University of Minnesota, School of Public Health, Division of Health Policy and Management, Minneapolis, MN.
Public Health Rep. 2014 May;129(3):237-44. doi: 10.1177/003335491412900305.
Since the introduction of the human papillomavirus (HPV) vaccine in 2006, there have been considerable efforts at the national and state levels to monitor uptake and better understand the individual and system-level factors that predict who gets vaccinated. A common method of measuring the vaccination status of adolescents is through parental recall. We examined how the accuracy of parents' reports of their daughters' HPV vaccination status varied by social characteristics.
Data were taken from the 2009-2010 National Immunization Survey (NIS)-Teen, which includes a household interview and a provider-completed immunization history. We evaluated concordance between parents' and providers' reports of teens' HPV vaccine initiation (≥1 dose) and completion (≥3 doses). We assessed bivariate associations of sociodemographic characteristics with having a concordant, false-positive (overreporting) or false-negative (underreporting) report, and used multinomial logistic regression to estimate the independent impact of each characteristic.
In bivariate analyses, concordance of parent-reported HPV vaccine initiation was associated with each of the sociodemographic characteristics investigated. In regression models, self-reported nonwhite race, lower household income, and lower education level of the teen's mother were associated with a higher likelihood of having a false-negative parental report than a concordant report.
Our results indicate that, while estimates of overall coverage based on parental report may be unbiased, the differences in the accuracy of parental report could result in misleading estimates of disparities in HPV vaccine coverage.
自 2006 年人乳头瘤病毒(HPV)疫苗问世以来,国家和州层面都在努力监测疫苗接种情况,并更好地了解预测谁接种疫苗的个人和系统层面因素。衡量青少年疫苗接种状况的一种常见方法是通过家长回忆。我们研究了父母报告其女儿 HPV 疫苗接种状况的准确性如何因社会特征而有所不同。
数据来自 2009-2010 年国家免疫调查(NIS)-青少年,其中包括家庭访谈和提供者完成的免疫史。我们评估了父母和提供者报告青少年 HPV 疫苗接种起始(≥1 剂)和完成(≥3 剂)情况的一致性。我们评估了社会人口统计学特征与报告一致、假阳性(多报)或假阴性(漏报)之间的关联,并使用多项逻辑回归来估计每个特征的独立影响。
在双变量分析中,父母报告 HPV 疫苗接种起始的一致性与调查的每个社会人口统计学特征均相关。在回归模型中,自我报告的非白人种族、家庭收入较低以及青少年母亲的教育程度较低与更有可能出现假阴性父母报告而不是一致报告相关。
我们的研究结果表明,尽管基于家长报告的总体覆盖率估计可能是无偏的,但家长报告准确性的差异可能导致 HPV 疫苗覆盖率差异的估计结果产生误导。