Maternal Cultural Barriers Correlate with Adolescent HPV Vaccine Use

Abstract

Purpose: Determine maternal cultural barriers in mothers who adhere to their own cancer preventive behavior that correlate with HPV vaccination in their adolescent daughters.Methods: We conducted a cross-sectional mailed survey of women attending breast and cervical cancer screening at two diverse institutions; one serving mostly black (54.1%) urban inner-city population and another serving a mostly (87.5%) white suburban population. Surveys queried the adolescent daughter's HPV vaccination status (adolescent defined as 9-17 years old), general health beliefs; HPV-specific beliefs; knowledge, perceived benefits and barriers to HPV vaccination; perceived social/peer group attitudes about HPV vaccines. HPV vaccine completion (receipt of all three doses) is the primary outcome. Cultural differences between groups were assessed using linear regression. Correlates of the primary outcome were assessed using univariate logistic regression.Results: 33% response rate with 68 black and 164 nonblack mothers. 6.8% of adolescent daughters of black mothers adhering to breast/cervical cancer screening completed HPV vaccination, compared 24.5% of nonblacks. In 11-12 year olds, for whom the CDC recommends universal vaccination, none of the daughters of black mothers completed HPV vaccination, compared to 17.5% in nonblacks. Black mothers more likely agreed with “Giving my daughter a new vaccine is like performing an experiment on her” (coefficient 0.38, P = 0.038). Overall knowledge about HPV lagged in black mothers (mean knowledge index 0.587 (95%CI 0.531-0.643)) compared to nonblacks (0.73(95%CI 0.70-0.76)). Black mothers more likely to scored lower on the vaccine benefit scale (coef −0.31, P = 0.007, α = 0.76) and more likely scored higher on the peer group disapproval scale (coef 0.44, P = 0.010, α = 0.73). Belief about vaccine experimentation on her daughter decreased adolescent HPV vaccine use by black moms (OR 0.15, P = 0.002).Conclusion: HPV vaccine completion in adolescent daughters of mothers who already participate in their own cancer preventive behavior remains suboptimal with significant racial disparity in vaccine use. Significant cultural differences correlate with decreased vaccine completion in daughters of black mothers.