Center for Health Promotion and Prevention Research, The University of Health Science Center at Houston School of Public Health, 7000 Fannin, 25th Floor, Houston, TX 77030, United States; Department of Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., E5.506S, Dallas, TX 75390, United States.
Center for Health Promotion and Prevention Research, The University of Health Science Center at Houston School of Public Health, 7000 Fannin, 25th Floor, Houston, TX 77030, United States.
Vaccine. 2018 Aug 9;36(33):5084-5090. doi: 10.1016/j.vaccine.2018.06.071. Epub 2018 Jul 3.
Hispanic women experience a disproportionate burden of cervical cancer morbidity and mortality compared to non-Hispanic women. Increasing HPV vaccination among Hispanic adolescents can help alleviate disparities. This study aimed to identify parental psychosocial predictors associated with HPV vaccine initiation and correlates of parental intentions to obtain the vaccine for their Hispanic adolescent daughters aged 11-17 years.
This study is part of a larger three-arm randomized controlled trial testing the effectiveness of interventions to increase HPV vaccination. Parents of adolescent females were recruited in community clinics where we conducted baseline surveys. We obtained electronic medical records six months after baseline to assess vaccination status. Multilevel logistic regression was used to identify correlates of parental intentions to vaccinate and predictors of HPV vaccine initiation. Analyses with initiation as the outcome also controlled for intervention study arm. The Integrated Behavioral Model guided selection of psychosocial and outcome variables.
Our sample (n = 765) consisted mostly of mothers with less than a high school education born outside of the U.S. Forty-one percent had a household income less than $15,000. Most daughters had public or private insurance. Twenty-one percent initiated the HPV vaccine series. Correlates of intention to vaccinate intention included subjective norms related to daughter's doctor (AOR = 1.04; 95% CI 1.01-1.07), belief that the vaccine is safe (AOR = 1.38; 95% CI 1.06-1.78), self-efficacy to obtain the vaccine for their daughter (AOR = 2.39; 95% CI 1.52-3.77), and parental concern about vaccine side effects (AOR = 0.73; 95% CI 0.60-0.89). Intentions predicted initiation (AOR = 2.01; 95% CI 1.10-5.26); concern about sexual disinhibition decreased the odds of having a vaccinated daughter at follow-up (AOR = 0.66; 95% CI 0.47-0.92).
Parental intention and concerns about sexual disinhibition predict vaccine initiation. Further research is needed to explore the role of intention as a potential mediator between psychosocial variables and vaccination status.
与非西班牙裔女性相比，西班牙裔女性在宫颈癌发病率和死亡率方面承受着不成比例的负担。增加西班牙裔青少年的 HPV 疫苗接种率有助于减轻这种差异。本研究旨在确定与 HPV 疫苗接种启动相关的父母心理社会预测因素，以及父母为 11-17 岁西班牙裔少女接种疫苗的意愿相关因素。
本研究是一项更大的三臂随机对照试验的一部分，该试验测试了增加 HPV 疫苗接种率的干预措施的有效性。在社区诊所招募青少年女性的父母，并在基线时进行调查。我们在基线后六个月获得电子病历，以评估疫苗接种情况。多水平逻辑回归用于确定父母接种意愿的相关因素和 HPV 疫苗接种启动的预测因素。以接种为结果的分析还控制了干预研究组。综合行为模型指导了心理社会和结果变量的选择。
我们的样本（n=765）主要由受教育程度低于高中、出生于美国以外的母亲组成。41%的家庭收入低于 15000 美元。大多数女儿有公共或私人保险。21%的人开始接种 HPV 疫苗系列。接种意愿的相关因素包括与女儿医生相关的主观规范（AOR=1.04；95%CI 1.01-1.07）、相信疫苗是安全的（AOR=1.38；95%CI 1.06-1.78）、为女儿获得疫苗的自我效能（AOR=2.39；95%CI 1.52-3.77）和对疫苗副作用的父母关注（AOR=0.73；95%CI 0.60-0.89）。意愿预测了接种（AOR=2.01；95%CI 1.10-5.26）；对性抑制的担忧降低了随访时女儿接种疫苗的几率（AOR=0.66；95%CI 0.47-0.92）。
父母的意愿和对性抑制的担忧预测了疫苗接种的启动。需要进一步研究探索意图作为心理社会变量与接种状态之间的潜在中介作用。
