From the Department of Internal Medicine.
School of Graduate Studies and Research, Meharry Medical College, Nashville, Tennessee.
Pediatr Infect Dis J. 2018 Aug;37(8):e222-e225. doi: 10.1097/INF.0000000000001906.
Improving human papillomavirus (HPV) vaccination among African-American (AA) female adolescents to reduce the cervical cancer burden is important and cost-effective. The study objective is to identify factors most influential to AA mothers' likelihood to comply with a physician's recommendation to get their daughters the HPV vaccine.
We conducted a cross-sectional survey. Participants were recruited through online and community sites (ie, schools, community centers, etc.) in Alabama. A total of 280 AA mothers and their adolescent daughters completed the survey. A binary logistic regression was used to determine factors influencing mother's likelihood to adhere with a physician's recommendation to get their daughters the HPV vaccine.
The most significant factors influencing mother's likelihood to comply with physician's recommendation were culture: future-time orientation (P = 0.001), perceived barriers of HPV vaccination (P = 0.007), perceived susceptibility to HPV (P = 0.047) and perceived benefits of HPV vaccination (P = 0.002). Further exploration of perceived barriers and perceived benefits found mother's perception that the HPV vaccine is a good way to protect my daughter's health as the only significant benefit. No measures of perceived barriers were significant.
A physician's recommendation should advise AA mothers on the risk of HPV and the importance of HPV vaccination at an early age to reduce cervical cancer risk. It should further address mothers' perceived disadvantages of HPV vaccination (eg, side effects). Incorporating this information in physician recommendation practices could increase HPV vaccination rates with implications in reducing the cervical cancer burden among this high-risk population.
提高非裔美国女性青少年的人乳头瘤病毒 (HPV) 疫苗接种率,以降低宫颈癌负担是重要且具有成本效益的。本研究的目的是确定影响非裔美国母亲最有可能遵从医生建议为女儿接种 HPV 疫苗的因素。
我们进行了一项横断面调查。参与者通过阿拉巴马州的在线和社区网站(例如学校、社区中心等)招募。共有 280 名非裔美国母亲及其青春期女儿完成了调查。采用二项逻辑回归确定影响母亲遵从医生建议为女儿接种 HPV 疫苗的因素。
影响母亲最有可能遵从医生建议的最重要因素是文化:未来时间取向(P = 0.001)、HPV 疫苗接种的感知障碍(P = 0.007)、HPV 感染的感知易感性(P = 0.047)和 HPV 疫苗接种的感知益处(P = 0.002)。进一步探讨感知障碍和感知益处发现,母亲认为 HPV 疫苗是保护女儿健康的好方法,这是唯一显著的益处。HPV 疫苗接种的感知障碍没有一项指标是显著的。
医生的建议应该告知非裔美国母亲 HPV 的风险以及在年轻时接种 HPV 疫苗以降低宫颈癌风险的重要性。它还应该进一步解决母亲对 HPV 疫苗接种的感知劣势(例如,副作用)。在医生建议实践中纳入这些信息可以提高 HPV 疫苗接种率,从而减少高危人群的宫颈癌负担。