Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Vaccine. 2019 Feb 4;37(6):869-876. doi: 10.1016/j.vaccine.2018.12.032. Epub 2019 Jan 6.
Parental reports are commonly used for adolescent HPV vaccination status but may be subjected to bias. Guided by the Socioecological Framework, our study explores potential multilevel factors influencing the inaccuracy of parental reports of adolescent HPV vaccination status.
Data from parents of 19,683 adolescents with provider-verified data were analyzed using multilevel modeling. Correlates included adolescent characteristics, parent/household factors, number of providers seen, state-level median income, and state-level HPV vaccine policy. Outcomes included inaccuracy in reporting: vaccine initiation (≥1 dose), completion (3 doses), and number of doses.
24% and 25% of parents reported initiation and completion inaccurately; 28% under-reported and 11% over-reported number of doses. All adolescent characteristics, parent/household factors, and number of healthcare providers seen were associated with the outcomes. Of note, compared to parents of White adolescents, parents of racial/ethnic minority adolescents were more likely to inaccurately report all outcomes (aOR ranges from 1.43 to 1.76 for initiation, 1.45-1.75 for completion, 1.98-2.05 for under-reporting, and 1.17-1.41 for over-reporting). Households with higher maternal education (aOR = 0.70, 0.92, 0.79, and 0.80) and income (aOR = 0.54, 0.62, 0.50, and 0.70) were less likely to inaccurately report initiation, report completion, under-report, and over-report, respectively. Those having seen more providers were less likely to inaccurately report initiation and completion but more likely to over-report number of vaccine doses.
Being parents of females, older adolescents, and racial/ethnic minority adolescents, having lower material education, and poverty status were associated with higher odds of inaccurately reporting HPV vaccination status. These results have implications for estimates drawn from self-reports. Future research can examine sources of inaccuracies (e.g., social desirability or health literacy); they could also explore solutions (e.g., access to vaccine records) that can help parents accurately report vaccination status. State policy does not appear to have an impact on report accuracy.
父母报告常用于青少年 HPV 疫苗接种状况，但可能存在偏差。本研究以社会生态学框架为指导，探讨影响青少年 HPV 疫苗接种状况父母报告准确性的潜在多水平因素。
利用多水平模型分析了 19683 名青少年提供者验证数据的父母数据。相关性包括青少年特征、父母/家庭因素、就诊提供者数量、州级中位数收入和州级 HPV 疫苗政策。结果包括报告不准确：疫苗接种起始（≥1 剂）、完成（3 剂）和剂量数。
24%和 25%的父母报告起始和完成不准确；28%少报，11%多报剂量数。所有青少年特征、父母/家庭因素和就诊提供者数量都与结果相关。值得注意的是，与白人青少年的父母相比，少数族裔青少年的父母更有可能不准确地报告所有结果（起始的比值比范围为 1.43 至 1.76，完成的比值比范围为 1.45 至 1.75，少报的比值比范围为 1.98 至 2.05，多报的比值比范围为 1.17 至 1.41）。母亲教育程度较高（比值比分别为 0.70、0.92、0.79 和 0.80）和收入较高（比值比分别为 0.54、0.62、0.50 和 0.70）的家庭不太可能不准确地报告起始、报告完成、少报和多报。就诊提供者数量较多的家庭不太可能不准确地报告起始和完成，但更有可能多报疫苗剂量数。
作为女性、年龄较大的青少年和少数族裔青少年的父母，受教育程度较低、经济贫困与更大概率不准确报告 HPV 疫苗接种状况相关。这些结果对基于自我报告的估计具有启示意义。未来的研究可以检查不准确报告的来源（例如，社会期望或健康素养）；也可以探索解决方案（例如，获取疫苗记录），帮助父母准确报告疫苗接种状况。州政策似乎对报告准确性没有影响。
