The human papillomavirus (HPV) is the necessary cause of virtually all cervical cancers and many anal cancers, and is also a noted cause of several other cancers. Effective vaccines are available to prevent HPV infection and are routinely recommended for adolescents. Unfortunately, vaccination rates remain low. Strategies aimed at improving vaccination rates have focused on increasing parental intentions to vaccinate. However, intention rates to vaccinate have been found to be higher than actual rates of vaccination;in our own on-going intervention study to promote HPV vaccination, exactly half of the parents who expressed intent to vaccinate actually initiated HPV vaccination for their adolescent. Thus any strategies aimed solely at increasing intentions may fall short of the desired goal. The gap between intentions and initiation of HPV vaccination may in part be explained by the way intent has been measured within the literature. The current categorical one snapshot in time method may not capture fluctuations in intent nor strength of intent. The discordance between intention and initiation of HPV vaccination could also result from procrastination, a behavior thought to be influenced by certain personality traits (e.g., conscientiousness), affect (e.g., anticipated regret), executive functioning abilities (e.g., planning, organization, and working memory), and competing factors (e.g., actual environmental barriers). Therefore, the specific aim of this proposal will be to explore reasons for the gaps between parental intentions and initiation of HPV vaccination, including 1) strength/stability of the parental HPV vaccine intention construct and 2) procrastination and factors that influence procrastination.
This aim will be accomplished by recruiting participants from a sample of parents who previously participated in an on-going brief message intervention study to promote HPV vaccination. Parents will be categorized into one of 6 categories based on their HPV vaccine intentions and initiation of HPV vaccination recorded in the on-going study. Qualitative interviews will explore reasons for the gap between intentions and initiation by inquiring about strength and stability of intentions and factors that may influence procrastination of vaccination (e.g., conscientiousness, anticipated regret, planning, organization, working memory, and actual environmental barriers).

Public Health Relevance

The human papillomavirus is the most common sexually transmitted infection in the United States and is the most frequent cause of cervical and anal cancers and genital warts. Thus, a public health priority is to increase uptake of the HPV vaccine, a very effective strategy for preventing HPV infection. The proposed study, which will examine reasons for the gap between parental intentions to vaccinate and actual initiation of HPV vaccination, will inform development of intention measures within the vaccine field and aid in the design of specifically tailored intervention strategies/messages to increase HPV vaccination rates, thereby providing greater vaccination coverage and protection for all against HPV-infection associated illnesses, including cervical and anal cancers.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Small Research Grants (R03)
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Special Emphasis Panel (ZCA1)
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Kobrin, Sarah
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University of Texas Medical Br Galveston
Schools of Medicine
United States
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