An integrative behavior theory derived model to assess factors affecting HPV vaccine acceptance using structural equation modeling

Abraham Degarege, Karl Krupp, Kristopher Fennie, Vijaya Srinivas, Tan Li, Dionne P. Stephens, Purnima Madhivanan

Research output: Contribution to journalArticle

Abstract

The study examined factors that affect parental intention-to-vaccinate adolescent daughters with HPV vaccine in Mysore district, India. A cross-sectional study was conducted among 1609 parents of adolescent girls attending schools in Mysore District between February 2010 and October 2011. A validated questionnaire was used to assess parental attitudes, beliefs related with HPV infection, cervical cancer, HPV vaccine and vaccination in general. Structural equation modeling was used to estimate parameters and assess whether a model based on the integrative behavior theory would fit the current data. More than two-thirds (78.0%) of parents would accept vaccinating their daughters with HPV vaccine. Intention to HPV vaccination significantly increased with increase in the perception of parents about the benefits (standardized regression coefficient (β) = 0.39) or sources of information about HPV vaccine (β = 0.24), but intention decreased significantly with an increase in the perception about barriers to HPV vaccination β = −0.44). The effect of beliefs about severity of HPV infection or cervical cancer (β = 0.20), and beliefs about benefits (β = 0.20) or barriers (β = −0.25) to vaccination in general on intention to HPV vaccination were significantly mediated by parental attitudes and source of information about the vaccine. Geographical location significantly moderated the awareness about HPV on beliefs about severity of HPV infection or cervical cancer (β = 0.33), and the effect of religion on norms related to HPV vaccination (β = 0.19). Fit of the model to the data was acceptable. This study identified modifiable parental attitudes about HPV vaccine and beliefs related with HPV infection, cervical cancer and vaccination, which predicted parental intention-to-vaccinate their daughters with HPV vaccine in India. Health education interventions tailored to counter parental negative attitudes and beliefs about HPV vaccine and vaccination in general would be important for the community to promote HPV vaccination.

Original languageEnglish (US)
Pages (from-to)945-955
Number of pages11
JournalVaccine
Volume37
Issue number7
DOIs
StatePublished - Feb 8 2019

Fingerprint

Papillomavirus Vaccines
Vaccination
vaccination
vaccines
uterine cervical neoplasms
Uterine Cervical Neoplasms
Nuclear Family
India
Parents
information sources
Infection
infection
structural equation modeling
health education
religion
Cancer Vaccines
Geographical Locations
Religion
Health Education
cross-sectional studies

Keywords

  • Acceptance
  • Daughter
  • HPV vaccine
  • India
  • Parent

ASJC Scopus subject areas

  • Molecular Medicine
  • Immunology and Microbiology(all)
  • veterinary(all)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

An integrative behavior theory derived model to assess factors affecting HPV vaccine acceptance using structural equation modeling. / Degarege, Abraham; Krupp, Karl; Fennie, Kristopher; Srinivas, Vijaya; Li, Tan; Stephens, Dionne P.; Madhivanan, Purnima.

In: Vaccine, Vol. 37, No. 7, 08.02.2019, p. 945-955.

Research output: Contribution to journalArticle

Degarege, Abraham ; Krupp, Karl ; Fennie, Kristopher ; Srinivas, Vijaya ; Li, Tan ; Stephens, Dionne P. ; Madhivanan, Purnima. / An integrative behavior theory derived model to assess factors affecting HPV vaccine acceptance using structural equation modeling. In: Vaccine. 2019 ; Vol. 37, No. 7. pp. 945-955.
@article{35404e89759c444ab1d40cf9881672f2,
title = "An integrative behavior theory derived model to assess factors affecting HPV vaccine acceptance using structural equation modeling",
abstract = "The study examined factors that affect parental intention-to-vaccinate adolescent daughters with HPV vaccine in Mysore district, India. A cross-sectional study was conducted among 1609 parents of adolescent girls attending schools in Mysore District between February 2010 and October 2011. A validated questionnaire was used to assess parental attitudes, beliefs related with HPV infection, cervical cancer, HPV vaccine and vaccination in general. Structural equation modeling was used to estimate parameters and assess whether a model based on the integrative behavior theory would fit the current data. More than two-thirds (78.0{\%}) of parents would accept vaccinating their daughters with HPV vaccine. Intention to HPV vaccination significantly increased with increase in the perception of parents about the benefits (standardized regression coefficient (β) = 0.39) or sources of information about HPV vaccine (β = 0.24), but intention decreased significantly with an increase in the perception about barriers to HPV vaccination β = −0.44). The effect of beliefs about severity of HPV infection or cervical cancer (β = 0.20), and beliefs about benefits (β = 0.20) or barriers (β = −0.25) to vaccination in general on intention to HPV vaccination were significantly mediated by parental attitudes and source of information about the vaccine. Geographical location significantly moderated the awareness about HPV on beliefs about severity of HPV infection or cervical cancer (β = 0.33), and the effect of religion on norms related to HPV vaccination (β = 0.19). Fit of the model to the data was acceptable. This study identified modifiable parental attitudes about HPV vaccine and beliefs related with HPV infection, cervical cancer and vaccination, which predicted parental intention-to-vaccinate their daughters with HPV vaccine in India. Health education interventions tailored to counter parental negative attitudes and beliefs about HPV vaccine and vaccination in general would be important for the community to promote HPV vaccination.",
keywords = "Acceptance, Daughter, HPV vaccine, India, Parent",
author = "Abraham Degarege and Karl Krupp and Kristopher Fennie and Vijaya Srinivas and Tan Li and Stephens, {Dionne P.} and Purnima Madhivanan",
year = "2019",
month = "2",
day = "8",
doi = "10.1016/j.vaccine.2019.01.012",
language = "English (US)",
volume = "37",
pages = "945--955",
journal = "Vaccine",
issn = "0264-410X",
publisher = "Elsevier BV",
number = "7",

