The objective of this study is to identify psychological, behavioral, and environmental factors associated with parents' attitudes regarding the acceptability of sexually transmitted infection (STI) immunization for their adolescent children. STI to be examined include hepatitis , gonorrhea, chlamydia, herpes, human papillomavirus, and human immunodeficiency virus. Subjects will be parent-adolescent pairs who are seeking health care at one of two urban community adolescent health clinics. Adolescents who use the clinics are 53% African-American, 42% non-Hispanic white, and 75% female. This research will have implications for the design of future interventions to increase rates of STI immunization among adolescents, a group likely to be targeted for future STI vaccine programs. The first specific aim is to assess the association of parental health beliefs to acceptability of STI immunization for adolescents. The Health Belief Model (HBM) will be used to guide the development of predictors of STI immunization. The Health Belief Model (HBM) will be used to guide the development of predictors of STI immunization. HBM factors include perceptions of: susceptibility, severity, benefits, and barriers (including environmental barriers).
The second aim i s to evaluate how certain key characteristics of STI immunization may influence parents' ratings of acceptability. Characteristics will include, but not be limited to, vaccine efficacy, vaccine cost, and whether a physician has specifically recommended that the adolescent child receive the vaccine.
The third aim i s to evaluate the concordance between parents' acceptance of STI immunization with the adolescents actual STI-related risk behaviors. During phase one (year one of the proposed plan), 40 parent-adolescent pairs (adolescents 12-17 years of age) will be recruited. Individual interviews with 40 parents will be used to develop a self-administered questionnaire (SAQ) based on the HBM, and conjoint analysis methodology (a technique particularly suited to evaluation of vaccine characteristics). Adolescents will complete behaviorally oriented SAQs. Also during the first year, drafts of the parent questionnaire will be pilot-tested via in-person interviews with 10 parents. During phase two (years two through five), 30 adults will pilot test written versions of the SAQ, then 300 parent-adolescent pairs (adolescents 12-17 years of age) will be recruited from two adolescent health clinics during routine medical visits to complete SAQs. During both phase one and phase two, information from an electronic medical record system will be used to supplement information gained from the adolescent SAG in terms of history of STI. Outcome measures of interest include parental acceptance of STI immunization and relative acceptability of vaccines with different characteristics. The relationships of socio-demographics, health beliefs, and adolescent health behaviors to parental acceptance of STI immunization will be assessed with multiple linear regression. The relative importance of different vaccine characteristics in influencing vaccine acceptability will be evaluated with ratings-based,, full-profile conjoint analysis, an analytic technique often used in marketing research.
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