Candidate for the Lee B. Lusted Student Prize Competition
Purpose: To assess determinants of parental intention, prior to their decision about their daughter’s uptake of Human Papillomavirus (HPV) vaccination.
Method: In June 2009 self-administered questionnaires were spread among 5918 parents with a 10 to 11-year-old daughter, assessing their uptake intention; knowledge about HPV vaccination; attitudes toward vaccination; and other determinants. Knowledge scores ranged from 0-18, with scores of ≥ 10 indicating sufficient decision-relevant knowledge. Rates of informed intention were measured, i.e. an intention that is in line with attitudes and based on sufficient HPV decision-relevant knowledge. An ordinal logistic regression model was used to determine predictors of intended HPV uptake. An interaction between attitude and knowledge was included in the model.
Result: The response rate was 29.8% (1762/5918). Multivariate analyses showed that a higher intention was determined by trust in the HPV vaccine (OR 2.03; 95%CI: 1.64-2.51), anticipated regret in case of no vaccination uptake (OR 1.68; 95%CI: 1.49-1.89), trust in the National Immunization Program (NIP) (OR 1.26; 95%CI: 1.01-1.57), and the belief that according to significant others their daughter should be vaccinated, and the motivation to comply to that (OR 1.05; 95%CI: 1.04-1.08). Higher perceived parental responsibility for their daughter’s health was related to a lower uptake intention (OR 0.60; 95%CI: 0.45-0.82). There was a significant interaction between attitude and knowledge (OR 1.07; 95%CI 1.03-1.11), meaning that at higher knowledge levels the relation between attitude and intention was stronger. Demographic characteristics, perceived susceptibility of mother and daughter to contract cervical cancer and severity of cervical cancer were not associated with intention. Less than half of the respondents (48%) made an informed intention.
Conclusion: The present findings suggest that the relation between attitude and intention was stronger at higher knowledge levels. Increasing adequate HPV relevant knowledge may be vital to ensure attitude-consistent informed decision-making. Nevertheless, the present study also underscores the role of trust in the vaccine and NIP, and anticipated regret, thus affective feelings may play an even more prominent role in situations of uncertainly.
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