Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

To vaccinate or not to vaccinate? Perspectives on HPV vaccination among girls, boys, and parents in the Netherlands: a Q-methodological study

Authors: Nathalie J. S. Patty, Hanna Maria van Dijk, Iris Wallenburg, Roland Bal, Theo J. M. Helmerhorst, Job van Exel, Jane Murray Cramm

Published in: BMC Public Health | Issue 1/2017

Login to get access

Abstract

Background

Despite the introduction of Human papillomavirus (HPV) vaccination in national immunization programs (NIPs), vaccination rates in most countries remain relatively low. An understanding of the reasons underlying decisions about whether to vaccinate is essential in order to promote wider spread of HPV vaccination. This is particularly important in relation to policies seeking to address shortfalls in current HPV campaigns. The aim of this study was to explore prevailing perspectives concerning HPV vaccination among girls, boys, and parents, and so to identify potential determinants of HPV vaccination decisions in these groups.

Method

Perspectives were explored using Q-methodology. Forty-seven girls, 39 boys, and 107 parents in the Netherlands were asked to rank a comprehensive set of 35 statements, assembled based on the health belief model (HBM), according to their agreement with them. By-person factor analysis was used to identify common patterns in these rankings, which were interpreted as perspectives on HPV vaccination. These perspectives were further interpreted and described using data collected with interviews and open-ended questions.

Results

The analysis revealed four perspectives: “prevention is better than cure,” “fear of unknown side effects,” “lack of information and awareness,” and “my body, my choice.” The first two perspectives and corresponding determinants of HPV vaccination decisions were coherent and distinct; the third and fourth perspectives were more ambiguous and, to some extent, incoherent, involving doubt and lack of awareness and information (perspective 3), and overconfidence (perspective 4).

