Caregiver and Adolescent Factors Associated with Delayed Completion of the Three-Dose Human Papillomavirus Vaccination Series
| Autor: | Lea E. Widdice, Jessica A. Kahn, S. Todd Callahan, Sharon E. Frey, Karen L. Kotloff, Kathryn M. Edwards, Jon Sudman, Aya Nakamura, David I. Bernstein, Rebecca Hoagland, Christopher J. Harrison, Mark J. Mulligan, Barbara A. Pahud, Andrea A. Berry |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Health Knowledge Attitudes Practice Multivariate analysis Adolescent Psychological intervention Logistic regression Article 03 medical and health sciences 0302 clinical medicine Immunogenicity Vaccine 030225 pediatrics Health care Medicine Humans Public Health Surveillance 030212 general & internal medicine Dosing Papillomavirus Vaccines Child Immunization Schedule Multinomial logistic regression General Veterinary General Immunology and Microbiology business.industry Papillomavirus Infections Vaccination Public Health Environmental and Occupational Health Age Factors Infectious Diseases Immunization Caregivers Family medicine Molecular Medicine Female business Delivery of Health Care |
| Popis: | Background Delayed completion of human papillomavirus vaccination (4vHPV) series is common. We sought to identify factors associated with delay. Methods This substudy was part of a large prospective, multi-site study recruiting 9–17 year old girls at the time of their third 4vHPV dose to assess immunogenicity associated with prolonged dosing intervals. At participating sites, parents/legal guardians (caregivers) of all enrolled girls (9–17 years old) and enrolled girls aged 14–17 years were approached for participation. Caregivers completed a questionnaire measuring adolescent and caregiver sociodemographic characteristics, caregiver attitudes and beliefs about on-schedule HPV vaccination and HPV vaccine safety, adolescent’s health behaviors, barriers to accessing health care, provider office vaccination practices and a Rapid Estimate of Adult Literacy in Medicine (REALM). Participating girls completed a separate questionnaire measuring their attitudes and beliefs about on-schedule HPV vaccination and HPV vaccine safety. Delay was defined as receiving the third 4vHPV dose >12 months after the first. Bivariate, multinomial logistic regression and multivariate logistic regression analyses were used to identify factors predicting delayed completion. Results Questionnaires were completed by 482 caregivers and 386 adolescents; 422 caregivers completed a REALM. Delayed 4vHPV dosing occurred in most adolescents (67%). In multivariate analyses, predictors of delayed completion included caregiver demographic factors (self-reported black vs. white race and high school or less education vs. college or more) and an interaction between caregiver’s inability to get an immunization appointment as soon as needed and adolescent’s type of insurance. Conclusions Caregiver’s race and educational level, accessibility of immunization appointments, and adolescent’s insurance type were found to be related to delays in completion of 4vHPV, but caregiver or adolescent attitudes and beliefs about on-schedule HPV vaccination or HPV vaccine safety were not. Therefore, interventions to improve adherence to recommended vaccination schedules could benefit from a focus on improving access to immunizations. ClinicalTrials.gov (NCT01030562). |
| Databáze: | OpenAIRE |
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