The effects of vaccine characteristics on adult women's attitudes about vaccination: a conjoint analysis study.

The number of current and future vaccines for adults has been steadily increasing. Yet, vaccine coverage rates for adult vaccinations have historically been low, and less is known about how adults in the mid-adult age range make vaccine decisions for themselves. The purpose of this study was to assess which vaccine characteristics affect vaccine decision-making among mid-adult women. Adult women, aged 27-55 (n=258) rated 9 hypothetical vaccine scenarios, each of which was defined along 4 dimensions: mode of transmission (STI or non-STI), severity of infection (curable, chronic, or fatal), vaccine efficacy (50%, 70%, or 90%), and availability of behavioral methods for prevention (available or not available). Ratings ranged from 0 to 100. Conjoint analysis was used to assess the effect of relative preferences for the vaccine scenario characteristics on participant ratings of scenarios. The mean vaccine scenario rating was 78.2. Nearly half (40%, n=104) of participants rated all nine scenarios the same, with the majority of those (84%) holding strongly positive views. Conjoint analysis of the other 154 participants who discriminated between scenarios indicated that the main drivers for vaccine acceptability were severity of the disease and the efficacy of the vaccine to prevent the disease. Mode of transmission and availability of a preventative behavioral measure did not play a significant role. Future studies should further assess how women's understanding of severity of the disease and efficacy of the vaccine to prevent disease may be useful for increasing vaccine acceptability.

Acceptability of the human papillomavirus vaccine among Latina mothers.

STUDY OBJECTIVE: To describe Latina mothers' acceptance of the human papillomavirus (HPV) vaccine for their daughters and explore their knowledge base regarding HPV-related issues. DESIGN: Individual interviews were conducted with a convenience sample of 40 Latina mothers of daughters 7-14 years old, from an urban, pediatric primary care clinic. Preliminary questions were asked regarding HPV knowledge and then information was verbally provided before exploring vaccine acceptance. RESULTS: Thirty-one of the Latina mothers had not heard of HPV and 34 were not aware of the connection between HPV and cervical cancer. Thirty-two mothers reported that they would allow their daughters to receive the HPV vaccine. Two overarching themes were identified as reasons for accepting the vaccine. The main theme for vaccine acceptance provided by 26 mothers was "to prevent disease." The other theme was "to protect" their child. Four mothers were undecided and 4 reported they would not vaccinate their daughter. The two themes identified from this group of mothers include not having sufficient information regarding the vaccine, and that their daughters are too young. CONCLUSION: Acceptance of the HPV vaccine was high in this sample of Latina mothers. The prevention of disease and the protection of their child were the motivating factors for vaccinating their daughters. Reasons for not accepting include lack of information and young age of daughter. The provision of information will be key to ensuring Latina mothers understand the rationale for vaccinating at a young age.

'What, me worry?': Parents' reasons for worry and nonworry about adolescent risk for sexually transmitted infections (STI).

Little is known about the bases of parental worry about adolescents' risk for acquiring a sexually transmitted infection (STI). Parents (N = 247) of adolescents 12-17 years endorsed reasons that explained their worry or nonworry. Parents' past experience of an STI, perception of the child's sexual activity, and racial self-identification were predictors of worry. Cluster analyses identified five groups of worriers and four groups of nonworriers. Worriers tended to select reasons reflecting an external parental locus of control or child-specific reasons. Nonworriers endorsed reasons consistent with internal parental locus of control. Findings suggest that preventive health communication should be tailored to parents' perceptions of risk and protective factors.

Acceptability to Latino parents of sexually transmitted infection vaccination.

