Longitudinal Predictors of Human Papillomavirus Vaccine Initiation Among Adolescent Girls in a High-Risk Geographic Area
Longitudinal Predictors of Human Papillomavirus Vaccine Initiation Among Adolescent Girls in a High-Risk Geographic Area
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DOI：
10.1097/olq.0b013e3181f12dbf
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发表时间：
2011-03-01
影响因子：
3.1
通讯作者：
Smith, Jennifer S.
中科院分区：
文献类型：
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作者：
Brewer, Noel T.;Gottlieb, Sami L.;Smith, Jennifer S.
背景：在美国青春期女孩中，人乳头瘤病毒(HPV)疫苗接种率很低。我们试图确定在宫颈癌高危人群中启动HPV疫苗接种的纵向预测因素。方法：我们采访了北卡罗来纳州宫颈癌发病率高的地区10至18岁女孩的父母，这些父母是基于人群的样本。基线访谈于2007年夏季进行，后续访谈于2008年秋季进行。措施包括健康信念模型的构建。结果：父母报告27%(149/567)的女儿在基线和随访期间接种过HPV疫苗。在基线上打算在明年给女儿接种疫苗的父母中，只有38%(126/348)的父母在随访时已经这样做了。在随访时仍未接种疫苗但自基线以来曾去看过医生的女儿的父母中，只有37%(122/388)接受了HPV疫苗推荐。在那些认为获得HPV疫苗的障碍较低、预期如果他们的女儿因为没有接种HPV而感染HPV会有更大遗憾、没有报告“需要更多信息”作为他们尚未接种疫苗、打算给女儿接种疫苗或不是重生基督徒的主要原因的父母中，启动HPV疫苗的比率较高。结论：错过了增加HPV疫苗接种的机会包括未实现父母的意图和缺乏医生建议。虽然早期可接受性研究中确定的几个健康信念模型结构(例如，感知风险、感知疫苗有效性)与HPV疫苗启动没有纵向关联，但我们的发现表明，感染的相关性(例如，预期后悔)为干预提供了新的机会。
Background: Human papillomavirus (HPV) vaccine uptake is low among adolescent girls in the United States. We sought to identify longitudinal predictors of HPV vaccine initiation in populations at elevated risk for cervical cancer.Methods: We interviewed a population-based sample of parents of 10- to 18-year-old girls in areas of North Carolina with elevated cervical cancer rates. Baseline interviews occurred in summer 2007 and follow-up interviews in fall 2008. Measures included health belief model constructs.Results: Parents reported that 27% (149/567) of their daughters had initiated HPV vaccine between baseline and follow-up. Of parents who at baseline intended to get their daughters the vaccine in the next year, only 38% (126/348) had done so by follow-up. Of parents of daughters who remained unvaccinated at follow-up but had seen a doctor since baseline, only 37% (122/388) received an HPV vaccine recommendation. Rates of HPV vaccine initiation were higher among parents who at baseline perceived lower barriers to getting HPV vaccine, anticipated greater regret if their daughters got HPV because they were unvaccinated, did not report "needing more information" as the main reason they had not already vaccinated, intended to get their daughters the vaccine, or were not born-again Christians.Conclusions: Missed opportunities to increase HPV vaccine uptake included unrealized parent intentions and absent doctor recommendations. While several health belief model constructs identified in early acceptability studies (e.g., perceived risk, perceived vaccine effectiveness) were not longitudinally associated with HPV vaccine initiation, our findings suggest correlates of uptake (e.g., anticipated regret) that offer novel opportunities for intervention.