Factors influencing adolescent girls’ decision in initiation for human papillomavirus vaccination: a cross-sectional study in Hong Kong

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Abstract

Background

Cervical cancer is one of the common cancers among women worldwide. Despite HPV vaccination being one of the effective preventive measures, it is not included in government vaccination programme in Hong Kong. This study aimed to assess the knowledge of and attitude towards cervical cancer prevention among Chinese adolescent girls in Hong Kong, and to identify factors influencing the initiation of HPV vaccination.

Methods

This was a cross-sectional study conducted in Hong Kong during the period of October 2010 to November 2010. A self-administered questionnaire was used, with 1,416 girls from 8 secondary schools completing the questionnaire. Knowledge scores were composited and initiation of HPV vaccination was staged based on stage of change. Analyses were conducted to identify the association of initiation of HPV vaccination with participant’s personal and family factors as well as their knowledge and attitude towards cervical cancer prevention.

Results

The uptake rate of HPV vaccination was low (7%) with 58% respondents in pre-contemplation and contemplation stage. The survey identified a significant gap in knowledge on cervical cancer prevention. The main channels of information were from media and very few from schools or parents. However, 70% expressed their wishes to have more information on cancer prevention, and 78% stated that they were willing to change their lifestyles if they knew the ways of prevention. Multivariate analysis identified three independent significant factors for initiation of vaccination (action and intention): perceived cancer as terrifying disease, school should provide more information on cancer prevention, and comments from relatives and friends having received the vaccine. The cost of vaccination and socio-economic background were not found to be significant.

Conclusions

Public education on cervical cancer needs to be well penetrated into the community for more sharing among friends and relatives. School as setting to provide source of information would facilitate uptake rate of HPV vaccine as students have expressed their wishes that school should provide more information on prevention of cancer. School and community education on cancer prevention would help adolescents to have better understanding of the seriousness of cancer.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2458-14-925) contains supplementary material, which is available to authorized users.

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Most cited references 26

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Self-Efficacy : The Exercise of Control

Albert Bandura (1997)

1 Theoretical Perspectives The Nature of Human Agency Human Agency in Triadic Reciprocal Causation Determinism and the Exercise of Self-Influence Related Views of Personal Efficacy 2 The Nature and Structure of Self-Efficacy Perceived Self-Efficacy as a Generative Capability Active Producers versus Passive Foretellers of Performances The Self-Efficacy Approach to Personal Causation Multidimensionality of Self-Efficacy Belief Systems Self-Efficacy Causality Sources of Discordance Between Efficacy Judgment and Action 3 Sources of Self-Efficacy Enactive Mastery Experience Vicarious Experience Verbal Persuasion Physiological and Affective States Integration of Efficacy Information 4 Mediating Processes Cognitive Processes Motivational Processes Affective Processes Selection Processes 5 Developmental Analysis of Self-Efficacy Origins of a Sense of Personal Agency Familial Sources of Self-Efficacy Peers and the Broadening and Validation of Self-Efficacy School as an Agency for Cultivating Self-Efficacy Growth of Self-Efficacy through Transitional Experiences of Adolescence Self-Efficacy Concerns of Adulthood Reappraisals of Self-Efficacy with Advancing Age 6 Cognitive Functioning Students' Cognitive Self-Efficacy Teachers' Perceived Efficacy Collective School Efficacy 7 Health Functioning Biological Effects of Perceived Self-Efficacy Perceived Self-Efficacy in Health Promoting Behavior Prognostic Judgments and Perceived Self-Efficacy 8 Clinical Functioning Anxiety and Phobic Dysfunctions Depression Eating Disorders Alcohol and Drug Abuse 9 Athletic Functioning Development of Athletic Skills Self-Regulation of Athletic Performance Collective Team Efficacy Psychobiological Effects of Physical Exercise 10 Organizational Functioning Career Development and Pursuits Mastery of Occupational Roles Self-Efficacy in Organizational Decision Making Self-Efficacy in Enactment of Occupational Roles Collective Organizational Efficacy 11 Collective Efficacy Gauging Collective Efficacy Political Efficacy Enablement by Media Modes of Influence Enablement for Sociocultural Change Underminers of Collective Efficacy References Name and Subject Indexes.

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Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases.

