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Open Access 01-12-2016 | Research article

Psychosocial determinants of parental human papillomavirus (HPV) vaccine decision-making for sons: Methodological challenges and initial results of a pan-Canadian longitudinal study

Authors: Samara Perez, Ovidiu Tatar, Gilla K. Shapiro, Eve Dubé, Gina Ogilvie, Juliet Guichon, Vladimir Gilca, Zeev Rosberger

Published in: BMC Public Health | Issue 1/2016

Abstract

Background

HPV vaccination decision-making is a complex process that is influenced by multiple psychosocial determinants. Given the change in policy recommendation to include males in routine HPV vaccination, our goals were to assess the HPV vaccination uptake in Canada, to understand where Canadian parents were situated in the HPV vaccine decision-making process for their son, how they changed over time and which psychosocial determinants were relevant for this process.

Methods

We used an online survey methodology and collected data from a nationally representative sample of Canadian parents of boys aged 9–16 at baseline (T1, February 2014) and at 9 months’ follow-up (T2). Our analyses were guided by the Precaution Adoption Process Model (PAPM), a theoretical health behavior model that classifies parents in one of six stages: unaware, unengaged, undecided, decided not to vaccinate, decided to vaccinate and those who had already vaccinated their sons. Rigorous methods were used to filter out careless responders: response variance, bogus items, psychometric antonyms and psychometric synonyms.

Results

At T1 and T2, we received 3,784 and 1,608 respectively completed questionnaires; after data cleaning 3,117 (T1) and 1,427 (T2) were retained. Less than 3% of boys were vaccinated at both time points. At both T1 and T2, most parents (over 70%) belonged to the earlier vaccination adoption stages: 57% were unaware (T1) and 15.3% (T2); 20.9% were unengaged (T1) and 32.4% (T2); and 9.1% were undecided (T1) and 25.2% (T2). At follow-up, 37.7% of participants did not move from their initial PAPM decision-making stage. Most parents (55%) preferred to receive information from their healthcare provider (HCP) but only 6% (T1) and 12% (T2) had actually spoken with a HCP about the HPV vaccine for their son.

Conclusions

HPV vaccination uptake in Canadian boys was very low in the absence of a publicly funded HPV vaccination programs for boys. Optimal HPV information preferences were identified and can be used in interventions to increase HPV knowledge and increase HPV vaccine uptake. Intentions to vaccinate or planning to speak to one’s HCP did not translate into action for most parents over the 9-month follow up; this finding is critical to consider to inform implementation strategies. Methodological challenges are described and suggestions for future research are offered.

Available only for authorised users

The PAPM original model consist of seven stages of health decision-making. The seventh stage is a maintenance stage and does not apply to HPV vaccination. For simplicity, only the six stages are described.

Leger has the largest representative panel in Canada and the largest Franco-Canadian panel. Since members are recruited randomly over the phone, the Leger Panel is highly representative and offers exceptional quality respondents. Leger sampling process is based on data from Statistics Canada (e.g., province, age, gender, language and region).

As the questionnaire was computer adapted, few items were asked of only some groups. For example, only those participants who indicated they vaccinated their son, were further asked about how many doses he received.

The informative statement read as follows: Please read carefully the following information about HPV. The Human Papillomavirus (HPV) is the most common sexually transmitted infection. HPV can cause genital warts. HPV can also cause cancers of the cervix, penis, anus, vagina, vulva and oral cancers. There are HPV vaccines available that are sometimes referred to as the cervical cancer vaccine, Gardasil®, or Cervarix®. The HPV vaccine is given in 2 or 3 doses and costs approximately $150–$200 per dose. Health Canada has approved and recommended an HPV vaccine for both males aged 9–26 years and females aged 9–45 years.

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Title: Psychosocial determinants of parental human papillomavirus (HPV) vaccine decision-making for sons: Methodological challenges and initial results of a pan-Canadian longitudinal study
Authors: Samara Perez
Ovidiu Tatar
Gilla K. Shapiro
Eve Dubé
Gina Ogilvie
Juliet Guichon
Vladimir Gilca
Zeev Rosberger
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-016-3828-9

At a glance: The STEP trials

Springer Medicine

Psychosocial determinants of parental human papillomavirus (HPV) vaccine decision-making for sons: Methodological challenges and initial results of a pan-Canadian longitudinal study

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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