Abstract: Parents' Uptake of HPV Vaccines for Children: A Systematic Review and Meta-Analysis (Society for Prevention Research 24th Annual Meeting)

Schedule:

Tuesday, May 31, 2016

Pacific D/L (Hyatt Regency San Francisco)

* noted as presenting author

Ashley Lacombe-Duncan, MSW, Doctoral student, University of Toronto, Toronto, ON, Canada

Peter A Newman, PhD, Professor, University of Toronto, Toronto, ON, Canada

Carmen Logie, PhD, Assistant Professor, University of Toronto, Toronto, ON, Canada

Philip Baiden, MA, Doctoral student, University of Toronto, Toronto, ON, Canada

Ahmad Farid Asey, MA, Doctoral student, University of Toronto, Toronto, ON, Canada

Clara Rubincam, PhD, Postdoctoral fellow, University of Toronto, Toronto, ON, Canada

Nick Doukas, MSW, Doctoral student, University of Toronto, Toronto, ON, Canada

Introduction: Human papillomavirus (HPV), among the most prevalent sexually transmitted infections globally, is causally associated with the majority of cervical cancers, and with anal, penile and several oropharyngeal cancers. HPV vaccines are safe and highly effective in reducing prevalent HPV infections and genital warts, and indicated for the prevention of HPV-associated cancers; yet North American data indicate suboptimal uptake. With HPV prevalence highest among youth, vaccination is recommended at age 11 or 12 years, prior to sexual debut; thus parents play a key role in uptake. We synthesized results from quantitative cross-sectional investigations of parents’ uptake of HPV vaccines for children to understand: 1) rates of parents’ HPV vaccine uptake, 2) factors correlated with parents’ uptake of HPV vaccines for children, and 3) influence of child gender on uptake.

Methods: We conducted a comprehensive search across multiple electronic databases for studies published from Jan 2000-Aug 2015 on parents’ uptake of HPV vaccines for children. Studies with sufficient data on correlates of HPV vaccine uptake were included in meta-analysis. The primary outcome variable was parents’ uptake of HPV vaccines for children. We computed effect sizes for each variable using a random effects model to compensate for clinical and methodological diversity between studies, and moderation analyses on child gender. We followed preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines.

Results: Across 50 studies (n=557,613), parents’ uptake of HPV vaccines for children ranged from 0.7%-89.0%, mean uptake=36.7% (weighted mean [WM]=13.7%), with higher uptake for girls (WM=53.1) than boys (WM=2.7; p<0.001). Factors associated with parents’ uptake include physician recommendation (r=0.50 [95% CI 0.34–0.67]), routine parent preventive check-up (r=0.34 [95% CI 0.21–0.46]), safety concerns (r=-0·31 [95% CI -0.41–-0.16]), HPV vaccine awareness (r=0.24 [95% CI 0.19–0.29]), health insurance for HPV vaccine (r=0.23, [95% CI 0.06–0.39]), belief in vaccines (r=0.21 [95% CI 0.07–0.34]) and perceived HPV vaccine benefits (r=0.11 [95% CI 0.06–0.17]). Significant moderation effects were found for child gender; physician recommendation and parent preventive check-up were associated with higher likelihood of uptake for girls than boys.

Conclusions: This meta-analysis highlights the importance of physician recommendation to HPV vaccine uptake, and suggests the need to increase recommendations for boys, in particular. Public health campaigns to promote parents’ HPV vaccine awareness and perceived benefits, and dispel undue safety concerns, and broadening insurance coverage for HPV vaccination may increase parents’ uptake of HPV vaccines for their children.

Abstract: Parents' Uptake of HPV Vaccines for Children: A Systematic Review and Meta-Analysis (Society for Prevention Research 24th Annual Meeting)

18 Parents' Uptake of HPV Vaccines for Children: A Systematic Review and Meta-Analysis