Skip to main content

Advertisement

SpringerLink
Log in

Human Papillomavirus (HPV) Vaccination Motivators, Barriers, and Brochure Preferences Among Parents in Multicultural Hawai‘i: a Qualitative Study

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

The human papillomavirus (HPV) vaccine can prevent cervical and other cancers. Unfortunately, according to the National Immunization Survey—Teen 2014 data, completion of the HPV vaccine was only 38 % for 13- to 17-year-old girls and 31 % for 13- to17-year-old boys in the USA, and prevalence was similar in Hawai‘i. Parents’ acceptability of the HPV vaccine is critical for the vaccine uptake, and this can be increased by educational materials and interventions. However, HPV materials are not widely distributed in Hawai‘i. The purpose of this qualitative study was to identify HPV vaccination barriers, motivators, and brochure preferences among parents of teens in multicultural Hawai‘i. Twenty parents were interviewed in person or by telephone. Four major themes emerged: (1) the physician is critical in the decision to vaccinate, (2) parental perception of the child’s sexual activity guides the timing of their willingness to vaccinate, (3) HPV health education materials should be provided and discussed by the physician, and (4) parents would prefer an educational brochure that features local faces and testimonials, includes an immunization chart, and addresses barriers to vaccination. These findings informed the development of HPV health education materials tailored to Asian Americans and Pacific Islanders in Hawai‘i.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Glick SB, Clarke AR, Blanchard A, Whitaker AK (2012) Cervical cancer screening, diagnosis and treatment, interventions for racial and ethnic minorities: a systematic review. J Gen Intern Med 27(8):1016–1032

    Article  PubMed  PubMed Central  Google Scholar 

  2. Markowitz LE, Tsu V, Deeks SL, Cubie H, Wang SA, Vicari AS, Brotherton JM (2012) Human papillomavirus vaccine introduction—the first 5 years. Vaccine 30(Suppl5):F139–F148

    Article  PubMed  Google Scholar 

  3. Arbyn M, Bryant A, Beutels P, Martin-Hirsch PPL, Paraskevaidis E, Van Hoof E, Hildesheim A (2011) Prophylactic vaccination against human papillomaviruses to prevent cervical cancer and its precursors. Cochrane Database Syst Rev 4:1–14

    Google Scholar 

  4. Reagen-Steiner S, Yankey D, Elam-Evans LD, Singleton JA, Curtis CR, MacNeil J, Stokely S (2015) Morb Mortal Wkly Rep 64(29):784–792

    Article  Google Scholar 

  5. Chan SS, Cheung TH, Lo WK, Chung TK (2007) Women’s attitudes on human papillomavirus vaccination to their daughters. J Adolesc Health 41(2):204–207

    Article  PubMed  Google Scholar 

  6. Davis K, Dickman ED, Ferris D, Dias JK (2004) Human papillomavirus vaccine acceptability among parents of 10- to 15-years-old adolescents. J Lower Genital Tract Dis 8(3):188–194

    Article  Google Scholar 

  7. Lechuga J, Swain G, Weinhardt LS (2012) Perceived need for a parental decision aid for the HPV vaccine: content and format preferences. Health Promot Pract 13(2):214–221

    Article  PubMed  Google Scholar 

  8. Dela Cruz MR (2013) Health education interventions for parents on the HPV vaccine: a systematic literature review. Unpublished qualifying paper

  9. Grandahl M, Oscarsson M, Stenhammar C, Nevéus T, Westerling R, Tydén T (2014) Not the right time: why parents refuse to let their daughters have the human papillomavirus vaccination. Acta Paediatr 103(4):436–441

    Article  PubMed  PubMed Central  Google Scholar 

  10. Tsui J, Gee GC, Rodriguez HP, Kominski GF, Glenn BA, Singhal R, Bastani R (2013) Exploring the role of neighborhood socio-demographic factors on HPV vaccine initiation among low-income, ethnic minority girls. J Immigr Minor Health 15(4):732–740