Suzanne Garland, Mauricio Hernández-Avila, Cosette M. Wheeler … (2007)

A phase 3 trial was conducted to evaluate the efficacy of a prophylactic quadrivalent vaccine in preventing anogenital diseases associated with human papillomavirus (HPV) types 6, 11, 16, and 18. In this randomized, placebo-controlled, double-blind trial involving 5455 women between the ages of 16 and 24 years, we assigned 2723 women to receive vaccine and 2732 to receive placebo at day 1, month 2, and month 6. The coprimary composite end points were the incidence of genital warts, vulvar or vaginal intraepithelial neoplasia, or cancer and the incidence of cervical intraepithelial neoplasia, adenocarcinoma in situ, or cancer associated with HPV type 6, 11, 16, or 18. Data for the primary analysis were collected for a per-protocol susceptible population of women who had no virologic evidence of HPV type 6, 11, 16, or 18 through 1 month after administration of the third dose. The women were followed for an average of 3 years after administration of the first dose. In the per-protocol population, those followed for vulvar, vaginal, or perianal disease included 2261 women (83%) in the vaccine group and 2279 (83%) in the placebo group. Those followed for cervical disease included 2241 women (82%) in the vaccine group and 2258 (83%) in the placebo group. Vaccine efficacy was 100% for each of the coprimary end points. In an intention-to-treat analysis, including those with prevalent infection or disease caused by vaccine-type and non-vaccine-type HPV, vaccination reduced the rate of any vulvar or vaginal perianal lesions regardless of the causal HPV type by 34% (95% confidence interval [CI], 15 to 49), and the rate of cervical lesions regardless of the causal HPV type by 20% (95% CI, 8 to 31). The quadrivalent vaccine significantly reduced the incidence of HPV-associated anogenital diseases in young women. (ClinicalTrials.gov number, NCT00092521 [ClinicalTrials.gov].). Copyright 2007 Massachusetts Medical Society.

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Parents' health beliefs and HPV vaccination of their adolescent daughters.

Paul L Reiter, Noel Brewer, Sami Gottlieb … (2009)

Though many studies have documented correlates of HPV vaccine acceptability, our study is one of the first to examine correlates of vaccine initiation. The current study aimed to identify modifiable correlates of HPV vaccine initiation among adolescent girls in high risk communities and whether correlates varied by race and urban/rural status. In 2007, we conducted a cross-sectional survey of 889 parents of adolescent girls aged 10-18 living in areas of North Carolina, USA with high cervical cancer rates. We analyzed data using logistic regression. Health Belief Model constructs were associated with HPV vaccine initiation in multivariate analyses, including doctor's recommendation to get HPV vaccine, perceived barriers to obtaining HPV vaccine, and perceived potential vaccine harms. While exploratory stratified analyses suggested that many of the same parent beliefs were important correlates of HPV vaccine initiation regardless of racial group or urban/rural status, a few differences did exist. These potentially modifiable beliefs offer well-defined targets for future interventions designed to increase HPV vaccine coverage. However, the beliefs' relative importance may differ between racial groups and regions.

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Author and article information

Contributors

Albert Lee: alee@cuhk.edu.hk

Mandy Ho: mandy.ho@sydney.ed.au

Calvin Ka Man Cheung: calvinckm@cuhk.edu.hk

Vera Mei Wen Keung: verakeung@cuhk.edu.hk

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 8 September 2014

Publication date PMC-release: 8 September 2014

Publication date Collection: 2014

Volume: 14

Issue: 1

Electronic Location Identifier: 925

Affiliations

[ ]Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, 4th Floor Lek Yuen Health Centre, Shatin, New Territory, Hong Kong

[ ]Department of Applied Health Science, Bloomington School of Public Health, Indiana University, Bloomington, USA

[ ]The Children’s Hospital at Westmead Clinical School, University of Sydney, Locked Bag 4001, Westmead, NSW 2145 Australia

Article

Publisher ID: 7061

DOI: 10.1186/1471-2458-14-925

PMC ID: 4176578

PubMed ID: 25195604

SO-VID: d09783ab-132a-470b-9087-4503b4103418

License:

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 19 February 2014

Date accepted : 3 September 2014

Custom metadata

ScienceOpen disciplines: Public health

Keywords: cervical cancer,cancer prevention,human papillomavirus (hpv) vaccine,chinese girls,school health education,community health education

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ScienceOpen disciplines: Public health

Keywords: cervical cancer, cancer prevention, human papillomavirus (hpv) vaccine, chinese girls, school health education, community health education

Factors influencing adolescent girls’ decision in initiation for human papillomavirus vaccination: a cross-sectional study in Hong Kong

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Chinese Journal of School Health

Most cited references 26

Self-Efficacy : The Exercise of Control

Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases.

Parents' health beliefs and HPV vaccination of their adolescent daughters.

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