Parental attitudes and beliefs about human papillomavirus (HPV) vaccination and vaccine receipt among adolescents in richmond county, Georgia

Abstract

Purpose: The Advisory Committee on Immunization Practices currently recommends human papillomavirus vaccination (HPV) for males and females ages 9-26 years. Parental attitudes can often influence health decisions, especially those involving vaccines for their adolescents. We investigated parental attitudes and beliefs about human papillomavirus vaccination as well as parental selfreported receipt and series completion for their adolescent. The HPV vaccine series requires three doses, an initial vaccination, a second vaccination 2 months after initial dose and a third vaccination six months after initial dose. Methods: We conducted a three-arm cluster-randomized controlled trial in middle and high schools in Richmond County, Georgia over three years. 11 schools were randomly assigned to one of three treatment arms: Arm 1) No Intervention; Arm 2) an educational brochure about adolescent vaccines mailed home for parents; and Arm 3) a curriculum delivered by teachers in classrooms of adolescents and an educational brochure for parents. Students received the intervention to which the school was assigned. Parents in all arms were surveyed annually to assess attitudes and beliefs about the four recommended adolescent vaccinations (yearly seasonal influenza, meningococcal conjugate, tetanus, diphtheria and pertussis and HPV vaccines), as well as selfreport of vaccine receipt by their adolescent. Survey topics included perceived susceptibility, perceived severity and perceived benefits about their child receiving the HPV vaccine. The surveys were administered before delivery of the interventions, Year 1 and in Years 2 and 3. Surveys were administered via telephone and online. Six attitude and belief questions about HPV vaccination were compiled into an attitude scale ranging from0-6,where 0means no positive attitudes about HPV vaccination and 6 means respondents indicated very positive attitudes about HPV vaccination. Chi-square tests were performed using SPSS to assess differences. Results: We identified 686 parents in total from the three intervention arms (Arm1 n = 210, Arm2 n = 251, Arm3 n= 225). Results show a range of opinions about HPV vaccination with participants receiving a score of 0 (3.8%), 1 (5.4%), 2 (8.2%), 3 (21.1%), 4 (20.3%), 5 (28%) or 6 (13.3%). Approximately half (48%) of parents reported that their adolescent received at least one dose of HPV vaccine. Higher scores on the attitude and belief scale were associated with the receipt of HPV vaccine (p < .001). Among parents whose adolescent initiated the series, 61% (n = 206) were reported to have completed the three dose series. However, there was no statistically significant association between parental attitudes and series completion. Conclusions: Parents in our sample showed positive attitudes and beliefs about HPV vaccine. 62% of parents scored 4 or greater on the attitudinal scale. These favorable opinions about the HPV vaccine were associated with initial vaccine receipt as reported by parents. Future efforts should be made to promote the benefits of HPV vaccination through sources of information that parents trust. Novel and innovative methods could potentially aid in increasing the rate of series completion among this population.