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kimmel SR (2010) Adolescent vaccination: physician challenges and solutions. J Adolesc Health 46(2S2):S16–S23

    Article  Google Scholar 

  12. Healy CM, Pickering LK (2011) How to communicate with vaccine-hesitant parents. Pediatrics 127(Suppl1):S127–S133

    Article  PubMed  Google Scholar 

  13. Holman DM, Benard V, Roland KB, Watson M, Liddon N, Stokley S (2014) Barriers to human papillomavirus vaccination among US adolescents: a systematic review of the literature. JAMA Pediatr 188(1):76–82

    Article  Google Scholar 

  14. Jeudin P, Liveright E, Del Carmen MG, Perkins RB (2014) Race, ethnicity, and income factors impacting human papillomavirus vaccination rates. Clin Ther 36(1):24–37

    Article  PubMed  Google Scholar 

  15. National Cancer Institute (2014) Accelerating HPV vaccine uptake: urgency for action to prevent cancer. A report to the President of the United States from the President’s Cancer Panel. Bethesda, MD.

  16. Gillespie L, Hicks CW, Santana M, Worley SE, Banas DA, Holmes S, Rome ES (2011) The acceptability of human papillomavirus vaccine among parents and guardians of newborn to 10-years-old children. J Pediatr Adolesc Gynecol 24(2):66–70

    Article  PubMed  Google Scholar 

  17. Kennedy A, Sapsis KF, Stokley S, Curtis CR, Gust D (2011) Parental attitudes toward human papillomavirus vaccination: evaluation of an educational intervention. J Health Commun 16(3):300–313

    Article  PubMed  Google Scholar 

  18. Podolsky R, Cremer M, Atrio J, Hochman T, Arslan AA (2009) HPV vaccine acceptability by Latino parents: a comparison of U.S. and Salvadoran populations. J Pediatr Adolesc Gynecol 22(4):205–215

    Article  PubMed  Google Scholar 

  19. Foster LR, Byers ES (2014) Predictors of the sexual well-being of individuals diagnosed with herpes and human papillomavirus. Arch Sex Behav

  20. Pearce C, Leask J, Ritchie J (2008) Tapping midwives’ views about the neonatal hepatitis B vaccine: how welcome is a move towards a health promoting orientation? Health Promot J Aust 19(2):161–163

    Google Scholar 

  21. Hughes JH, Cates JR, Liddon N, Smith JS, Gottlieb SL, Brewer NT (2009) Disparities in how parents are learning about the human papillomavirus vaccine. Cancer Epidemiol Biomark Prev 18(2):363–372

    Article  Google Scholar 

  22. Centers for Disease Control and Prevention (2013) HPV also known as human papillomavirus [Flyer]. Atlanta, GA: CDC. Retrieved from http://www.cdc.gov/vaccines/vpd-vac/hpv/downloads/dis-HPV-color-office.pdf on May 2014

  23. Channing-Bete Company, Inc (2013) Girls, boys, and the HPV vaccine: information for parents [Brochure]. Channing-Bete, South Deerfield, MA

    Google Scholar 

  24. Centers for Disease Control and Prevention (2013) HPV: common infection, common reality (Tagalog & English) [Booklet]. Atlanta, GA: CDC. Retrieved from http://www.cdc.gov/std/hpv/common/tg/tagalog_native-english.pdf on May 2014

  25. Elo S, Kyngas H (2008) The qualitative content analysis process. J Adv Nurs 62(1):107–115

    Article  PubMed  Google Scholar 

  26. Hawai‘i Cancer Facts & Figures 2010 (2010) Hawai‘i cancer facts & figures 2010

  27. Javanbakht M, Stahlman S, Walker S, Gottlieb S, Markowitz L, Liddon N, Guerry S (2012) Provider perceptions of barriers and facilitators of HPV vaccination in a high-risk community. Vaccine 30(3):4511–4516

    Article  PubMed  Google Scholar 

  28. Bynum SA, Staras SA, Malo TL, Giuliano AR, Shenkman E, Vadaparampil ST (2013) Factors associated with Medicaid providers’ recommendation of the HPV vaccine to low-income adolescent girls. J Adolesc Health 54(2):190–196

