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Int. J. Environ. Res. Public Health 2018, 15(2), 185;

Exploring Facilitators and Barriers to Initiation and Completion of the Human Papillomavirus (HPV) Vaccine Series among Parents of Girls in a Safety Net System

Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, USA
The Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO 80045, USA
Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
Division of Pediatrics, Denver Health and Hospital Authority, Denver, CO 80204, USA
The Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
Author to whom correspondence should be addressed.
Received: 21 December 2017 / Revised: 13 January 2018 / Accepted: 15 January 2018 / Published: 23 January 2018
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Objective: To assess, among parents of predominantly minority, low-income adolescent girls who had either not initiated (NI) or not completed (NC) the HPV vaccine series, attitudes and other factors important in promoting the series, and whether attitudes differed by language preference. Design/Methods: From August 2013–October 2013, we conducted a mail survey among parents of girls aged 12–15 years randomly selected from administrative data in a Denver safety net system; 400 parents from each group (NI and NC) were targeted. Surveys were in English or Spanish. Results: The response rate was 37% (244/660; 140 moved or gone elsewhere; 66% English-speaking, 34% Spanish-speaking). Safety attitudes of NIs and NCs differed, with 40% NIs vs. 14% NCs reporting they thought HPV vaccine was unsafe (p < 0.0001) and 43% NIs vs. 21% NCs that it may cause long-term health problems (p < 0.001). Among NCs, 42% reported they did not know their daughter needed more shots (English-speaking, 20%, Spanish-speaking 52%) and 39% reported that “I wasn’t worried about the safety of the HPV vaccine before, but now I am” (English-speaking, 23%, Spanish-speaking, 50%). Items rated as very important among NIs in the decision regarding vaccination included: more information about safety (74%), more information saying it prevents cancer (70%), and if they knew HPV was spread mainly by sexual contact (61%). Conclusions: Safety concerns, being unaware of the need for multiple doses, and low perceived risk of infection remain significant barriers to HPV vaccination for at-risk adolescents. Some parents’ safety concerns do not appear until initial vaccination. View Full-Text
Keywords: vaccination; human papillomavirus; disparities vaccination; human papillomavirus; disparities

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O’Leary, S.T.; Lockhart, S.; Barnard, J.; Furniss, A.; Dickinson, M.; Dempsey, A.F.; Stokley, S.; Federico, S.; Bronsert, M.; Kempe, A. Exploring Facilitators and Barriers to Initiation and Completion of the Human Papillomavirus (HPV) Vaccine Series among Parents of Girls in a Safety Net System. Int. J. Environ. Res. Public Health 2018, 15, 185.

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