Abstract
The human papillomavirus (HPV) is a public health concern because of its association with cancer. HPV vaccine rates among college students remains low. This is a critical catch-up age for individuals to receive the HPV vaccine and research shows parents still play a role in college students’ medical decision-making. Therefore, the purpose of this study was to examine factors related to college women making a solo decision to initiate the HPV vaccination in comparison to making a joint parent-daughter decision. Data collected using an internet-delivered questionnaire were analyzed from 799 college women who had initiated or completed the HPV vaccination. Multinomial logistic regression was performed to compare study variables on who decided the participant should be vaccinated (self-decision, parent-only decision, joint parent-daughter decision). Participants who were older (OR 1.68, p < 0.001) and sexually active (OR 4.97, p < 0.001) were significantly more likely to have made a solo decision to be vaccinated. Participants who completed the HPV vaccination (OR 0.33, p < 0.001) and those who talked with a parent about the HPV vaccine (OR 0.12, p < 0.001) were significantly less likely to have made a solo decision to be vaccinated. Findings indicate joint parent-daughter decisions may improve HPV vaccination cycle completion.
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References
American Cancer Society. (2017). HPV and cancer. Retrieved Febuary 17, 2018 from https://www.cancer.org/cancer/cancer-causes/infectious-agents/hpv/hpv-and-cancer-info.html.
Centers for Disease Control and Prevention. (2017). Genital HPV infection - CDC fact sheet. Retrieved January 30, 2018 from http://www.cdc.gov/std/HPV/STDFact-HPV.htm.
Centers for Disease Control and Prevention. (2018). Human papillomavirus (HPV) and cancer. Retrieved Febuary 20, 2018 from https://www.cdc.gov/cancer/hpv/index.htm.
American Cancer Society. (2017). What are the key statistics about cervical cancer? Retrieved Febuary 16, 2018 from http://www.cancer.org/cancer/cervicalcancer/detailedguide/cervical-cancer-key-statistics.
Centers for Disease Control and Prevention. (2015). HPV and cancer. Retrieved Febuary 16, 2018 from http://www.cdc.gov/hpv/cancer.html.
Centers for Disease Control and Prevention. (2017). HPV vaccine information for young women. Retrieved Febuary 16, 2018 from http://www.cdc.gov/std/hpv/stdfact-hpv-vaccine-young-women.htm.
Meites, E., Kempe, A., & Markowitz, L. E. (2016). Use of a 2-dose schedule for human papillomavirus vaccination - updated recommendations of the advisory committee on immunization practices. MMWR. Morbidity and Mortality Weekly Report, 65(49), 1405.
US Department of Health and Human Services, Healthy People 2020. (2018). Immunization and infectious disease. Retrieved Febuary 15, 2018 from https://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases/objectives.
Walker, T. Y., Elam-Evans, L. D., Singleton, J. A., Yankey, D., Markowitz, L. E., Fredua, B.,.. . Stokley, S. (2017). National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years—united states. 2016. MMWR, 66(33), 874–882.
Williams, W. W., Lu, P., O’Halloran, A., Kim, D. K., Grohskopf, L. A., & Pilishvili, T... . Centers for Disease Control and Prevention (CDC). (2016). Surveillance of vaccination coverage among adult populations - united states, 2014. Morbidity and Mortality Weekly Report.Surveillance Summaries (Washington, D.C.: 2002), 65(1), 1.
Kessels, S. J. M., Marshall, H. S., Watson, M., Braunack-Mayer, A. J., Reuzel, R., & Tooher, R. L. (2012). Factors associated with HPV vaccine uptake in teenage girls: A systematic review. Vaccine, 30(24), 3546–3556.
Thompson, E. L., Vamos, C. A., Straub, D. M., Sappenfield, W. M., & Daley, E. M. (2016). Human papillomavirus vaccine information, motivation, and behavioral skills among young adult US women. Journal of Health Psychology. https://doi.org/10.1177/1359105316672924.
Hughes, J., Cates, J. R., Liddon, N., Smith, J. S., Gottlieb, S. L., & Brewer, N. T. (2009). Disparities in how parents are learning about the human papillomavirus vaccine. Cancer Epidemiology, Biomarkers & Prevention, 18(2), 363–372.
Ragan, K. R., Bednarczyk, R. A., Butler, S. M., & Omer, S. B. (2018). Missed opportunities for catch-up human papillomavirus vaccination among university undergraduates: Identifying health decision-making behaviors and uptake barriers. Vaccine, 36(2), 331–341.
Smith, M. L., Wilson, K. L., Pulczinski, J. C., & Ory, M. G. (2014). Support for HPV vaccination mandates for both females and males. American Journal of Health Behavior, 38(6), 831–838.
Wilson, K. L., White, A., Rosen, B. L., Chiappone, A., Pulczinski, J. C., Ory, M. G., & Smith, M. L. (2016). Factors associated with college students’ intentions to vaccinate their daughters against HPV: Protecting the next generation. Journal of Community Health, 41(5), 1078–1089.
Wilson, K. L., Cowart, C. J., Rosen, B. L., Pulczinski, J. C., Solari, K. D., Ory, M. G., & Smith, M. L. (2016). Characteristics associated with HPV diagnosis and perceived risk for cervical cancer among unmarried, sexually active college women. Journal of Cancer Education, 33, 1–13.
Wilson, K. L., Smith, M. L., Rosen, B. L., Pulczinski, J. C., & Ory, M. G. (2017). HPV vaccination status and mandate support for school-aged adolescents among college females: A descriptive study. The Journal of School Nursing, 33(3), 232–245.
