Abstract A47: What low-income mothers don't know (but wish they did) about childhood HPV vaccination: A qualitative study
Authors: Floyd Tiffany D. , Rao Jessica , Isaac Kathleen 
Published: May 2015

Human papillomavirus (HPV) is the leading cause of cervical cancer, which disproportionately affects women of low income. Efficacious vaccines against HPV are approved for children as young as nine years of age and thus offer unprecedented opportunity to eliminate cervical cancer disparities. In order to better understand factors that influenced their decision to either vaccinate or not vaccinate their daughters against HPV, N=41 low-income mothers of vaccine-eligible minor (i.e., 9-17 year old) girls completed a brief semi-structured telephone interview. Mothers were a subset of those who participated in a larger mixed-methods prospective study regarding maternal decision-making about childhood HPV vaccination. Interview questions were guided by the Decision Support Framework and included assessment of decision determinants such as knowledge, norms and expectations, along with questions specific to their daughters' HPV vaccination status (vaccine initiated/completed or vaccine not initiated). All interviews were audiotaped, transcribed and coded using an iterative, or “constant comparative,” method. At the time of their interview, n=13 mothers (32%) had a daughter who had either initiated or completed the 3-dose HPV vaccine series whereas n=28 (62%) had not initiated the vaccine series for their daughter. Major themes that emerged from the interviews included: (1) Lack of accurate knowledge about what HPV is, such as how it is transmitted, (2) Lack of knowledge about the HPV vaccine, such as what types of cancer it offers protection against, and (3) The desire for more information about the HPV vaccine; in particular, information about potential side effects. Importantly, each of these themes emerged regardless of whether or not the mother had initiated the HPV vaccine series for her daughter. Among mothers who did initiate the HPV vaccine series, the perceived recommendation of their daughter's pediatrician was the most commonly cited reason for having done so. The desire for more information and concerns about potential side effects were the most commonly cited reasons for not having vaccinated ones daughter against HPV; however, most mothers of unvaccinated daughters had not ruled out the option. These findings underscore the importance of physician recommendation in promoting cancer prevention and risk-reducing health behaviors such as childhood HPV vaccination. Pediatricians working within low-income communities should educate parents about HPV and the HPV vaccine given that lack of information, rather than lack of interest, appears to be the most common barrier to vaccinating their daughters against HPV. Moreover, such health education efforts would promote informed decision-making among low-income mothers faced with making this important preventive-health decision for their child.

Citation Format: Tiffany D. Floyd, Jessica Rao, Kathleen Isaac. What low-income mothers don't know (but wish they did) about childhood HPV vaccination: A qualitative study. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A47. doi:10.1158/1538-7755.DISP13-A47