Conclusions

Given the aim of publically funded vaccination programs to minimize the spread of HPV infection and HPV-related disease and the concerns about current uptake levels, our results indicate that focus should be placed on increasing awareness and knowledge, in particular among those in a modifiable phase.
Appendix
Available only for authorised users
Literature
1.
2.
3.
Garland SM. Prevention strategies against human papillomavirus in males. Gynecol Oncol. 2010;117(2):20–5.CrossRef
4.
Stanley M. HPV vaccination in boys and men. Hum Vaccin & Immunother. 2014;10(7):2109–11.CrossRef
5.
6.
7.
8.
Hopkins TG, Wood N. Female human papillomavirus (HPV) vaccination: global uptake and the impact of attitudes. Vaccine. 2013;31(13):1673–9.CrossRefPubMed
9.
Gottvall M, Grandahl M, Hoglund AT, Larsson M, Stenhammar C, Andrae B, et al. Trust versus concerns: how parents reason when they accept HPV vaccination for their young daughter. Ups J Med Sci. 2013;118(4):263–70.CrossRefPubMedPubMedCentral
10.
Grandahl M, Oscarsson M, Stenhammar C, Neveus T, Westerling R, Tyden T. Not the right time: why parents refuse to let their daughters have the human papillomavirus vaccination. Acta Paediatr. 2014;103(4):436–41.CrossRefPubMedPubMedCentral
11.
Reiter PL, Brewer NT, Gottlieb SL, McRee AL, Smith JS. Parents' health beliefs and HPV vaccination of their adolescent daughters. Soc Sci Med. 2009;69(3):475–80.CrossRefPubMed
12.
Alexander AB, Stupiansky NW, Ott MA, Herbenick D, Reece M, Zimet GD. Parent-son decision-making about human papillomavirus vaccination: a qualitative analysis. BMC Pediatr. 2012;12:192.CrossRefPubMedPubMedCentral
13.
Moss JL, Reiter PL, Brewer NTHPV. Vaccine for teen boys: dyadic analysis of parents' and sons' beliefs and willingness. Am J Prev Med. 2015;78:65–71.CrossRef
14.
Haesebaert J, Lutringer-Magnin D, Kalecinski J, Barone G, Jacquard A-C, Régnier V, et al. French women’s knowledge of and attitudes towards cervical cancer prevention and the acceptability of HPV vaccination among those with 14–18 year old daughters: a quantitative-qualitative study. BMC Public Health. 2012;12(1):1–10.CrossRef
15.
Gefenaite G, Smit M, Nijman HW, Tami A, Drijfhout IH, Pascal A, et al. Comparatively low attendance during human papillomavirus catch-up vaccination among teenage girls in the Netherlands: insights from a behavioural survey among parents. BMC Public Health. 2012;12:498.CrossRefPubMedPubMedCentral
16.
Lee Mortensen G, Adam M, Idtaleb L. Parental attitudes towards male human papillomavirus vaccination: a pan-European cross-sectional survey. BMC Public Health. 2015;15:624.CrossRefPubMedPubMedCentral
17.
Reiter PL, Oldach BR, Randle KE, Katz ML. Acceptability of HPV vaccine for males and preferences for future education programs among Appalachian residents. Am JMens Health. 2014;8(2):167–74.CrossRef
18.
Tisi G, Salinaro F, Apostoli P, Bassani R, Bellicini A, Groppi L, et al. HPV vaccination acceptability in young boys. Ann I Super Sanita. 2013;49(3):286–91.
19.
Blodt S, Holmberg C, Muller-Nordhorn J, Rieckmann N. Human papillomavirus awareness, knowledge and vaccine acceptance: a survey among 18-25 year old male and female vocational school students in berlin, Germany. Eur J Pub Health. 2012;22(6):808–13.CrossRef
20.
Crosby RA, Casey BR, Vanderpool R, Collins T, Moore GR. Uptake of free HPV vaccination among young women: a comparison of rural versus urban rates. J Rural Health. 2011;27(4):380–4.CrossRefPubMedPubMedCentral
21.
van Keulen HM, Otten W, Ruiter RA, Fekkes M, van Steenbergen J, Dusseldorp E, et al. Determinants of HPV vaccination intentions among Dutch girls and their mothers: a cross-sectional study. BMC Public Health. 2013;13:111.CrossRefPubMedPubMedCentral
22.
Newman PA, Logie CH, Doukas N, Asakura KHPV. Vaccine acceptability among men: a systematic review and meta-analysis. Sex Transm Infect. 2013;89(7):568–74.CrossRefPubMedPubMedCentral
23.
Ziarnowski KL, Brewer NT, Weber B. Present choices, future outcomes: anticipated regret and HPV vaccination. Am J Prev Med. 2009;48(5):411–4.CrossRef
24.
McRee AL, Reiter PL, Brewer NT. Vaccinating adolescent girls against human papillomavirus-who decides? Am J Prev Med. 2010;50(4):213–4.CrossRef
25.
Griffioen AM, Glynn S, Mullins TK, Zimet GD, Rosenthal SL, Fortenberry JD, et al. Perspectives on decision making about human papillomavirus vaccination among 11- to 12-year-old girls and their mothers. Clin Pediatr. 2012;51(6):560–8.CrossRef
26.
Allen JD, Othus MKD, Shelton RC, Li Y, Norman N, Tom L, et al. Parental decision making about the HPV vaccine. Cancer Epidemiol Biomark Prev. 2010;19(9):2187–98.CrossRef
