Sense &amp; sensibility: Decision-making and sources of information in mothers who decline HPV vaccination of their adolescent daughters

Baumann, Astrid; Andersen, Berit; Østergaard, Lars; Larsen, Mette Bach

doi:10.1016/j.jvacx.2019.100020

Cited by 14 publications

(23 citation statements)

References 25 publications

(29 reference statements)

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“…A study dealing with mothers’ decisions for not allowing their adolescent children to be vaccinated against human papillomavirus (HPV) reported an overall response rate of 54%. 16 Their higher response rate may be explained by the topic, which had extensive media coverage in Denmark at that time. Their response rates for the 20–29 years old and 30–39 years old were 14% and 17% larger than ours for these age groups, but their response rate for mothers who were working was 5% higher than the response rate for our working individuals.…”

Section: Discussionmentioning

confidence: 99%

The Danish Diabetes Musculoskeletal Cohort: Non-Responder Analysis of an Electronic Survey Using Registry Data

Boyle¹,

Folkestad²,

Frafjord³

et al. 2021

CLEP

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Purpose To conduct a non-responder analysis on a musculoskeletal (MSK) electronic questionnaire. Methods Individuals aged 18 years and older, diagnosed with diabetes mellitus (DM), and attended an ambulatory DM clinic formed the sample frame. They were invited to complete an electronic musculoskeletal (MSK) conditions and symptoms questionnaire booklet using a secured electronic email system. Individuals whose secured email box was not active at the time were discarded. Using the Central Person Registry number, a unique number assigned to all Danish residents, we linked the sample frame to different registries to learn more about non-responders. Non-responders were either individuals who did not respond to a single question and those who responded “No” to the first question about willing to participate. We calculated descriptive statistics for each characteristic. Univariate logistic regression models were conducted to determine the relationship between each characteristic and non-responder status. Results The response rate was 36% (n = 3812). Individuals with type 2 DM (OR 2.0 (95% CI 1.8–2.2)), secondary DM (1.9 (1.3–2.8)) or unspecified DM (2.1 (1.8–2.4)) were more likely to be non-responders than individuals with Type 1 DM. Also, individuals aged 70–79 (1.3 (1.1–1.6)) and 80 years and older (5.9 (4.5–7.7)) were more likely to be non-responders than 18–29 years old individuals. However, individuals aged 40–49 (1.5 (1.2–1.8)), 50–59 (1.5 (1.3–1.8)) or 60–69 (1.4 (1.1–1.6)) were more likely to be responders than 18–29 years old individuals. Individuals with Charlson Comorbidity Index (CCI) of 1 (2.0 (1.3.2.9) or CCI of 2 (1.7 (1.1–2.5) were more likely to be responders than individuals with a CCI of 0. Lastly, individuals who were currently outside of the workforce (1.6 (2.4–2.9) or had unknown/missing socioeconomic status (3.9 (2.8–5.3) were more likely to be non-responders than individuals who were working. Conclusion Although we did find a non-response bias, this cohort will be an important source to determine the prevalence and consequences of MSK conditions in a secondary care DM population.

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Section: Discussionmentioning

confidence: 99%

The Danish Diabetes Musculoskeletal Cohort: Non-Responder Analysis of an Electronic Survey Using Registry Data

Boyle¹,

Folkestad²,

Frafjord³

et al. 2021

CLEP

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“…Parents have reported receiving stories about the harms of HPV vaccines on social media and news media, while stories on the prevention of HPV disease occurred in conversations (12). In one study, mothers who first learned about HPV vaccines through social media tended not to vaccinate daughters, while those first hearing about it from their general practitioner vaccinated them (36). There have been calls for efforts to improve accurate HPV content on social media and correct misinformation (37)(38)(39)(40)(41) to improve clinical encounters on HPV vaccines (32).…”

Section: Introductionmentioning

confidence: 99%

Human Papillomavirus Vaccination and Social Media: Results in a Trial With Mothers of Daughters Aged 14–17

