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Published in: BMC Women's Health 1/2016

Open Access 01-12-2016 | Research article

Factors related to HPV vaccine uptake and 3-dose completion among women in a low vaccination region of the USA: an observational study

Authors: Andrew R. Wilson, Mia Hashibe, Julia Bodson, Lisa H. Gren, Brooke A. Taylor, Jessica Greenwood, Brian R. Jackson, Rosemary She, Marlene J. Egger, Deanna Kepka

Published in: BMC Women's Health | Issue 1/2016

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Abstract

Background

To assess the demographic and attitudinal factors associated with HPV vaccine initiation and completion among 18–26 year old women in Utah.

Method

Between January 2013 and December 2013, we surveyed 325 women from the University of Utah Community Clinics about their HPV vaccine related beliefs and behaviors. Odds ratios (ORs) were estimated from logistic regression models to identify variables related to HPV vaccine initiation and series completion.

Results

Of the 325 participants, 204 (62.8 %) had initiated the vaccine and 159 (48.9 %) had completed the 3-dose series. The variables associated with HPV vaccine initiation were lower age (OR = 1.18 per year); being unmarried (OR = 3.62); not practicing organized religion (OR = 2.40); knowing how HPV spreads (OR = 6.29); knowing the connection between HPV and cervical cancer (OR = 3.90); a belief in the importance of preventive vaccination (OR = 2.45 per scale unit); strength of doctor recommendation (OR = 1.86 per scale unit); and whether a doctor’s recommendation was influential (OR = 1.70 per scale unit). These variables were also significantly associated with HPV vaccine completion.