}

TY - JOUR

T1 - An integrative behavior theory derived model to assess factors affecting HPV vaccine acceptance using structural equation modeling

AU - Degarege, Abraham

AU - Krupp, Karl

AU - Fennie, Kristopher

AU - Srinivas, Vijaya

AU - Li, Tan

AU - Stephens, Dionne P.

AU - Madhivanan, Purnima

PY - 2019/2/8

Y1 - 2019/2/8

N2 - The study examined factors that affect parental intention-to-vaccinate adolescent daughters with HPV vaccine in Mysore district, India. A cross-sectional study was conducted among 1609 parents of adolescent girls attending schools in Mysore District between February 2010 and October 2011. A validated questionnaire was used to assess parental attitudes, beliefs related with HPV infection, cervical cancer, HPV vaccine and vaccination in general. Structural equation modeling was used to estimate parameters and assess whether a model based on the integrative behavior theory would fit the current data. More than two-thirds (78.0%) of parents would accept vaccinating their daughters with HPV vaccine. Intention to HPV vaccination significantly increased with increase in the perception of parents about the benefits (standardized regression coefficient (β) = 0.39) or sources of information about HPV vaccine (β = 0.24), but intention decreased significantly with an increase in the perception about barriers to HPV vaccination β = −0.44). The effect of beliefs about severity of HPV infection or cervical cancer (β = 0.20), and beliefs about benefits (β = 0.20) or barriers (β = −0.25) to vaccination in general on intention to HPV vaccination were significantly mediated by parental attitudes and source of information about the vaccine. Geographical location significantly moderated the awareness about HPV on beliefs about severity of HPV infection or cervical cancer (β = 0.33), and the effect of religion on norms related to HPV vaccination (β = 0.19). Fit of the model to the data was acceptable. This study identified modifiable parental attitudes about HPV vaccine and beliefs related with HPV infection, cervical cancer and vaccination, which predicted parental intention-to-vaccinate their daughters with HPV vaccine in India. Health education interventions tailored to counter parental negative attitudes and beliefs about HPV vaccine and vaccination in general would be important for the community to promote HPV vaccination.

AB - The study examined factors that affect parental intention-to-vaccinate adolescent daughters with HPV vaccine in Mysore district, India. A cross-sectional study was conducted among 1609 parents of adolescent girls attending schools in Mysore District between February 2010 and October 2011. A validated questionnaire was used to assess parental attitudes, beliefs related with HPV infection, cervical cancer, HPV vaccine and vaccination in general. Structural equation modeling was used to estimate parameters and assess whether a model based on the integrative behavior theory would fit the current data. More than two-thirds (78.0%) of parents would accept vaccinating their daughters with HPV vaccine. Intention to HPV vaccination significantly increased with increase in the perception of parents about the benefits (standardized regression coefficient (β) = 0.39) or sources of information about HPV vaccine (β = 0.24), but intention decreased significantly with an increase in the perception about barriers to HPV vaccination β = −0.44). The effect of beliefs about severity of HPV infection or cervical cancer (β = 0.20), and beliefs about benefits (β = 0.20) or barriers (β = −0.25) to vaccination in general on intention to HPV vaccination were significantly mediated by parental attitudes and source of information about the vaccine. Geographical location significantly moderated the awareness about HPV on beliefs about severity of HPV infection or cervical cancer (β = 0.33), and the effect of religion on norms related to HPV vaccination (β = 0.19). Fit of the model to the data was acceptable. This study identified modifiable parental attitudes about HPV vaccine and beliefs related with HPV infection, cervical cancer and vaccination, which predicted parental intention-to-vaccinate their daughters with HPV vaccine in India. Health education interventions tailored to counter parental negative attitudes and beliefs about HPV vaccine and vaccination in general would be important for the community to promote HPV vaccination.

KW - Acceptance

KW - Daughter

KW - HPV vaccine

KW - India

KW - Parent

UR - http://www.scopus.com/inward/record.url?scp=85059814579&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85059814579&partnerID=8YFLogxK

U2 - 10.1016/j.vaccine.2019.01.012

DO - 10.1016/j.vaccine.2019.01.012

M3 - Article

C2 - 30655176

AN - SCOPUS:85059814579

VL - 37

SP - 945

EP - 955

JO - Vaccine

JF - Vaccine

SN - 0264-410X

IS - 7

ER -