27.
28.
Lenselink CH, Schmeink CE, Melchers WJG, Massuger LFAG, Hendriks JCM, van Hamont D, et al. Young adults and acceptance of the human papillomavirus vaccine. Am J Public Health. 2008;122(12):1295–301.
29.
30.
Watts S, Stenner P. Doing Q methodological research: theory, method and interpretation. London: Sage; 2012.
31.
Abraham C, Sheeran P. The health belief model. In: Conner M, Norman P, editors. Predicting health behaviour. 2nd ed. New York: Open University Press; 2005. p. 28–80.
32.
Marlow LA, Forster AS, Wardle J, Waller J. Mothers’ and adolescents’ beliefs about risk compensation following HPV vaccination. J Adolesc Health. 2009;44(5):446–51.CrossRefPubMed
33.
Brewer NT, Fazekas KI. Predictors of HPV vaccine acceptability: a theory-informed, systematic review. Am J Prev Med. 2007;45(2–3):107–14.CrossRef
34.
Champion V, Skinner C. The health belief model. In: Glanz K, Riemer B, Viswanath K, editors. Health behaviour and health education: theory, research and practice. 4th ed. San Francisco: Jossey-Bass; 2008. p. 45–62.
35.
Rosenstock IM. The health belief model and preventive health behaviour. Health Educ Monogr. 1974;2(4):354–86.CrossRef
36.
Orji R, Vassileva J, Mandryk R. Towards an effective health interventions design: an extension of the health belief model. Online JPublic Health Inform. 2012;4(3):e9.
37.
Taylor D, Bury M, Campling N, Carter S, Garfied S, Newbould J, et al. A review of the use of the health belief model (HBM), the theory of reasoned action (TRA), the theory of planned behaviour (TPB) and the trans-theoretical model (TTM) to study and predict health related behaviour change. The School of Pharmacy, University of London; 2007. https://​goo.​gl/​hFVSBg . Accessed 18 August 2016.
38.
39.
Geelen E, van Vliet H, de Hoogh P, Horstman K. Taming the fear of voice. Dilemmas in maintaining a high vaccination rate in the Netherlands. Soc Sci Med. 2016;153:12–9.CrossRefPubMed
40.
Horstman K, de Vries GH, Haverman O. Health Policy in a risk culture: Citizenship in a Predictive Medicine Era [in Dutch]. Den Haag: Rathenau Instituut; December 1999. Report no. Studie 38. https://​goo.​gl/​ruhvWY. Accessed 12 December 2016.
41.
Hobson-West P. 'Trusting blindly can be the biggest risk of all': organised resistance to childhood vaccination in the UK. Sociol Health Illn. 2007;29(2):198–215.CrossRefPubMed
42.
Kaufman SR. Regarding the rise in autism: vaccine safety doubt, conditions of inquiry, and the shape of freedom. J Soc Psychol Anthropol. 2010;38(1):8–32.
43.
Rammstedt B, John OP. Measuring personality in one minute or less: a 10-item short version of the big five inventory in English and German. J Res Pers. 2007;41(1):203–12.CrossRef
44.
Wynne B. Public understanding of science. In: Jasanoff S, Markle GE, Petersen JC, Pinch T, editors. Handbook of science and technology studies. Thousand Oaks: Sage Publications; 1995. p. 361–88.
45.
Baker R, Van Exel J, Mason H, Stricklin M. Connecting Q & Surveys: three methods to explore factor membership in large samples. Operant Subjectivity. 2010;34(1):38–58.
Metadata
Title
To vaccinate or not to vaccinate? Perspectives on HPV vaccination among girls, boys, and parents in the Netherlands: a Q-methodological study
Authors
Nathalie J. S. Patty
Hanna Maria van Dijk
Iris Wallenburg
Roland Bal
Theo J. M. Helmerhorst
Job van Exel
Jane Murray Cramm
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4879-2

Other articles of this Issue 1/2017

BMC Public Health 1/2017 Go to the issue

Research article

A possible dose–response association between distance to farmers’ markets and roadside produce stands, frequency of shopping, fruit and vegetable consumption, and body mass index among customers in the Southern United States

Research article

Prevalence, awareness, treatment and control of dyslipidemia in older persons in urban and rural population in the Astana region, Kazakhstan

Research article

Measured, opportunistic, unexpected and naïve quitting: a qualitative grounded theory study of the process of quitting from the ex-smokers’ perspective

Research article

Associations between media use and health information-seeking behavior on vaccinations in South Korea

Research article

Physical activity, obesity and mortality: does pattern of physical activity have stronger epidemiological associations?

Research article

How does the media portray drinking water security in Indigenous communities in Canada? An analysis of Canadian newspaper coverage from 2000-2015