Conclusion

The implications of these findings may help inform policies and interventions focused on increasing HPV vaccination rates among young women. For example, without this information, programs might focus on HPV awareness; however, the results of this study illustrate that awareness is already high (near saturation) in target populations and other factors, such as strong and consistent physician recommendations, are more pivotal in increasing likelihood of vaccination. Additionally, our findings indicate the need for discussions of risk assessment be tailored to the young adult population.
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Literature
3.
go back to reference Satterwhite CL, et al. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis. 2013;40(3):187–93.CrossRefPubMed Satterwhite CL, et al. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis. 2013;40(3):187–93.CrossRefPubMed
4.
go back to reference Bhatia N, et al. Understanding genital warts: epidemiology, pathogenesis, and burden of disease of human papillomavirus. J Cutan Med Surg. 2013;17 Suppl 2:S47–54.PubMed Bhatia N, et al. Understanding genital warts: epidemiology, pathogenesis, and burden of disease of human papillomavirus. J Cutan Med Surg. 2013;17 Suppl 2:S47–54.PubMed
6.
go back to reference Walboomers JM, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999;189(1):12–9.CrossRefPubMed Walboomers JM, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999;189(1):12–9.CrossRefPubMed
7.
go back to reference Vaccine Information Statement: HPV Vaccine Gardasil. Centers for Disease Control and Prevention. 2013. Vaccine Information Statement: HPV Vaccine Gardasil. Centers for Disease Control and Prevention. 2013.
9.
go back to reference Bosch FX, et al. Prevalence of human papillomavirus in cervical cancer: a worldwide perspective. International biological study on cervical cancer (IBSCC) Study Group. J Natl Cancer Inst. 1995;87(11):796–802.CrossRefPubMed Bosch FX, et al. Prevalence of human papillomavirus in cervical cancer: a worldwide perspective. International biological study on cervical cancer (IBSCC) Study Group. J Natl Cancer Inst. 1995;87(11):796–802.CrossRefPubMed
10.
go back to reference Hariri S, et al. Prevalence of genital human papillomavirus among females in the United States, the National Health And Nutrition Examination Survey, 2003–2006. J Infect Dis. 2011;204(4):566–73.CrossRefPubMed Hariri S, et al. Prevalence of genital human papillomavirus among females in the United States, the National Health And Nutrition Examination Survey, 2003–2006. J Infect Dis. 2011;204(4):566–73.CrossRefPubMed
11.
go back to reference Vaccine Information Statement: HPV Vaccine Cervarix. Centers for Disease Control and Prevention. 2011. Vaccine Information Statement: HPV Vaccine Cervarix. Centers for Disease Control and Prevention. 2011.
12.
13.
go back to reference Barnabas RV, et al. Epidemiology of HPV 16 and cervical cancer in Finland and the potential impact of vaccination: mathematical modelling analyses. PLoS Med. 2006;3(5):e138.CrossRefPubMedPubMedCentral Barnabas RV, et al. Epidemiology of HPV 16 and cervical cancer in Finland and the potential impact of vaccination: mathematical modelling analyses. PLoS Med. 2006;3(5):e138.CrossRefPubMedPubMedCentral
14.
go back to reference Markowitz LE, et al. Reduction in human papillomavirus (HPV) prevalence among young women following HPV vaccine introduction in the United States, National Health and Nutrition Examination Surveys, 2003–2010. J Infect Dis. 2013;208(3):385–93.CrossRefPubMed Markowitz LE, et al. Reduction in human papillomavirus (HPV) prevalence among young women following HPV vaccine introduction in the United States, National Health and Nutrition Examination Surveys, 2003–2010. J Infect Dis. 2013;208(3):385–93.CrossRefPubMed
15.
go back to reference Elam-Evans LD, et al. National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years - United States, 2013. MMWR Morb Mortal Wkly Rep. 2014;63(29):625–33.PubMed Elam-Evans LD, et al. National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years - United States, 2013. MMWR Morb Mortal Wkly Rep. 2014;63(29):625–33.PubMed
16.
go back to reference Williams WW, et al. Noninfluenza vaccination coverage among adults - United States, 2012. MMWR Morb Mortal Wkly Rep. 2014;63(5):95–102.PubMed Williams WW, et al. Noninfluenza vaccination coverage among adults - United States, 2012. MMWR Morb Mortal Wkly Rep. 2014;63(5):95–102.PubMed
18.
go back to reference Brewer NT, Fazekas KI. Predictors of HPV vaccine acceptability: a theory-informed, systematic review. Prev Med. 2007;45(2–3):107–14.CrossRefPubMed Brewer NT, Fazekas KI. Predictors of HPV vaccine acceptability: a theory-informed, systematic review. Prev Med. 2007;45(2–3):107–14.CrossRefPubMed
19.
go back to reference Gold R, Naleway A, Riedlinger K. Factors predicting completion of the human papillomavirus vaccine series. J Adolesc Health. 2013;52(4):427–32.CrossRefPubMed Gold R, Naleway A, Riedlinger K. Factors predicting completion of the human papillomavirus vaccine series. J Adolesc Health. 2013;52(4):427–32.CrossRefPubMed
20.
22.
go back to reference Kharbanda EO, et al. Receipt of human papillomavirus vaccine among privately insured adult women in a U.S. Midwestern Health Maintenance Organization. Prev Med. 2013;57(5):712–4.CrossRefPubMed Kharbanda EO, et al. Receipt of human papillomavirus vaccine among privately insured adult women in a U.S. Midwestern Health Maintenance Organization. Prev Med. 2013;57(5):712–4.CrossRefPubMed
23.
