Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, China.

Cervical cancer China Human papillomavirus Mixed methods Vaccine delay

Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
15 Jan 2024
Historique:
received: 25 05 2023
accepted: 08 01 2024
medline: 16 1 2024
pubmed: 16 1 2024
entrez: 15 1 2024
Statut: epublish

Résumé

Adolescent girls in China have a low HPV vaccination rate. Although vaccination is recommended by the Chinese health authorities, the cost is not covered by the national immunisation programme. Vaccination delay, among other reasons such as supply shortage and poor affordability, may contribute to low uptake. This sequential mixed methods study aimed to identify potential factors of delayed HPV vaccination among Chinese adolescent girls. Quantitative data about the attitudes and perceptions of HPV vaccination were collected from 100 caregivers of 14-18-year-old girls using an online survey in Chengdu, China. The survey data informed a subsequent qualitative study using four focus group discussions. We conducted a descriptive analysis of the survey data and a thematic analysis of the qualitative data. The findings were interpreted using a health behaviour model adapted from the Health Belief Model and the Andersen's Behavioural Model for Health Services Use. A total of 100 caregivers - 85 were mothers and 15 were fathers - participated in the survey; 21 caregivers joined focus group discussions. When asked about their intended course of action if the 9vHPV vaccine was out-of-stock, 74% chose to delay until the 9vHPV vaccine is available while 26% would consider 2vHPV or 4vHPV vaccines or seek alternative ways to procure the vaccine. Qualitative results confirmed that caregivers preferred delaying HPV vaccination for adolescent girls. The intent to delay was influenced by systemic barriers such as supply shortage and individual-level factors such as a preference for the 9vHPV vaccine, safety concerns, inadequate health communication, and the belief that adolescents were unlikely to be sexually active. In urban areas, Chinese caregivers' intent to delay vaccination in favour of 9vHPV vaccine over receiving the more accessible options was influenced by a mix of individual and contextual factors. Focussed health communication strategies are needed to accelerate HPV vaccination among adolescents.

Sections du résumé

BACKGROUND BACKGROUND
Adolescent girls in China have a low HPV vaccination rate. Although vaccination is recommended by the Chinese health authorities, the cost is not covered by the national immunisation programme. Vaccination delay, among other reasons such as supply shortage and poor affordability, may contribute to low uptake. This sequential mixed methods study aimed to identify potential factors of delayed HPV vaccination among Chinese adolescent girls.
METHODS METHODS
Quantitative data about the attitudes and perceptions of HPV vaccination were collected from 100 caregivers of 14-18-year-old girls using an online survey in Chengdu, China. The survey data informed a subsequent qualitative study using four focus group discussions. We conducted a descriptive analysis of the survey data and a thematic analysis of the qualitative data. The findings were interpreted using a health behaviour model adapted from the Health Belief Model and the Andersen's Behavioural Model for Health Services Use.
RESULTS RESULTS
A total of 100 caregivers - 85 were mothers and 15 were fathers - participated in the survey; 21 caregivers joined focus group discussions. When asked about their intended course of action if the 9vHPV vaccine was out-of-stock, 74% chose to delay until the 9vHPV vaccine is available while 26% would consider 2vHPV or 4vHPV vaccines or seek alternative ways to procure the vaccine. Qualitative results confirmed that caregivers preferred delaying HPV vaccination for adolescent girls. The intent to delay was influenced by systemic barriers such as supply shortage and individual-level factors such as a preference for the 9vHPV vaccine, safety concerns, inadequate health communication, and the belief that adolescents were unlikely to be sexually active.
CONCLUSION CONCLUSIONS
In urban areas, Chinese caregivers' intent to delay vaccination in favour of 9vHPV vaccine over receiving the more accessible options was influenced by a mix of individual and contextual factors. Focussed health communication strategies are needed to accelerate HPV vaccination among adolescents.

Identifiants

pubmed: 38225563
doi: 10.1186/s12889-024-17697-6
pii: 10.1186/s12889-024-17697-6
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

183

Subventions

Organisme : Bill & Melinda Gates Foundation
ID : INV-034554
Pays : United States
Organisme : Bill & Melinda Gates Foundation
ID : INV-034554
Pays : United States
Organisme : Bill & Melinda Gates Foundation
ID : INV-034554
Pays : United States
Organisme : NIH HHS
ID : NIH NIAID R01AI158826
Pays : United States

Informations de copyright

© 2024. The Author(s).

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Auteurs

Vivian Wan-Cheong Yim (VW)

Department of Obstetrics & Gynaecology, Tuen Mun Hospital, Hong Kong, China.

Qianyun Wang (Q)

Department of Social Welfare, University of California, Los Angeles, USA.
SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China.

Yifan Li (Y)

West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.

Chuanyun Qin (C)

West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.

Weiming Tang (W)

School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China.

Shenglan Tang (S)

Global Health Research Centre, Duke Kunshan University, Jiangsu, China.
Duke Global Health Institute, Duke University, Durham, NC, USA.

Mark Jit (M)

Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, GB, UK.

Jennifer S Smith (JS)

Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.

Heidi J Larson (HJ)

Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, GB, UK.
Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.

Joseph D Tucker (JD)

School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China.
Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Room 360, Keppel St, London, WC1E 7HT, UK.

Jing Li (J)

West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.

Leesa Lin (L)

Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, GB, UK.
Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, Hong Kong SAR, China.
WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.

Dan Wu (D)

Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA. danwu@njmu.edu.cn.
Department of Social Medicine and Health Education, School of Public Health of Nanjing Medical University, No. 101 Longmian Avenue, Nanjing Jiangsu, China. danwu@njmu.edu.cn.

Classifications MeSH