Journal of Immigrant and Minority Health

, Volume 21, Issue 6, pp 1356–1364 | Cite as

Hispanic Mothers’ Beliefs About Having Their Adolescent Sons Initiate the HPV Vaccine Series

  • Angelica M. RoncancioEmail author
  • Sally W. Vernon
  • Chakema C. Carmack
  • Kristy K. Ward
  • Becky T. Muñoz
  • Felicity L. Cribbs
Original Paper


Rates of HPV vaccination among adolescent Hispanic males lag far behind the Healthy People 2020 80% goal. This study identified Hispanic mothers’ salient beliefs regarding having their sons initiate the HPV vaccine series. Twenty-seven Hispanic mothers completed in-depth interviews. They responded to questions that elicited the salient behavioral, normative and control beliefs associated with initiating the HPV vaccine series. We content analyzed their responses. We found that, regarding having their sons initiate the HPV vaccine, mothers: (1) express mostly positive feelings; (2) believe that the vaccine has positive effects, with side effects as the main negative effect; (3) believe that their sons’ father and doctor support vaccination while some friends do not; and (4) believe that vaccine affordability, transportation and the support of their sons’ father facilitate vaccine initiation. Overall, mothers held positive salient beliefs about the HPV vaccine including that it protects their son’s health, has minimal side effects and is recommended by physicians. We are more likely to increase vaccination rates among adolescent Hispanic males if we address mothers’ salient beliefs, including reinforcing their positive beliefs.