Buller

Pagoto

Henry

et al. 2021

Front. Digit. Health

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Introduction: Parents acquire information about human papillomavirus (HPV) vaccines online and encounter vaccine-critical content, especially on social media, which may depress vaccine uptake. Secondary analysis in a randomized trial of a Facebook-delivered adolescent health campaign targeting mothers with posts on HPV vaccination was undertaken with the aims of (a) determining whether the pre–post-change occurred in self-reports of the mothers on HPV vaccination of their adolescent daughters; (b) describing the comments and reactions to vaccine posts; (c) exploring the relationship of campaign engagement of the mothers assessed by their comments and reactions to posts to change in the self-reports of the mothers of HPV vaccination.Materials and Methods: Mothers of daughters aged 14–17 were recruited from 34 states of the US (n = 869). A social media campaign was delivered in two Facebook private groups that differed in that 16% of posts in one were focused on indoor tanning (IT) and 16% in the other, on prescription drug misuse, assigned by randomization. In both groups, posts promoted HPV vaccination (n = 38 posts; no randomization) and vaccination for other disease (e.g., influenza, n = 49). HPV and other vaccination posts covered the need for a vaccine, the number of adolescents vaccinated, how vaccines are decreasing the infection rates, and stories of positive benefits of being vaccinated or harms from not vaccinating. Guided by social cognitive theory and diffusion of innovations theory, posts were intended to increase knowledge, perceived risk, response efficacy (i.e., a relative advantage over not vaccinated daughters), and norms for vaccination. Some vaccination posts linked to stories to capitalize on identification effects in narratives, as explained in transportation theory. All mothers received the posts on vaccination (i.e., there was no randomization). Mothers completed surveys at baseline and 12- and 18-month follow-up to assess HPV vaccine uptake by self-report measures. Reactions (such as sad, angry) and comments to each HPV-related post were counted and coded.Results: Initiation of HPV vaccination (1 dose) was reported by 63.4% of mothers at baseline, 71.3% at 12-month posttest (pre/post p < 0.001), and 73.3% at 18-month posttest (pre/post p < 0.001). Completion of HPV vaccination (two or three doses) was conveyed by 50.2% of mothers at baseline, 62.5% at 12-month posttest (pre/post p < 0.001), and 65.9% at 18-month posttest (pre/post p < 0.001). For posts on HPV vaccines, 8.1% of mothers reacted (n = 162 total), and 68.4% of posts received a reaction (63.2% like; 13.2% love, 7.9% sad). In addition, 7.6% of mothers commented (n = 122; 51 unfavorable, 68 favorable, 1 neutral), and 50.0% of these posts received a comment. There were no differences in pre–post change in vaccine status by the count of reactions or comments to HPV vaccine posts (Ps > 0.05). Baseline vaccination was associated with the valence of comments to HPV vaccine posts (7.2% of mothers whose daughters had completed the HPV series at baseline made a favorable comment but 7.6% of mothers whose daughters were unvaccinated made an unfavorable comment).Conclusion: Effective strategies are needed in social media to promote HPV vaccines and counter misinformation about and resistance to them. Mothers whose daughters complete the HPV vaccine course might be recruited as influencers on HPV vaccines, as they may be predisposed to talk favorably about the vaccine. Comments from mothers who have not been vaccinated should be monitored to ensure that they do not spread vaccine-critical misinformation. Study limitations included lack of randomization and control group, relatively small number of messages on HPV vaccines, long measurement intervals, inability to measure views of vaccination posts, reduced generalizability related to ethnicity and social media use, and use of self-reported vaccine status.Clinical Trial Registration:www.clinicaltrials.gov, identifier NCT02835807.

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Section: Discussionmentioning

confidence: 99%

“…However, increasing use of robots may worsen the problem [43]. Health professionals should therefore acknowledge the threat and engage with social media [23,44], especially following the revelation that mothers who declined HPV vaccination sought information on social media rather than from their general practitioner [45]. Indeed, Betsch et al [46] showed that accessing vaccine-critical websites increases the perception of the risk of vaccinating and decreases the perception of the risk of omitting vaccinations.…”

Section: Discussionmentioning

confidence: 99%

Vaccination against HPV: boosting coverage and tackling misinformation

Bigaard

Franceschi

2020

Molecular Oncology

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The availability of human papillomavirus (HPV) vaccines and screening tests has raised the possibility of globally eliminating cervical cancer, which is caused by HPV. Cervical cancer is a very common malignancy worldwide, especially among deprived women. High vaccination coverage is key to the containment and eventual elimination of the infection. Public HPV vaccination programmes in Italy and Denmark were swiftly established and are among the most successful worldwide. Still, in both countries, it has been challenging to achieve and maintain the recommended coverage of > 80% in girls. In a well-studied Italian region, vaccination coverage in girls at age 15 years (World Health Organization's gold standard) reached 76% in 2015 but decreased to 69% in 2018, likely due to work overload in public immunization centres. In Denmark, doubts about safety and efficacy of the HPV vaccine generated a decline in coverage among girls age 12-17, from 80% in 2013 down to 37% in 2015, when remedial actions made it rise again. Insights from these two countries are shared to illustrate the importance of monitoring coverage in a digital vaccine registry and promptly reacting to misinformation about vaccination.

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Sense & sensibility: Decision-making and sources of information in mothers who decline HPV vaccination of their adolescent daughters

Cited by 14 publications

References 25 publications

The Danish Diabetes Musculoskeletal Cohort: Non-Responder Analysis of an Electronic Survey Using Registry Data

The Danish Diabetes Musculoskeletal Cohort: Non-Responder Analysis of an Electronic Survey Using Registry Data

Human Papillomavirus Vaccination and Social Media: Results in a Trial With Mothers of Daughters Aged 14–17

Vaccination against HPV: boosting coverage and tackling misinformation

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