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-- Influences on Parental Acceptance of HPV Vaccination in Demonstration Projects in Uganda and Vietnam

Monday, 28th of January 2013

Abstract Title: Influences on parental acceptance of HPV vaccination in demonstration projects in Uganda and Vietnam

Presenter: D. Scott LaMontagne, PhD MPH, FRSPH

Investigators / Collaborators: Sean R Galagan1, Proma Paul2, Lysander Menezes3, and D. Scott LaMontagne4

1 Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

2 University of Pittsburg, Pittsburgh, Pennsylvania, USA

3 PATH, New Delhi, India

4 PATH, Seattle, Washington, USA

Country: United States

 

Objectives

To investigate the associations between exposure to communication materials and community influencers and HPV vaccine uptake in demonstration projects in Uganda and Vietnam.

 

Method

We conducted a secondary analysis of a population-based survey of a representative sample of parents/guardians whose daughters were eligible for HPV vaccine through demonstration projects in Vietnam and Uganda. We determined the association between exposure to various components of communication strategies and HPV vaccine uptake using univariate analysis and logistic regression. Two main aspects of communication strategies were assessed. The first was exposure to messages through interactive (e.g., group meetings or house-to-house visits) and non-interactive channels (e.g., leaflets, informational radio or television spots). The second was the type of community influencers (e.g., health workers, family member, community leader) with whom parents spoke about their decision to have (or not have) their daughter vaccinated. We further assessed different combinations of communication channels and influencers on HPV vaccine uptake by calculating the uptake achieved from each.

 

Results

Speaking with trained personnel was the communication strategy most strongly associated with HPV vaccine uptake in both Uganda and Vietnam [ORUganda y1 = 5.8 (3.3-10.0), ORUganda y2 =3.5 (2.2-5.5), ORVietnam = 4.3 (2.5-7.4)]. Speaking with other influencers, such as family members, neighbors, or friends, was also strongly associated with vaccine uptake. Except for the first year, when radio spots in Uganda [ORadj = 1.8 (1.0-3.4)] and written materials in Vietnam [ORadj = 2.3 (1.1-4.8)] were slightly associated with uptake, non-interactive communication channels had no discernible association with vaccine uptake. Speaking with community influencers was the strongest predictor of HPV vaccine uptake: among parents who spoke to no one but received communication materials uptake was 61.4%, compared to 92.7% among parents who spoke with trained personnel but did not receive communication materials.

 

Implications and Impact

This study provides valuable information for policymakers and vaccination programs set to introduce HPV vaccine in low- and middle-income countries. These data indicate that the people you speak with, rather than exposure to communication materials and activities, are the primary drivers of HPV vaccine uptake in these settings. Therefore, HPV vaccine programs may need to focus on communication strategies that incorporate key community influencers and stakeholders, such as health workers, teachers, family members, and friends, as opposed to targeted delivery of non-interactive messages, such as leaflets and posters.