Associations of trust and healthcare provider advice with HPV vaccine acceptance among African American parents |
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| Affiliation: | 1. General and Community Pediatrics, Children''s National Health System, 111 Michigan Ave, NW, Washington, DC 20010, United States;2. Department of Pediatrics, Indiana University, 410 W. 10th Street, HS 1001, Indianapolis, IN 46202, United States;3. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, 7th Floor, Baltimore, MD 21205, United States;4. Betty Irene Moore School of Nursing, University of California, Davis, CA, 4610 “X” Street, Sacramento, CA 95817, United States;1. Emory University, School of Medicine, 1760 Haygood Road, Atlanta, GA 30322, United States;2. Emory University, Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, United States;3. Task Force for Global Health, 330 West Ponce de Leon Ave., Decatur, GA 30030, United States;4. University of Georgia Grady College of Journalism and Mass Communication, 120 Hooper St, Athens, GA 30602, United States;5. National Vaccine Program Office, Health and Human Services, Washington, D.C., United States;1. Center for Health and Risk Communication (Emeritus), University of Georgia, Athens, GA, USA;2. Center for Health Equity, School of Public Health, University of Maryland, College Park, MD, USA;3. Department of Human Development and Quantitative Methodology, College of Education, University of Maryland, College Park, MD, USA;4. Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA;1. Department of Pediatrics, Sections of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Ind;2. Department of Pediatrics, Children''s Health Services Research, Indiana University School of Medicine, Indianapolis, Ind;3. Department of Pediatrics, Child Development, Indiana University School of Medicine, Indianapolis, Ind;1. University of Texas School of Public Health, San Antonio Regional Campus, Department of Health Promotion and Behavioral Sciences, 7411 John Smith Drive, Suite 1100, San Antonio, TX 78229, USA;2. Texas A & M University, Department of Communication, 102 Bolton Hall, College Station, TX 77843-4234, USA;3. Baylor College of Medicine, Department of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA;4. Southern Methodist University, Department of Psychology, PO Box 750235, Dallas, TX 75275-0235, USA;5. University of Texas Southwestern Medical Center, Department of Clinical Sciences, 5323 Harry Hines Blvd, Dallas, TX 75390-8557, USA;6. Harold C. Simmons Comprehensive Cancer Center, 2201 Inwood Road, Dallas, TX 75390, USA;7. Parkland Health & Hospital System, 5200 Harry Hines Blvd, Dallas, TX 75235, USA;1. Public Health, Seattle & King County, Seattle, Washington;2. Seattle Children''s Hospital, Seattle, Washington;3. Adolescent Medicine and Orthopedics and Sports Medicine, University of Washington, Seattle, Washington;4. Division of Allergy and Infectious Diseases and School of Public Health and Community Medicine, University of Washington, Seattle, Washington |
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| Abstract: | ObjectiveHealthcare providers (HCPs) are advised to give all parents a strong recommendation for HPV vaccination. However, it is possible that strong recommendations could be less effective at promoting vaccination among African Americans who on average have greater mistrust in the healthcare system. This study examines the associations of parental trust in HCPs and strength of HCP vaccination recommendation on HPV vaccine acceptance among African American parents.MethodsParticipants were recruited from an urban, academic medical center between July 2012 and July 2014. We surveyed 400 African American parents of children ages 10–12 years who were offered HPV vaccine by their HCPs to assess sociodemographic factors, vaccine beliefs, trust in HCPs, and the HPV vaccine recommendation received. Medical records were reviewed to determine vaccination receipt.ResultsIn multivariable analysis, children whose parents were “very strongly” recommended the HPV vaccine had over four times higher odds of vaccine receipt compared with those whose parents were “not very strongly” recommended the vaccine. Having a parent with “a lot of” versus “none” or only “some” trust in HCPs was associated with over twice the odds of receiving HPV vaccine. Very strong HCP recommendations were associated with higher odds of vaccination among all subgroups, including those with more negative baseline attitudes toward HPV vaccine and those with lower levels of trust. Adding the variables strength of HCP recommendation and parental trust in HCPs to a multivariable model already adjusted for sociodemographic factors and parental vaccine beliefs improved the pseudo R2 from 0.52 to 0.55.ConclusionsAmong participants, receiving a strong vaccine recommendation and having a higher level of trust in HCPs were associated with higher odds of HPV vaccination, but did not add much to the predictive value of a model that already adjusted for baseline personal beliefs and sociodemographic factors. |
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| Keywords: | Human papillomavirus vaccines African Americans Directive counseling Health knowledge, attitudes, practice |
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