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

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机构: [1]Department of Obstetrics & Gynaecology, Tuen Mun Hospital, Hong Kong, China. [2]Department of Social Welfare, University of California, Los Angeles, USA. [3]West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China. [4]School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. [5]SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China. [6]Global Health Research Centre, Duke Kunshan University, Jiangsu, China. [7]Duke Global Health Institute, Duke University, Durham, NC, USA. [8]Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, GB, UK. [9]Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA. [10]Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, GB, UK. [11]Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA. [12]Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Room 360, Keppel St, London WC1E 7HT, UK. [13]Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, Hong Kong SAR, China. [14]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. [15]Department of Social Medicine and Health Education, School of Public Health of Nanjing Medical University, No. 101 Longmian Avenue, Nanjing Jiangsu, China.
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关键词: Cervical cancer Human papillomavirus Vaccine delay China Mixed methods

摘要:
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.© 2024. The Author(s).

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出版当年[2023]版:
大类 | 2 区 医学
小类 | 2 区 公共卫生、环境卫生与职业卫生
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 公共卫生、环境卫生与职业卫生
第一作者:
第一作者机构: [1]Department of Obstetrics & Gynaecology, Tuen Mun Hospital, Hong Kong, China.
通讯作者:
通讯机构: [11]Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA. [15]Department of Social Medicine and Health Education, School of Public Health of Nanjing Medical University, No. 101 Longmian Avenue, Nanjing Jiangsu, China.
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