Factors Associated with Intention of Human Papillomavirus (HPV) Vaccine Initiation Among Females With and Without a Hist
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Factors Associated with Intention of Human Papillomavirus (HPV) Vaccine Initiation Among Females With and Without a History of Childhood Cancer Robin N. Hardin1,2 · Kathryn M. Russell1 · Jessica S. Flynn1 · Heather L. Gammel1 · Jasmine R. Eddinger1,2 · Lauren A.‑M. Schenck1,2 · James L. Klosky1,3,4
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Vaccination is available to prevent human papillomavirus (HPV) types that cause cervical and other cancers. This study aimed to describe and compare vaccine intention among young females with and without a cancer history, in addition to identifying factors associated with a HPV vaccination intention. Vaccine-naïve females (aged 18–26 years, n = 120) and maternal caregivers with vaccine-naïve daughters (aged 9–17 years, n = 197) completed surveys querying HPV vaccination intention, HPV knowledge, and communication, along with sociodemographic, medical, and health belief factors. Multivariable logistic regression was utilized to calculate odds ratio (OR) and 95% confidence intervals for HPV vaccination intention. No differences in vaccine intention were identified across cancer and comparison groups. Vaccine intention and predictors of intention among vaccine-naïve females differ by age, and there is variation in the factors which influence vaccine intention by age group. These results suggest interventions should be tailored based on developmental level. Keywords Oncology · Adolescents · Young adults · Human papillomavirus · Vaccination · Intention HPV is the most common sexually transmitted infection (Satterwhite et al., 2013) with approximately 85% of sexually active women being exposed in their lifetime (Chesson, Dunne, Hariri, & Markowitz, 2014). Because HPV has a causal role in the expression of cervical and other cancers (Lajer et al., 2012), efforts have been successful in producing safe and effective vaccinations against HPV(Kreimer et al., 2015). Rates of infection are highest among 20–24-year-old females (Horner et al., 2009) with rates rising significantly after sexual debut. Females surviving childhood cancer are at increased risk for HPV-related complications including * James L. Klosky [email protected] 1
Departments of Psychology, St. Jude Children’s Research Hospital, Memphis, TN, USA
2
University of Memphis, Memphis, TN, USA
3
Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, ECC #412, Atlanta, GA 30322, USA
4
Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA, USA
the development of HPV-associated malignancies (Ojha et al., 2013, 2014), and these cancers are expressed earlier in adulthood compared to peers (Ojha et al., 2014). Due to these increased risks, the Children’s Oncology Group (Ransome, Carty, Cogburn, & Williams, 2017) has recommended HPV vaccination for all eligible females surviving childhood cancer (Children’s Oncology Group, 2013). To assist in vaccine promotion among females who remain vaccine naïve, factors associ
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