study using the theory of planned behavior framework to explore attitudes and beliefs about HPV vaccination among urban, economically disadvantaged adolescents. Fifty adolescents aged 14-18 years were recruited from community-based organizations to complete a written survey and participate in a focus group. The mean age was 15.5 ± 1.3 years; 98 % were African American or mixed race; 64 % were female; 52 % reported previous sexual intercourse; 40 % reported receipt of ≥1 HPV vaccine dose. The knowledge deficit about the HPV vaccine was profound and seemed slightly greater among males. Mothers, fathers and grandmothers were mentioned as important referents for HPV vaccination, but peers and romantic partners were not. Common barriers to vaccination were lack of awareness, anticipated side effects (i.e., pain), and concerns about vaccine safety. Characteristics associated with ≥1 vaccine dose were: having heard of the HPV vaccine versus not (65 vs. 20 %, p = 0.002) and agreeing with the statement "Most people I know would think HPV vaccine is good for your health" versus not (67 vs. 27 %, p = 0.007). Our work indicates a profound lack of awareness about HPV vaccination as well as the important influence of parents among urban, economically-disadvantaged youth. Awareness of these attitudes and beliefs can assist providers and health officials by informing specific interventions to increase vaccine uptake.
虽然人乳头瘤病毒（HPV）疫苗有潜力预防大多数与HPV相关的癌症，但美国的疫苗接种率仍然很低。HPV疫苗接种完成率存在种族/族裔和经济差异。我们采用计划行为理论框架进行了一项混合方法研究，以探讨城市经济弱势青少年对HPV疫苗接种的态度和信念。从社区组织招募了50名14 - 18岁的青少年，完成一份书面调查并参加一个焦点小组。平均年龄为15.5±1.3岁；98%为非裔美国人或混血儿；64%为女性；52%报告有过性行为；40%报告已接种≥1剂HPV疫苗。对HPV疫苗的知识缺乏非常严重，男性中的情况似乎略为更甚。母亲、父亲和祖母被提及是HPV疫苗接种的重要参照对象，但同龄人及恋爱伴侣则不然。疫苗接种的常见障碍包括缺乏认知、预期的副作用（如疼痛）以及对疫苗安全性的担忧。与接种≥1剂疫苗相关的特征有：听说过HPV疫苗与否（65%对20%，p = 0.002）以及是否同意“我认识的大多数人会认为HPV疫苗对健康有益”这一说法（67%对27%，p = 0.007）。我们的研究表明，城市经济弱势青少年对HPV疫苗接种严重缺乏认知，且父母有重要影响。了解这些态度和信念可为医护人员和卫生官员提供帮助，以便制定具体干预措施来提高疫苗接种率。