OBJECTIVE: To evaluate the acceptability to Latino parents of having their adolescent children vaccinated against sexually transmitted infections, and to identify potential demographic correlates of acceptability. METHODS: We applied established methodology to a sample of 119 Latino parents who accompanied their children (51% female, aged 12-17 years) to medical appointments. The parents used computer-based questionnaires to rate 9 hypothetical vaccine scenarios. The scenarios had 4 dimensions: mode of transmission (sexually transmitted or not sexually transmitted), severity of infection (curable, chronic, or fatal), vaccine efficacy (50%, 70%, or 90%), and availability of behavioral methods for prevention (available or not available). Willingness by parents to vaccinate their adolescents under each vaccine scenario was assessed on a scale (range, 0-100). Conjoint analysis was used to determine the relative contribution of each dimension to the ratings. RESULTS: The study sample consisted of predominantly Mexican immigrant parents, 94% of whom chose to complete the Spanish version of the computerized interview. The mean value of the parents' willingness to accept vaccination for their adolescent children was exceptionally high. For example, the mean score of the Latino parents for the 6 sexually transmitted infection (STI) vaccine scenarios (score 86.2; SD 21.1) was far higher than the mean score in previous studies (81.3, SD 21.1). Conjoint analysis revealed that the dimensions of vaccine efficacy and severity of infection were equal in terms of their influence on vaccine ratings for the Latino parents. The next most influential dimension on vaccine ratings was the availability of behavioral prevention, followed by the sexual transmissibility of the infection. CONCLUSIONS: Our sample of predominantly Mexican parents was accepting of the concept of STI vaccination for their adolescent children. Important issues for parents include vaccine efficacy and severity of infection, followed by vaccines for infections that had no method of behavioral prevention available. Overall, there is little difference in the relative preference of a STI versus non-STI vaccine for their adolescent children.

Prevalence and risk factors for hepatitis C virus infection among adolescents in detention.

OBJECTIVE: To assess the prevalence and correlates of hepatitis C virus infection in a sample of detained adolescents. DESIGN/SETTING/PARTICIPANTS: Cross-sectional prevalence study with 10- to 18-year-old adolescents who were consecutively admitted to a juvenile detention center in San Antonio, Tex. MAIN OUTCOME MEASURES: The prevalence of hepatitis C virus infection and associated risk factors. RESULTS: Of the 1002 participants, 75% were Hispanic and the mean age was 15 years. Twenty adolescents had laboratory data consistent with hepatitis C virus infection, giving an overall prevalence of 2.0% (95% confidence interval, 1.2-3.1). All adolescents infected with hepatitis C virus were Hispanic (13 boys and 7 girls). Although a high proportion of the participants reported having had intranasal drug use (55.6%), tattooing (50.5%), or body piercing (25.3%), the only factor significantly associated with hepatitis C virus infection was having a history of injection drug use. Injection drug use was reported by 5.3% of the participants but by 95% (19/20) of those infected with the hepatitis C virus. CONCLUSIONS: This study indicates that injection drug use was linked with the majority of hepatitis C virus infections in this population of detained adolescents, similar to findings in adults. These adolescents reported a high frequency of other behaviors that could potentially pose a risk for contracting bloodborne infections. Effective prevention and awareness programs in a detention setting need to be comprehensive and include screening, hepatitis A and B immunizations, and risk-reduction counseling.

Predictors of STI vaccine acceptability among parents and their adolescent children.

PURPOSE: To identify attitudes and behavioral factors associated with parental intent to vaccinate their adolescent children against sexually transmitted infections (STI) and adolescent intent to accept vaccination for the prevention of STI. METHODS: In this cross-sectional study, 320 parents and their adolescent children (aged 12-17 years) were recruited from urban adolescent health clinics and private practice pediatric offices to complete audio, computer-assisted self-interviews (A-CASI). Parents and their adolescents were asked about acceptability of gonorrhea, genital herpes, and human immumodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) vaccines. These three items were summed to create an STI vaccine acceptability scale, the primary outcome variable. Potential predictors measured included health beliefs, sociodemographic factors, and health and sexual behaviors. RESULTS: A substantial majority of parents and their adolescent children rated the three STI vaccines as very acceptable. Parental health beliefs and parental history of STI diagnosis were significant independent predictors of intent to vaccinate adolescent children against STI. Parental intent to vaccinate and having a friend who had engaged in sexual intercourse were significant independent predictors of adolescents' intent to accept STI vaccination. CONCLUSIONS: The majority of these parents and their adolescent children found STI vaccination very acceptable, suggesting that there will be great interest in these vaccines once they become available. Interventions designed to address parental health beliefs may prove successful at maintaining or increasing interest in STI vaccines. Adolescents are likely to look to their parents for guidance around acceptance of these vaccines, but personal experiences also may play a role.