title: Adolescents' knowledge, beliefs, and behaviors regarding hepatitis B: Insights and implications for programs targeting vaccine-preventable diseases.
abstract: OBJECTIVE
  To gain a better understanding of adolescents' knowledge, beliefs, and behaviors regarding hepatitis B.
  
  
  METHODS
  Three types of data were collected as part of this investigation: (a) 45 in-depth individual interviews with staff from 20 adolescent health, sexually transmitted disease (STD), and family planning clinics; (b) 96 individual interviews with adolescents and young adults; and (c) questionnaires completed by 17,063 adolescents and young adults. All instruments focused on one or more of the following five topics: (a) knowledge about vaccines; (b) knowledge about hepatitis B; (c) barriers to vaccine acceptance, and ways to overcome these barriers; (d) benefits of the vaccine acceptance, and ways to enhance these benefits; and (e) eight hepatitis B risk factors. Interview data was analyzed using qualitative thematic note-based analyses. Survey data was analyzed using descriptive statistics and Chi-square tests.
  
  
  RESULTS
  Adolescents and young adults seen in these clinics know very little about vaccinations in general, or hepatitis B, in particular. Adolescents exhibit low levels of perceived susceptibility, severity, response efficacy, and self-efficacy toward hepatitis B and the hepatitis B vaccine. On average, these adolescents engage in 2.36 high-risk behaviors (the most frequent of which include sexual activity, body piercing, and tattooing). Those who were sexually active, had a tattoo, had a STD, or worked with blood were significantly more likely to begin the vaccination series.
  
  
  CONCLUSIONS
  There is a clear need for additional educational efforts regarding both vaccinations in general, and hepatitis B in particular. Though adolescents are engaging in a variety of high-risk behaviors, most perceive their risk to be low, and therefore many are not taking the necessary precautions to protect themselves.
authors.affiliation: Michigan Public Health Institute, Okemos, Michigan, USA.
authors.forename: Amy B
authors.initials: AB
authors.lastname: Slonim
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Roberto
authors.forename: Christi R
authors.initials: CR
authors.lastname: Downing
authors.forename: Inez F
authors.initials: IF
authors.lastname: Adams
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Fasano
authors.forename: Loretta
authors.initials: L
authors.lastname: Davis-Satterla
authors.forename: Mark A
authors.initials: MA
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001294:Attitude to Health; D046288:Body Piercing; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006509:Hepatitis B / Q000517:prevention & control* / Q000635:transmission*; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D020380:Needs Assessment; D012307:Risk Factors; D012309:Risk-Taking; D020377:Self Efficacy; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases; D013653:Tattooing
chemical_list: D017325:Hepatitis B Vaccines