# Presentation: 025240

## Parental Receptiveness to a Hypothetical HPV Vaccine

- AJ Lenar, E Anderson, M Wentworth, K Connolly
- MVD Business Research, Merck & Company

## Study Objectives

- To assess parental awareness of cervical cancer and HPV
- To measure the extent of parental receptiveness to a hypothetical HPV vaccine
- To identify differentiating demographic and attitudinal characteristics of more vs. less receptive parents

## Methodology

- Internet survey conducted with 2,053 parents of daughters 9-17 years of age
- Average of 26 minutes to complete
- Respondents had to have either primary responsibility or shared responsibility for deciding whether their children would receive a particular vaccine** **
- Concept provided information regarding the incidence of cervical cancer,  genital warts, the role of sexual activity in contracting  these diseases, and described a  hypothetical HPV vaccine

## Sample Characteristics

- Sample was balanced across age, gender, marital status, income, geographic location, and ethnicity
- Sample generally paralleled the US Census for families that include 9-17 year old daughters except:
- Internet sample generally better educated
- African-Americans (n=170) and Hispanics (n=160) were underrepresented
- Since responses did not differ across racial/ethnic categories, the sample was not weighted

## Analytic Framework

- Research explored variables affecting willingness to vaccinate
- T-tests between groups were first used to test statistical significance
- Focused on differences that achieve or surpass p_<_.01 to p_<_.001 (two-tailed, 95% level of confidence)
- Cumulative logistic regression models were used to further clarify and prioritize variables that contributed to receptiveness

## Results

## Awareness of Cervical Cancer

**Unaware**

**Almost**
**Nothing**

**Know **
**A Little**

**Know **
**Some**

**Know **
**A lot**

**16%**

** ****14%**

** ****46%**

** ****24%**

** ****11%**

** ****5%**

- •	60% of parents said they knew some or a lot about cervical cancer
- Only 5% of parents were unaware of cervical cancer

**(n=2,053)**

**60%**

- Q.21  "Have you ever heard of cervical cancer?"
- Q.22  "Would you say you know a lot, some, a little or almost nothing about cervical cancer?"

## Awareness of Genital Warts

**Unaware**

**Almost**
**Nothing**

**Know **
**A Little**

**Know **
**Some**

**Know **
**A lot**

** ****11%**

** ****38%**

** ****29%**

** ****17%**

** ****6%**

- •	Parents claim to have greater knowledge of cervical cancer than genital warts (60% vs. 49%)

**(n=2,053)**

**23%**

**49%**

- Q.23  "Have you ever heard of genital warts?"
- Q.24  "Would you say you know a lot, some, a little or almost nothing about them?"

## Knowledge of Relationship

**	****100%****	****75%****	****50%****	****25%****	****0%****	****25%****	****50%**

**(n=2,053)**

**	****% No/Don't Know****	****% Yes**

- •	71% of parents were unaware of the relationship between genital warts and the virus that causes cervical cancer

**71%**

**29%**

- Q.25  "Are you aware of any relationship between genital warts and the virus that causes cervical cancer?"

## Vaccination Interest Segments for a Hypothetical HPV Vaccine

**11%**

**50%****	****25%****	****0%****	****25%****	****50%****	****75%**

**	****Leave The****	****Definitely****	****Probably****	****Might/****	****Probably****	****Definitely**
**	****Decision Up****	**** Not****	****Not****	****Might Not****	****Would****	****Would**
**	****To Her Once**
**	****She Turns 18**

**Average Current ****Age Of Daughter:**

**	****13 yrs.****	****13 yrs.****	****13 yrs.****	****13 yrs.**

_**Likelihood To Vaccinate Before 18 Yrs. **_

**62%**

**(n=2,053)**

- •	Based on the concept alone, 62% of parents said they would definitely (30%) or probably (32%) have their daughters vaccinated before their 18th birthdays

## Vaccination Interest Segments for a Hypothetical HPV Vaccine for Males

**50%****	****25%****	****0%****	****25%****	****50%****	****75%**

**Daughter****1             ****(n=2,053)**

**62%**

**Reluctant   ****	****      Might or Might Not     Probably Would ****	****      Definitely Would**

**62%**

**Sons 9-17 Yrs. Old****(n=783)**

_**Likelihood To Vaccinate Before 18 Yrs. **_

- Parents with 9-17 year old sons were as receptive to vaccinating their sons as their daughters

- 1For parents with more than one 9-17 year old daughter, parents were asked about their attitudes towards vaccinating the daughter with the most recent birthday.

## Impact Of Physician Recommendations On Vaccination Segments

**a****	****1%-2% of respondents answered "don't know."**
**Q.26****	****"****Think about what you are likely to do between now and the next few years.  And, for purposes of this study, assume that the cost of this vaccine will be about the same as you ****	****have experienced in the past for other childhood vaccinations.  Based on what you’ve read so far, would you say that **_**eventually**_**, before she turns 18, you...vaccinate?"**
**Q.33****	****"****Physicians may offer different advice about the vaccine.  Suppose that, on your daughter’s **_**next**_** **_**visit**_** to the doctor, her physician explained the HPV vaccine and said, (ITEM).  ****	****How likely or unlikely are you to get your daughter vaccinated **_**at or around the time of that visit**_**?"**
**Q.34****	****"(IF NOT “DEFINITELY WOULD” OR “PROBABLY WOULD” FOR ITEM IN Q.33:)  If her physician said, (ITEM), how likely or unlikely would you be to get your daughter vaccinated ****	****at some point before she turns 18?" **

**Physician Characterize HPV Vaccine As Helpful, But Unnecessary****a**

**	****50%****	****25%****	****0%****	****25%****	****50%****	****75%****	****100%**

**	****Resistant****	****Hesitant****	****Tempted****	****Convinced**

**62%**

**79%**

**61%**

**49%**

**Physician Characterizes Vaccine As Good/Leaves It Up To Parent****a**

**With Strong Physician Recommendation****“If It Were My Daughter...”****a**

**HPV Concept Only**

**69%**

**Physician States: "Today Your Daughter Will Be Receiving The HPV Vaccine"****a**

**(n=2,053)**

## Predicting Likelihood To Vaccinate

- •	Cumulative logistic regression was carried out to understand which independent variables contribute most to distinguishing between receptiveness segments
- Any individual variable for which the correlation with receptiveness was not significant at _p____.05_ or less was dropped
- 26 demographic and attitudinal variables remained
- Correctly classified 83.3% of parents, chance gives 32%
- Increased the odds of correctly classifying a parent 2.6 fold (83.3% ÷ 32% = 2.6)

## Predicting Likelihood To Vaccinate

**Predicting Likelihood To Vaccinate**

## Predicting Likelihood To Vaccinate

**Predicting Likelihood To Vaccinate**

## Summary

- Most parents were aware of cervical cancer and genital warts
- Parents felt they know more about cervical cancer than genital warts
- When questioned further, 71% said they were unaware of the relationship genital warts and the virus that causes cervical cancer
- Based on the concept alone, 62% of parents said they would definitely (30%) or probably (32%) vaccinate their daughters with a hypothetical HPV vaccine

## Summary

- Most of the remainder (30%) were unsure—might or might not—rather than reluctant (11%)
- Among reluctant parents, only 2% said they definitely would not vaccinate
- Parents were equally receptive to vaccinating their sons
- A strong personal recommendation from a physician increased parent receptivity (definitely or probably would) from 62% to 79%
- A parent’s general desire to protect his or her children was the greatest predictor of parental receptiveness