Determinants of HPV vaccination intentions among Dutch girls and their mothers: a cross-sectional study

Abstract

BackgroundThe Dutch government recently added universal Human Papilloma Virus (HPV) vaccination for 12-year-old girls to the existing national immunization program. The participation rate for the initial catch-up campaign for girls aged 13 to 16 years in 2009 was lower (47%) than expected (70%). To inform future HPV information campaigns, this paper examines the social and psychological determinants of the HPV vaccination intentions of girls aged 13 to 16 years and their mothers who were targeted by the Dutch catch-up campaign of 2009.MethodsA random sample of girls and their mothers was chosen from the Dutch vaccination register and received a letter inviting them to participate (n = 5,998 mothers and daughters). In addition, a random sample was recruited via an online panel by a marketing research company (n = 650 mothers; n = 350 daughters). Both groups were asked to complete a web-based questionnaire with questions on social demographic characteristics, social-psychological factors and HPV vaccination intention. Backward linear regression analyses were conducted to examine which social-psychological factors were most dominantly associated with vaccination intention.ResultsData from 952 mothers (14%) and 642 daughters (10%) were available for the intended analyses. The contribution of social demographic variables to the explained variance of HPV vaccination intention was small but significant for mothers (ΔR2 = .01; p = .007), but not significant for daughters (ΔR2 = .02; p = .17) after controlling for HPV vaccination uptake and the sample. In addition, social-psychological determinants largely contributed to the explained variance of HPV vaccination intention of mothers (ΔR2 = .35; p < .001) and daughters (ΔR2 = .34; p < .001). Attitudes, beliefs, subjective norms and habit strength were significantly associated with participants’ HPV vaccination intentions.ConclusionsBecause of the large contribution of social-psychological variables to the explained variance of HPV vaccination intentions among the mothers and daughters, future communication strategies targeting HPV vaccination uptake should address attitudes, beliefs, subjective norms and habit strength. There is a need for longitudinal research to confirm the causality of the association between these determinants and HPV vaccination behavior indicated by this study.

Mothers’ Perceptions of their Daughters’ Susceptibility to HPV-related Risk Factors: An Experimental Pretest Comparing Narrative and Statistical Risk Information

“…Power analysis showed that a minimal sample size of 32 participants per condition was needed (with power = 0.80, and two-sided = 0.05; Hintze, 2004). We took into account an attrition rate of 30% and a response rate of 5%, based on previous experiences (Van Keulen et al, 2013). Consequently, 3,680 mothers were invited.…”

“…Several studies have provided insight in factors constituting HPV-vaccination acceptability (e.g., Alberts et al, 2017;Hofman et al, 2014;Pot et al, 2017;Van Keulen et al, 2013). Results from two Dutch studies among mothers of girls to-be-invited showed that 'modifiable' social-psychological determinants (e.g., perceived daughters' susceptibility towards HPV-related risks) accounted for large proportions of variance in HPV-vaccination intention (Van Keulen et al, 2013;Pot et al, 2017). Mothers' intention, in turn, was found to be the main and stable predictor of their daughters' actual uptake (Pot et al, 2017).…”

“…This was also found by Hofman and colleagues (2014) among parents of invited girls and is in line with social cognitive models such as the Reasoned Action Approach (Fishbein & Ajzen, 2010). Furthermore, mothers appeared most important in the process of decision-making about their daughters' HPV-vaccination (Van Keulen et al, 2013). These insights led to the development of an innovative, interactive, web-based, tailored intervention promoting HPV-vaccination acceptability among mothers of invited girls (Pot et al, 2018).…”

Putting public health infrastructures to the test: introducing HPV vaccination in Austria and the Netherlands

“…This led to an increased investment in risk communication skills and more attention paid to the role of social media (van Keulen et al . ). Once again, this points to a lasting transformative effect of the vaccine on the infrastructure.…”

Willingness of reproductive‐aged women in a Nigerian community to accept human papillomavirus vaccination for their children

“…Government, regulatory bodies and development partners have adopted different vaccination models that aim to ensure smooth uninterrupted administration of the three approved vaccine dosages for the eligible population with high acceptability . For instance, some developed countries incorporated HPV vaccination into their national immunization program with health insurance coverage, whereas others make eligible subjects pay for the vaccine . In most developing countries, the Global Alliance for Vaccine Immunisation (GAVI) has championed the course of cost‐reduction and access for vaccines, such as the HPV vaccine, to the population at risk .…”