U.S. Vietnamese parents’ HPV vaccine decision-making for their adolescents: an exploration of practice-, provider-, and patient-level influences

• Published in: Journal of behavioral medicine Vol. 45; no. 2; pp. 197 - 210
• Main Authors: Vu, Milkie, Bednarczyk, Robert A., Escoffery, Cam, Ta, Danny, Huynh, Victoria N., Berg, Carla J.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-04-2022; Springer; Springer Nature B.V
• Subjects: Acculturation; Adolescent; Adolescent girls; Adolescents; Adult; Age; Beliefs, opinions and attitudes; Cancer; Cervical cancer; Cervix; Child; Children; Cross-Sectional Studies; Decision making; Family Medicine; Female; Females; General Practice; Health aspects; Health Knowledge, Attitudes, Practice; Health Psychology; Human papillomavirus; Humans; Immunization; Intervention; Male; Medicine; Medicine & Public Health; Misconceptions; Older children; Papillomavirus Infections - prevention & control; Papillomavirus Vaccines; Parents; Parents & parenting; Patients; Perceptions; Sexually transmitted diseases; STD; Teenagers; Vaccination; Vaccines; Vietnamese Americans; Willingness; Youth; United States; United States > US; Vietnamese; Sexual activity; HPV vaccine; Adolescents; Provider recommendation
• ISSN: 0160-7715; 1573-3521
• DOI: 10.1007/s10865-021-00265-3

U.S. Vietnamese have high cervical cancer incidence and low human papillomavirus (HPV) vaccine initiation. Using the P3 model, we explored practice-, provider-, and patient-level determinants of U.S. Vietnamese parents’ HPV vaccine decision-making for their adolescents. We conducted a cross-sectional, online survey (04/2020–12/2020) with U.S. Vietnamese parents who had ≥ 1 adolescent ages 9–18. We assessed HPV vaccination outcomes (initiation, willingness to initiate, completion) and provider recommendation. Modified Poisson regressions were used to identify practice-, provider- and patient-level correlates of outcomes. The sample (
n
 = 408) was 44 years old on average; 83% were female and 85% had a Bachelor’s degree. Around half of adolescents were female (51%) and 13–18 year old (54%). Only 41 and 23% of parents had initiated and completed the HPV vaccine series for their child, respectively. Initiation was associated with receiving provider recommendation (either low- or high-quality), while willingness to initiate was associated with receiving high-quality recommendation. Both initiation and willingness to initiate was negatively associated with parental perception that their child was too young for a “sexually transmitted infection (STI)-preventing vaccine.” Provider recommendation was associated with higher parental U.S. acculturation and the child being older and female. Provider-facing interventions should promote high-quality, age-based, gender-neutral HPV vaccine recommendation. These and population- and individual-facing interventions should recognize the need for additional parental education, particularly related to misconceptions regarding STI prevention.