Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA.
Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA; Cancer Prevention and Control Program, Winship Cancer Institute, 1365-C Clifton Rd NE, Atlanta, GA 30322, USA; Emory Vaccine Center, 954 Gatewood Rd, Atlanta, GA 30329, USA.
Vaccine. 2018 Jan 4;36(2):331-341. doi: 10.1016/j.vaccine.2017.07.041. Epub 2017 Jul 26.
Suboptimal adolescent human papillomavirus (HPV) vaccine rates in the US highlight the need for catch-up vaccination. When teenagers enter college, there may be a shift in healthcare decision-making from parents and guardians to the students themselves. Little is known about factors influencing college students' healthcare decision-making processes.
We evaluated HPV vaccine decision-making among 18-to-26-year-old college students through a self-administered, anonymous, cross-sectional survey. This survey was distributed to a sample of men and women in classroom settings at two universities. Categorical data comparisons were conducted using Chi-square and Fisher's exact tests. Multivariate Poisson regression was used to model initiation of HPV vaccine and compute prevalence ratios while controlling for key influential covariates at the 0.05 alpha level.
A total of 527 students participated (response proportion=93.1%). Overall, 55.8% of participants received the HPV vaccine. Encouraging conversations with doctors and/or parents/guardians were identified as one of the most influential factors to increase vaccine uptake. Among students who received encouragement from both a doctor and parent, 95.8% received the vaccine. Campaigns about cancer prevention were viewed as more influential than those that focus on preventing genital warts. Approximately one-third of students indicated they didn't know where to get the HPV vaccine. Women were more likely to report that their parents would not let them get the HPV vaccine compared to men (26.7% vs. 2.3%). The majority of students (77.3%) indicated their parents were sometimes, equally, or mostly involved in making decisions about receiving vaccines (other than flu).
Students' decision-making is greatly influenced by their parents; therefore, interventions for this population should work to increase students' control over decision-making while also addressing parental concerns.
美国青少年人乳头瘤病毒（HPV）疫苗接种率不理想，突出了补种疫苗的必要性。当青少年进入大学时，医疗保健决策可能会从父母和监护人转移到学生自己身上。对于影响大学生医疗保健决策过程的因素知之甚少。
我们通过自我管理、匿名、横断面调查评估了 18 至 26 岁大学生的 HPV 疫苗接种决策。该调查在两所大学的课堂环境中对男性和女性进行了抽样。使用卡方检验和 Fisher 确切检验比较分类数据。使用多变量泊松回归对 HPV 疫苗接种的启动进行建模，并在 0.05 阿尔法水平下控制关键影响因素的协变量，计算患病率比。
共有 527 名学生参与（应答率=93.1%）。总体而言，55.8%的参与者接种了 HPV 疫苗。与医生和/或父母/监护人进行鼓励性对话被认为是增加疫苗接种率的最具影响力因素之一。在同时从医生和父母那里获得鼓励的学生中，95.8%接种了疫苗。预防癌症的宣传活动比那些专注于预防生殖器疣的宣传活动更具影响力。大约三分之一的学生表示他们不知道在哪里可以获得 HPV 疫苗。与男性相比，女性更有可能报告称父母不会让她们接种 HPV 疫苗（26.7%比 2.3%）。大多数学生（77.3%）表示，父母在决定接种疫苗（除流感疫苗外）方面有时、平等或主要参与。
学生的决策受到父母的极大影响；因此，针对这一人群的干预措施应努力增加学生对决策的控制，同时解决家长的担忧。
