Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Womens Health Issues. 2019 May-Jun;29(3):238-244. doi: 10.1016/j.whi.2018.12.001. Epub 2019 Jan 11.
Our objective was to explore how mothers' attitudes and relationships with their daughters may impact the cervical cancer prevention behaviors of daughters with diverse sexual orientations.
We examined 8,143 mother-daughter dyads from the Nurses' Health Study 2 and Growing Up Today Study. During the daughter's adolescence, each mother reported her beliefs about the importance of regular Pap testing for her daughter, the frequency of communication with her daughter about Pap testing, her beliefs about Pap testing and human papillomavirus (HPV) vaccines, and her acceptance of sexual minorities (e.g., bisexuals, lesbians). Mothers and daughters separately reported relationship satisfaction. Log-binomial models were used to examine the longitudinal association between maternal factors and daughter's receipt of a Pap test and HPV vaccination.
Nearly all maternal factors predicted the daughter's likelihood to have a Pap test and HPV vaccination. Higher levels of acceptance for sexual minorities and better relationship quality were also positively associated with these cervical cancer prevention behaviors. Yet, after adjusting for the maternal factors, there was little attenuation of the existing sexual orientation-related disparities in Pap tests or HPV vaccination.
Mothers can play an important role in their daughters' cervical cancer prevention behaviors through novel processes like being more accepting of sexual minorities and having a good relationship quality. However, in this study, maternal factors did not explain much of the sexual orientation-related disparities in cervical cancer prevention. Efforts to ensure a mother is accepting of sexual minorities and has a good relationship quality with her daughter may improve that daughter's reproductive health.
本研究旨在探讨母亲对女儿的态度和关系如何影响不同性取向女儿的宫颈癌预防行为。
我们分析了来自护士健康研究 2 期和今日成长研究的 8143 对母女数据。在女儿的青春期，每位母亲报告了其对女儿定期巴氏涂片检查重要性的看法、与女儿交流巴氏涂片检查的频率、对巴氏涂片检查和人乳头瘤病毒（HPV）疫苗的看法，以及对性少数群体（如双性恋、女同性恋者）的接受程度。母亲和女儿分别报告了关系满意度。采用对数二项式模型检验母亲因素与女儿接受巴氏涂片检查和 HPV 疫苗接种之间的纵向关联。
几乎所有的母亲因素都预测了女儿进行巴氏涂片检查和 HPV 疫苗接种的可能性。对性少数群体的更高接受度和更好的关系质量也与这些宫颈癌预防行为呈正相关。然而，在调整了母亲因素后，巴氏涂片检查或 HPV 疫苗接种方面与性取向相关的差异几乎没有减弱。
母亲可以通过一些新的过程（如对性少数群体更加包容和保持良好的关系质量）在女儿的宫颈癌预防行为中发挥重要作用。然而，在本研究中，母亲因素并不能解释宫颈癌预防方面与性取向相关的大部分差异。努力确保母亲对性少数群体的包容和与女儿的良好关系质量可能会改善女儿的生殖健康。