Hispanic mothers Adolescent sons HPV vaccine uptake Salient beliefs 



This study was funded by NIH/NCI Grant K01CA181437.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Abeloff MD, Armitage JO, Niederhauber JE, Kastan MB, Mckenna WG. Review of clinical oncology. 3rd ed. Philadelphia: Churchill Livingstone; 2004.Google Scholar
  2. 2.
    Markowitz LE, Dunne EF, Saraiya M, Chesson HW, Curtis CR, Gee J, et al. Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP). Morb Mortal Wkly Rep. 2014;63:1–30.Google Scholar
  3. 3.
    Amano K, International Agency for Research on Cancer. IARC monograph on biological agents: a review of human carcinogens. Lyon: International Agency for Research on Cancer; 2012.Google Scholar
  4. 4.
    Forman D, de Martel C, Lacey CJ, Soerjomataram I, Lortet-Tieulent J, Bruni L, et al., Global burden of human papillomavirus and related diseases. Vaccine. 2012;30(Suppl 5):F12–23. Scholar
  5. 5.
    Markowitz LE, Dunne EF, Saraiya M, Chesson HW, Curtis CR, Gee J, et al. Quadrivalent human papillomavirus vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). Morb Mortal Wkly Rep. 2007;56(RR-2):1–24.
  6. 6.
    Howlader N, Noone AM, Krapcho M, et al. SEER cancer statistics review, 1975–2008, Bethesda, 2011.
  7. 7.
    Joura EA, Giuliano AR, Iversen O-E, Bouchard C, Mao C, Mehlsen J, et al. A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women. N Engl J Med. 2015;372:711–23. Scholar
  8. 8.
    Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, Xiao W, Kim E, et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol. 2011;29:4294–301. Scholar
  9. 9.
    Jemal A, Simard EP, Dorell C, Noone AM, Markowitz LE, Kohler B, et al. Annual report to the nation on the status of cancer, 1975–2009, featuring the burden and trends in human papillomavirus (HPV)-associated cancers and HPV vaccination coverage levels. J Natl Cancer Inst. 2013;105:175–201. Scholar
  10. 10.
    Meites E, Kempe A, Markowitz LE. Use of a 2-dose schedule for human papillomavirus vaccination—updated recommendations of the Advisory Committee on Immunization Practices. Morb Mortal Wkly Rep. 2016;65:1405–8. Scholar
  11. 11.
    CDC, National Immunization Survey, 2014, Atlanta, 2014.
  12. 12.
    ODPHP U.S. Department of Health and Human Services. Healthy People 2020 [Internet], D.C., n.d.
  13. 13.
    Fazekas KI, Brewer NT, Smith JS. HPV vaccine acceptability in a rural Southern area. J Womens Health (Larchmt). 2008;17:539–48. Scholar
  14. 14.
    Leader AE, Weiner JL, Kelly BJ, Hornik RC, Cappella JN. Effects of information framing on human papillomavirus vaccination. J Womens Health (Larchmt). 2009;18:225–33. Scholar
  15. 15.
    Sperber NR, Brewer NT, Smith JS. Influence of parent characteristics and disease outcome framing on HPV vaccine acceptability among rural, Southern women. Cancer Causes Control. 2008;19:115–8. Scholar
  16. 16.
    Reiter PL, Brewer NT, Gilkey MB, Katz ML, Paskett ED, Smith JS. Early adoption of the human papillomavirus vaccine among hispanic adolescent males in the united states. Cancer. 2014;120:3200–7. Scholar
  17. 17.
    Reiter PL, McRee AL, Pepper JK, Gilkey MB, Galbraith KV, Brewer NT. Longitudinal predictors of human papillomavirus vaccination among a national sample of adolescent males. Am J Public Health. 2013;103:1419–27. Scholar
  18. 18.
    Warner EL, Lai D, Carbajal-Salisbury S, Garza L, Bodson J, Mooney K, et al. Latino parents’ perceptions of the HPV vaccine for sons and daughters. J Community Health. 2015;40:387–94. Scholar
  19. 19.
    Glanz K, Bishop DB. The role of behavioral science theory in development and implementation of public health interventions. Annu Rev Public Health. 2010;31:399–418. Scholar
  20. 20.
    Fishbein M, Cappella JN. The role of theory in developing effective health communications. J Commun. 2006;56(Suppl_1):S1–S7. Scholar
  21. 21.
    Fishbein M, Yzer MC. Using theory to design effective health behavior interventions. Commun Theory. 2003;13:164–83.CrossRefGoogle Scholar
  22. 22.
    Montaño D, Kasprzyk D. Theory of reasoned action, theory of planned behaviour, and the integrated behavioral model. Health Behav. 2008. Scholar
  23. 23.
    Fishbein M. The role of theory in HIV prevention. AIDS Care. 2000;12:273–8. Scholar
  24. 24.
    Francis AJJ, Eccles MPM, Johnston M, Walker A, Grimshaw J, Foy R, et al. Constructing questionnaires based on the theory of planned behaviour: a manual for health services researchers. UK: Centre for Health Services Research, University of Newcastle; 2004.Google Scholar
  25. 25.
    Kasprzyk D, Montaño DE, Fishbein M. Application of an integrated behavioral model to predict condom use: a prospective study among high HIV risk groups. J Appl Soc Psychol. 1998;28:1557–83.CrossRefGoogle Scholar
  26. 26.
    Hamilton K, White KM. Identifying parents’ perceptions about physical activity: a qualitative exploration of salient behavioural, normative and control beliefs among mothers and fathers of young children. J Health Psychol. 2010;15:1157–69. Scholar
  27. 27.
    Tipton JA. Caregivers’ psychosocial factors underlying sugar-sweetened beverage intake among non-hispanic black preschoolers: an elicitation study. J Pediatr Nurs. 2014;29:47–57. Scholar
  28. 28.
    Middlestadt SE, Bhattacharyya K, Rosenbaum J, Fishbein M, Shepherd M. The use of theory based semistructured elicitation questionnaires: formative research for CDC’s Prevention Marketing Initiative. Public Health Rep. 1996;111(Suppl 1):18–27.PubMedPubMedCentralGoogle Scholar
  29. 29.
    Hsieh H-F. Three approaches to qualitative content analysis. Qual Health Res. 2005;15:1277–88. Scholar
  30. 30.
    Ajzen I, Fishbein M. Understanding attitudes and predicting social behavior. Englewood Cliffs: Prentice-Hall; 1980.Google Scholar
  31. 31.
    Perkins RB, Tipton H, Shu E, Marquez C, Belizaire M, Porter C, et al. Attitudes toward HPV vaccination among low-income and minority parents of sons: a qualitative analysis. Clin Pediatr (Phila). 2013;52:231–40. Scholar
  32. 32.
    Brewer NT, Fazekas KI. Predictors of HPV vaccine acceptability: a theory-informed, systematic review. Prev Med (Baltim). 2007;45:107–14. Scholar
  33. 33.
    Moss JL, Reiter PL, Brewer NT. HPV vaccine for teen boys: dyadic analysis of parents’ and sons’ beliefs and willingness. Prev Med (Baltim). 2015;78:65–71. Scholar
  34. 34.
    Schuler CL, Coyne-Beasley T. Has their son been vaccinated? Beliefs about other parents matter for human papillomavirus vaccine. Am J Mens Heal. 2015. Scholar
  35. 35.
    Marlow LaV, Waller J, Wardle J. Trust and experience as predictors of HPV vaccine acceptance. Hum Vaccines. 2007;3:171–5. Scholar
  36. 36.
    Vanderpool RC, Casey BR, Crosby RA. HPV-related risk perceptions and HPV vaccine uptake among a sample of young rural women. J Community Health. 2011;36:903–9. Scholar
  37. 37.
    van Keulen HM, Otten W, Ruiter RaC, Fekkes M, van Steenbergen J, Dusseldorp E, et al. Determinants of HPV vaccination intentions among Dutch girls and their mothers: a cross-sectional study. BMC Public Health. 2013;13:111. Scholar
  38. 38.
    Nowalk MP, Lin CJ, Zimmerman RK, Fox DE, Raymund M, Tanis MD, et al. Establish the habit: influenza vaccination for health care personnel. J Healthc Qual. 2010;32:35–42. Scholar
  39. 39.
    Kepka DL, Ulrich AK, Coronado GD. Low knowledge of the three-dose HPV vaccine series among mothers of rural Hispanic adolescents. J Health Care Poor Underserved. 2012;23:626–35. Scholar
  40. 40.
    Walhart T. Parents, adolescents, children and the human papillomavirus vaccine: a review. Int Nurs Rev. 2012;59:305–11. Scholar
  41. 41.
    Hertweck SP, LaJoie AS, Pinto MD, Flamini L, Lynch T, Logsdon MC. Health care decision making by mothers for their adolescent daughters regarding the quadrivalent HPV vaccine. J Pediatr Adolesc Gynecol. 2013;26:96–101. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Angelica M. Roncancio
    • 1
    • 2
    Email author
  • Sally W. Vernon
    • 2
  • Chakema C. Carmack
    • 3
  • Kristy K. Ward
    • 4
  • Becky T. Muñoz
    • 5
  • Felicity L. Cribbs
    • 6
  1. 1.Department of Social SciencesUniversity of Houston-DowntownHoustonUSA
  2. 2.Center for Health Promotion and Prevention ResearchThe University of Texas School of Public HealthHoustonUSA
  3. 3.Psychological Health and Learning SciencesUniversity of HoustonHoustonUSA
  4. 4.Texas Oncology Sugar LandSugar LandUSA
  5. 5.Department of PsychologyMount St. Mary’s UniversityEmmitsburgUSA
  6. 6.Graduate College of Social WorkUniversity of HoustonHoustonUSA

Personalised recommendations