A Sociocultural Perspective of HPV Vaccine-Related Decision Making Among Immigrant Mothers in the United States.

Abstract

Purpose: The U.S. immigrants are at high risk for human papillomavirus (HPV) infection and death from HPV-related diseases. Children of immigrants have lower HPV vaccine initiation and completion rates compared to children of U.S.-born parents. Previous research suggests that sociocultural factors may play a role in these disparities, but this is still largely understudied. This study examines the relationship between sociocultural factors and immigrant mothers' HPV vaccine-related decision-making.

Methods: An online survey was administered to 272 immigrant women (18+ years) residing in the United States with children ages 9-25 years. Multivariate logistic regression was employed to determine sociocultural predictors (i.e., acculturation) of HPV vaccine initiation and refusal. We also examined the relationship between HPV vaccination behaviors and vaccine-related decision-making in immigrant households.

Results: Immigrant mothers who had a greater orientation toward their home culture were less likely to initiate HPV vaccination for their children (odds ratio [OR] = 0.92; 95% CI [0.87, 0.98]). Mothers who made vaccination decisions for their families either solely (OR = 0.37; 95% CI [-0.99, 0.47]) or jointly with their partners (OR = 0.24; 95% CI [-1.42, 0.46]) were less likely to refuse HPV vaccination for their children compared to mothers who relied solely on their partners to make these decisions. Lastly, mothers who were more adapted to the United States were more likely to make vaccination decisions jointly with their partners (OR = 1.03; 95% CI [1.01, 1.06]).

Discussion: Findings show that acculturation and decision-making processes in immigrant households are significantly associated with HPV vaccination. Culturally appropriate interventions that address both partners' perceived barriers to HPV vaccination are needed.