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A Physician’s Recommendation for HPV Vaccination: What Makes African American Mothers Compliant?

Cunningham-Erves, Jennifer, L., PhD, MAEd, MSa*; Kelly-Taylor, Kendria, D., BSb; Mayo-Gamble, Tilicia, L., PhD, MA, MPHc; Deakings, Jason, A., BSb; Talbott, Laura, L., PhD, MHAd

The Pediatric Infectious Disease Journal: January 11, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/INF.0000000000001906
Brief Reports: PDF Only

Background: Improving HPV vaccination among African American (AA) female adolescents to reduce the cervical cancer burden is important and cost-effective. The study objective is to identify factors most influential to AA mothers’ likelihood to comply with a physician’s recommendation to get their daughters the human papillomavirus (HPV) vaccine.

Methods: We conducted a cross-sectional survey. Participants were recruited through online and community sites (i.e. schools, community centers, etc.) in Alabama. A total of 280 AA mothers and their adolescent daughters completed the survey. A binary logistic regression was used to determine factors influencing mother’s likelihood to adhere with a physician’s recommendation to get their daughters the HPV vaccine.

Results: The most significant factors influencing mother’s likelihood to comply with physician’s recommendation were culture: future-time orientation (p=.001), perceived barriers of HPV vaccination (p=.007), perceived susceptibility to HPV (p=.047), and perceived benefits of HPV vaccination (p=.002). Further exploration of perceived barriers and perceived benefits found mother’s perception that the HPV vaccine is a good way to protect my daughter’s health as the only significant benefit. No measures of perceived barriers were significant.

Conclusion: A physician’s recommendation should advise AA mothers on the risk of HPV and the importance of HPV vaccination at an early age to reduce cervical cancer risk. It should further address mothers’ perceived disadvantages of HPV vaccination (e.g., side effects). Incorporating this information in physician recommendation practices could increase HPV vaccination rates with implications in reducing the cervical cancer burden among this high-risk population.

aDepartment of Internal Medicine, Meharry Medical College, Nashville, TN

bSchool of Graduate Studies and Research, Meharry Medical College, Nashville, TN;

cDepartment of Community Health Education and Behavior, Georgia Southern University, Statesboro, GA

dDepartment of Human Studies, University of Alabama at Birmingham, Birmingham, Alabama

Conflict of interest: The authors declare that they have no conflict of interest.

Author Disclosure Statement: The authors declare no competing financial interest exist.

Acknowledgements The authors would like to thank the community organizations of Birmingham, Alabama, that assisted in the study design and allowed us to conduct this research within their organizations.

Address correspondence to: Jennifer Cunningham Erves, PhD, Department of Internal Medicine, 1005 Dr. D. B. Todd Jr. Blvd., Nashville, TN 37208-3599, Email:, Phone: 615-327-5692.

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