Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, China
Abstract Background 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,...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-024-17697-6 |
| _version_ | 1797349638594887680 |
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| author | Vivian Wan-Cheong Yim Qianyun Wang Yifan Li Chuanyun Qin Weiming Tang Shenglan Tang Mark Jit Jennifer S. Smith Heidi J. Larson Joseph D. Tucker Jing Li Leesa Lin Dan Wu |
| author_facet | Vivian Wan-Cheong Yim Qianyun Wang Yifan Li Chuanyun Qin Weiming Tang Shenglan Tang Mark Jit Jennifer S. Smith Heidi J. Larson Joseph D. Tucker Jing Li Leesa Lin Dan Wu |
| author_sort | Vivian Wan-Cheong Yim |
| collection | DOAJ |
| description | Abstract Background 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. Methods 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. Results 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. Conclusion 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. |
| first_indexed | 2024-03-08T12:33:11Z |
| format | Article |
| id | doaj.art-49b8fbe114bb4158a07075972c6f9d7e |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-08T12:33:11Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-49b8fbe114bb4158a07075972c6f9d7e2024-01-21T12:38:31ZengBMCBMC Public Health1471-24582024-01-0124111210.1186/s12889-024-17697-6Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, ChinaVivian Wan-Cheong Yim0Qianyun Wang1Yifan Li2Chuanyun Qin3Weiming Tang4Shenglan Tang5Mark Jit6Jennifer S. Smith7Heidi J. Larson8Joseph D. Tucker9Jing Li10Leesa Lin11Dan Wu12Department of Obstetrics & Gynaecology, Tuen Mun HospitalDepartment of Social Welfare, University of CaliforniaWest China School of Public Health and West China Fourth Hospital, Sichuan UniversityWest China School of Public Health and West China Fourth Hospital, Sichuan UniversitySchool of Medicine, University of North Carolina at Chapel HillGlobal Health Research Centre, Duke Kunshan UniversityCentre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical MedicineDepartment of Epidemiology, UNC Gillings School of Global Public HealthDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical MedicineSchool of Medicine, University of North Carolina at Chapel HillWest China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical MedicineInstitute for Health Metrics and Evaluation, University of WashingtonAbstract Background 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. Methods 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. Results 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. Conclusion 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.https://doi.org/10.1186/s12889-024-17697-6Cervical cancerHuman papillomavirusVaccine delayChinaMixed methods |
| spellingShingle | Vivian Wan-Cheong Yim Qianyun Wang Yifan Li Chuanyun Qin Weiming Tang Shenglan Tang Mark Jit Jennifer S. Smith Heidi J. Larson Joseph D. Tucker Jing Li Leesa Lin Dan Wu Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, China BMC Public Health Cervical cancer Human papillomavirus Vaccine delay China Mixed methods |
| title | Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, China |
| title_full | Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, China |
| title_fullStr | Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, China |
| title_full_unstemmed | Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, China |
| title_short | Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, China |
| title_sort | between now and later a mixed methods study of hpv vaccination delay among chinese caregivers in urban chengdu china |
| topic | Cervical cancer Human papillomavirus Vaccine delay China Mixed methods |
| url | https://doi.org/10.1186/s12889-024-17697-6 |
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