"I Just Signed": Factors Influencing Decision-Making for School-Based HPV Vaccination of Adolescent Girls

• Published in: Health psychology 2010-11, Vol.29 (6), p.618-625
• Main Authors: Cooper Robbins, Spring Chenoa, Bernard, Diana, McCaffery, Kirsten, Brotherton, Julia M. L, Skinner, S. Rachel
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Biological and medical sciences; Cognition. Intelligence; Decision Making; Decision making. Choice; Faculty; Female; Focus Groups; Fundamental and applied biological sciences. Psychology; Girls; Health Knowledge, Attitudes, Practice; Human; Human Females; Human Papillomavirus; Human papillomaviruses; Humans; Immunization; Medical sciences; Mental health; Mothers; Narration; New South Wales; Papillomavirus Infections - prevention & control; Patient Acceptance of Health Care; Prevention. Health policy. Planification; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Psychopathology. Psychiatry; School based; School Based Intervention; School Health Services - utilization; School Nursing; Schools; Social psychiatry. Ethnopsychiatry; Vaccination - utilization
• ISSN: 0278-6133; 1930-7810
• DOI: 10.1037/a0021449

Objectives: Australia was one of the first countries to implement a nationwide program providing HPV vaccination to girls at school. To date, there are no published studies describing decision-making processes and behavior postimplementation of HPV vaccination of adolescents participating in a school-based program. Design: A purposive sample of nine schools was selected to reflect a range of vaccination coverage and school types. Semistructured focus groups with girls and interviews with parents, teachers, and immunization nurses ( n = 185) were conducted until saturation was reached. Transcripts were analyzed inductively and emergent themes were subject to constant comparison. Main Outcome Measures: Explanatory model of decision-making in HPV vaccination. Results: An explanatory model of decision-making and behavior was constructed from the data. Five decision-making states emerged across a continuum of vaccination behavior: active decision-vaccinated, passive decision- vaccinated, passive decision- not vaccinated, active decision- not vaccinated, and antivaccination. A range of factors influenced participants in each decision-behavior state. Adolescents were often part of the decision-making process. Where adolescents were not involved, nonagreement sometimes occurred. Conclusion: We have presented a variety of paths girls and their parents experience regarding decision-making and behavior in HPV vaccination. Attitudes, past experiences, and worldviews contributed to this process.