go back to reference Rosenthal SL, et al. Predictors of HPV vaccine uptake among women aged 19–26: importance of a physician’s recommendation. Vaccine. 2011;29(5):890–5.CrossRefPubMed Rosenthal SL, et al. Predictors of HPV vaccine uptake among women aged 19–26: importance of a physician’s recommendation. Vaccine. 2011;29(5):890–5.CrossRefPubMed
24.
go back to reference Verdenius I, et al. Predictors of three dose on-time compliance with HPV4 vaccination in a disadvantaged, underserved, safety net population in the US Midwest. PLoS One. 2013;8(8):e71295.CrossRefPubMedPubMedCentral Verdenius I, et al. Predictors of three dose on-time compliance with HPV4 vaccination in a disadvantaged, underserved, safety net population in the US Midwest. PLoS One. 2013;8(8):e71295.CrossRefPubMedPubMedCentral
26.
go back to reference Donadiki EM, et al. Health Belief Model applied to non-compliance with HPV vaccine among female university students. Public Health. 2014;128(3):268–73.CrossRefPubMed Donadiki EM, et al. Health Belief Model applied to non-compliance with HPV vaccine among female university students. Public Health. 2014;128(3):268–73.CrossRefPubMed
27.
go back to reference Reiter PL, et al. Parents’ health beliefs and HPV vaccination of their adolescent daughters. Soc Sci Med. 2009;69(3):475–80.CrossRefPubMed Reiter PL, et al. Parents’ health beliefs and HPV vaccination of their adolescent daughters. Soc Sci Med. 2009;69(3):475–80.CrossRefPubMed
28.
go back to reference Chan SS, et al. Adolescent girls’ attitudes on human papillomavirus vaccination. J Pediatr Adolesc Gynecol. 2009;22(2):85–90.CrossRefPubMed Chan SS, et al. Adolescent girls’ attitudes on human papillomavirus vaccination. J Pediatr Adolesc Gynecol. 2009;22(2):85–90.CrossRefPubMed
29.
30.
go back to reference Bandura A, Self-efficacy: The exercise of control. 1997: W.H. Freeman Bandura A, Self-efficacy: The exercise of control. 1997: W.H. Freeman
31.
go back to reference Greenland S, Pearl J, Robins JM. Causal diagrams for epidemiologic research. Epidemiology. 1999;10(1):37–48.CrossRefPubMed Greenland S, Pearl J, Robins JM. Causal diagrams for epidemiologic research. Epidemiology. 1999;10(1):37–48.CrossRefPubMed
32.
go back to reference Dillman DA. Internet, mail, and mixed-mode surveys: the tailored design method. Hoboken, New Jersey: Wiley & Sons; 2009. Dillman DA. Internet, mail, and mixed-mode surveys: the tailored design method. Hoboken, New Jersey: Wiley & Sons; 2009.
33.
go back to reference Evans D, et al. Combining directed acyclic graphs and the change-in-estimate procedure as a novel approach to adjustment-variable selection in epidemiology. BMC Med Res Methodol. 2012;12:156.CrossRefPubMedPubMedCentral Evans D, et al. Combining directed acyclic graphs and the change-in-estimate procedure as a novel approach to adjustment-variable selection in epidemiology. BMC Med Res Methodol. 2012;12:156.CrossRefPubMedPubMedCentral
35.
go back to reference Textor J, Hardt J, Knuppel S. DAGitty: a graphical tool for analyzing causal diagrams. Epidemiology. 2011;22(5):745.CrossRefPubMed Textor J, Hardt J, Knuppel S. DAGitty: a graphical tool for analyzing causal diagrams. Epidemiology. 2011;22(5):745.CrossRefPubMed
36.
go back to reference Collins, L.M. and A. Welling, Huntsman donates $1 million to prevent cervical cancer, in Deseret News. 2007: Salt Lake City, UT Collins, L.M. and A. Welling, Huntsman donates $1 million to prevent cervical cancer, in Deseret News. 2007: Salt Lake City, UT
39.
go back to reference Cohen EL, Head KJ. Identifying knowledge-attitude-practice gaps to enhance HPV vaccine diffusion. J Health Commun. 2013;18(10):1221–34.CrossRefPubMed Cohen EL, Head KJ. Identifying knowledge-attitude-practice gaps to enhance HPV vaccine diffusion. J Health Commun. 2013;18(10):1221–34.CrossRefPubMed
41.
go back to reference Krawczyk AL, et al. Human papillomavirus vaccination intentions and uptake in college women. Health Psychol. 2012;31(5):685–93.CrossRefPubMed Krawczyk AL, et al. Human papillomavirus vaccination intentions and uptake in college women. Health Psychol. 2012;31(5):685–93.CrossRefPubMed
42.
go back to reference Cui Y, et al. Human papillomavirus vaccine among adult women: disparities in awareness and acceptance. Am J Prev Med. 2010;39(6):559–63.CrossRefPubMed Cui Y, et al. Human papillomavirus vaccine among adult women: disparities in awareness and acceptance. Am J Prev Med. 2010;39(6):559–63.CrossRefPubMed
43.
go back to reference Gerend MA, Magloire ZF. Awareness, knowledge, and beliefs about human papillomavirus in a racially diverse sample of young adults. J Adolesc Health. 2008;42(3):237–42.CrossRefPubMed Gerend MA, Magloire ZF. Awareness, knowledge, and beliefs about human papillomavirus in a racially diverse sample of young adults. J Adolesc Health. 2008;42(3):237–42.CrossRefPubMed
44.
go back to reference Jain N, et al. Human papillomavirus (HPV) awareness and vaccination initiation among women in the United States, National Immunization Survey-Adult 2007. Prev Med. 2009;48(5):426–31.CrossRefPubMed Jain N, et al. Human papillomavirus (HPV) awareness and vaccination initiation among women in the United States, National Immunization Survey-Adult 2007. Prev Med. 2009;48(5):426–31.CrossRefPubMed
Metadata
Title
Factors related to HPV vaccine uptake and 3-dose completion among women in a low vaccination region of the USA: an observational study
Authors
Andrew R. Wilson
Mia Hashibe
Julia Bodson
Lisa H. Gren
Brooke A. Taylor
Jessica Greenwood
Brian R. Jackson
Rosemary She
Marlene J. Egger
Deanna Kepka
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2016
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-016-0323-5

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