Rosen, B. L., Thompson, E., Wilson, K. L., & Smith, M. L. (2017). Do political and religious affiliations impact HPV vaccine mandate support? Health Behavior and Policy Review, 4(5), 472–483.
Kahn, J. A., Rosenthal, S. L., Hamann, T., & Bernstein, D. I. (2003). Attitudes about human papillomavirus vaccine in young women. International Journal of STD & AIDS, 14, 300–306.
Centers for Disease Control and Prevention. (2010). Behavioral risk factor surveillance system questionnaire-2010. Retrieved Febuary 15, 2018 from http://www.cdc.gov/brfss/annual_data/pdf-ques/2010brfss.pdf.
Dunne, E. F., Unger, E. R., Sternberg, M., et al. (2007). Prevalence of HPV infection among females in the united states. Journal of American Medical Association, 297(8), 813–819.
Markowitz, L., Liu, G., Hariri, S., Steinau, M., Dunne, E., & Unger, E. (2016). Prevalence of HPV after introduction of the vaccination program in the united states. Pediatrics, 137(3), e20151968–e20151968.
Kosenko, K. A., Harvey-Knowles, J., & Hurley, R. J. (2014). The information management processes of women living with HPV. Journal of Health Communication: International Perspectives, 19(7), 813–824.
Smith, R. A., Hernandez, R., & Catona, D. (2014). Investigating initial disclosures and reactions to unexpected, positive HPV diagnosis. Western Journal of Communication, 78(4), 426–440.
Bendik, M. K., Mayo, R. M., & Parker, V. G. (2011). Knowledge, perceptions, and motivations related to HPV vaccination among college women. Journal of Cancer Education, 26(3), 459–464.
Bynum, S. A., Brandt, H. M., Sharpe, P. A., Williams, M. S., & Kerr, J. C. (2011). Working to close the gap: Identifying predictors of HPV vaccine uptake among young african american women. Journal of Health Care for the Poor & Underserved, 22(2), 549–561.
Daley, E. M., Vamos, C. A., Buhi, E. R., Kolar, S. K., McDermott, R. J., Hernandez, N., & Fuhrmann, H. J. (2010). Influences on human papillomavirus vaccination status among female college students. Journal of Women’s Health, 19(10), 1885–1891.
Dempsey, A., Cohn, L., Dalton, V., & Ruffin, M. (2010). Patient and clinic factors associated with adolescent human papillomavirus vaccine utilization within a university-based health system. Vaccine, 28(4), 989–995.
Wei, F., Moore, P. C., & Green, A. L. (2013). Geographic variability in human papillomavirus vaccination among U.S. young women. American Journal of Preventive Medicine, 44(2), 154–157.
Williams, W. W., Lu, P., Saraiya, M., Yankey, D., Dorell, C., Rodriguez, J. L.,.. . Markowitz, L. E. (2013). Factors associated with human papillomavirus vaccination among young adult women in the united states. Vaccine, 31(28), 2937–2946.
Dempsey, A., Cohn, L., Dalton, V., & Ruffin, M. (2011). Worsening disparities in HPV vaccine utilization among 19–26 year old women. Vaccine, 29(3), 528–534.
Pourat, N., & Jones, J. M. (2012). Role of insurance, income, and affordability in human papillomavirus vaccination. The American Journal of Managed Care, 18(6), 320–330.
Wilson, R., Brown, D. R., Boothe, M. A. S., & Harris, C. E. S. (2013). 2012). Knowledge and acceptability of the HPV vaccine among ethnically diverse black women. Journal of Immigrant and Minority Health, 15(4), 747–757.
Thompson, V. L. S., Arnold, L. D., & Notaro, S. R (2012). African american parents’ HPV vaccination intent and concerns. Journal of Health Care for the Poor & Underserved, 23(1), 290–301.
Centers for Disease Control and Prevention. (2017). VFC program. Retrieved Febuary 16, 2018 from https://www.cdc.gov/features/vfcprogram/#vfclist.
Cox, D. S., Cox, A. D., Sturm, L., & Zimet, G. (2010). Behavioral interventions to increase HPV vaccination acceptability among mothers of young girls. Health Psychology, 29(1), 29–39.
Roberts, M. E., Gerrard, M., Reimer, R., & Gibbons, F. X. (2010). Mother-daughter communication and human papillomavirus vaccine uptake by college students. Pediatrics, 125(5), 982–989.
Hughes, C. C., Jones, A. L., Feemster, K. A., & Fiks, A. G. (2011). HPV vaccine decision making in pediatric primary care: A semi-structured interview study. BMC Pediatrics, 11, 74.
Hilton, S., & Smith, E. (2011). “I thought cancer was one of those random things. I didn’t know cancer could be caught… Adolescent girls’ understandings and experiences of the HPV programme in the UK. Vaccine, 29(26), 4409–4415.
Williams, K., Forster, A., Marlow, L., & Waller, J. (2011). Attitudes towards human papillomavirus vaccination: A qualitative study of vaccinated and unvaccinated girls aged 17–18 years. The Journal of Family Planning and Reproductive Health Care/Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists, 37(1), 22–25.
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Rosen, B.L., Bishop, J.M., McDonald, S. et al. Factors Associated with College Women’s Personal and Parental Decisions to be Vaccinated Against HPV. J Community Health 43, 1228–1234 (2018). https://doi.org/10.1007/s10900-018-0543-8
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DOI: https://doi.org/10.1007/s10900-018-0543-8