    Article  PubMed  PubMed Central  Google Scholar 

  29. Liddon N, Michael SL, Dittus P, Markowitz LE (2013) Maternal underestimation of child’s sexual experience: suggested implications for HPV vaccine uptake at recommended ages. J Adolesc Health 53(5):674–676

    Article  PubMed  Google Scholar 

  30. Yitalo KR, Lee H, Mehta NK (2013) Health care provider recommendation, human papillomavirus vaccination, and race/ethnicity in the US National Immunization Survey. Am J Public Health 103(1):164–169

    Article  Google Scholar 

  31. Tristram A (2006) HPV information needs. Best Pract Res Clin Obstet Gynaecol 20(2):267–277

    Article  PubMed  Google Scholar 

  32. Cates JR, Ortiz R, Shafer A, Romocki LS, Coyne-Beasley T (2012) Designing messages to motivate parents to get their preteenage sons vaccinated against human papillomavirus. Perspect Sex Reprod Health 44(1):39–47

    Article  PubMed  PubMed Central  Google Scholar 

  33. Kulukulualani M, Braun KL, Tsark JU (2008) Using a participatory four-step protocol to develop culturally targeted cancer education brochures. Health Promot Pract 9(4):344–355

    Article  PubMed  PubMed Central  Google Scholar 

  34. Allen JD, de Jesus M, Mars D, Tom L, Cloutier L, Shelton RC (2012) Decision-making about the HPV vaccine among ethnically diverse parents: implications for health communications. J Oncol. doi:10.1155/2012/401979, 1–5

    PubMed  Google Scholar 

Download references

Acknowledgments

This project was funded by the ‘Imi Hale Native Hawaiian Cancer Network (U54CA153459, a grant from the Center to Reduce Cancer Health Disparities, National Cancer Institute, National Institutes of Health), a program of Papa Ola Lōkahi, The Queen’s Medical Center’s Interdisciplinary Seed Grant, and RMATRIX (U54MD007584, Research Centers in Minority Institutions, a grant from the National Institute on Minority Health and Health Disparities, National Institutes of Health). JJC is partially supported by grants P20GM103466 and G12MD007601 from the National Institutes of Health. We also acknowledge Maya Uemoto who assisted in qualitative data analysis.

Author information

Authors and Affiliations

  1. Papa Ola Lōkahi, ‘Imi Hale Native Hawaiian Cancer Network, 894 Queen Street, Honolulu, HI, 96813, USA

    May Rose Isnec Dela Cruz, Jo Ann Umilani Tsark & Kathryn Lenzner Braun

  2. John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, 96822, USA

    John Jiangtian Chen

  3. School of Nursing & Dental Hygiene, University of Hawai‘i at Mānoa, Honolulu, HI, 96822, USA

    Cheryl Lynn Albright

  4. Office of Public Health Sciences, University of Hawai‘i at Mānoa, Honolulu, HI, 96822, USA

    Kathryn Lenzner Braun

Authors
  1. May Rose Isnec Dela Cruz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jo Ann Umilani Tsark
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John Jiangtian Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cheryl Lynn Albright
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kathryn Lenzner Braun
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to May Rose Isnec Dela Cruz.

Appendix: National HPV vaccine education materials critiqued by participants

Appendix: National HPV vaccine education materials critiqued by participants

Material no. 1: CDC flyer (CDC, 2013)

figure a

Material no. 2: Channing-Bete brochure (Channing-Bete, 2013)

figure b

Material no. 3: CDC booklet (CDC, 2013)

figure c

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dela Cruz, M.R.I., Tsark, J.A.U., Chen, J.J. et al. Human Papillomavirus (HPV) Vaccination Motivators, Barriers, and Brochure Preferences Among Parents in Multicultural Hawai‘i: a Qualitative Study. J Canc Educ 32, 613–621 (2017). https://doi.org/10.1007/s13187-016-1009-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-016-1009-2

Keywords

Search

Navigation