title: Human papillomavirus vaccine initiation among adolescent girls in high-risk communities.
abstract: BACKGROUND
  We assessed human papillomavirus (HPV) vaccine uptake among adolescent girls, parents' intentions to vaccinate daughters, and barriers and facilitators of vaccination in a population at elevated risk for cervical cancer.
  
  
  METHODS
  Between October 2007 and June 2008, telephone surveys were conducted with randomly selected parents/guardians of 11-18 year old girls attending public middle and high schools serving economically disadvantaged populations in Los Angeles County.
  
  
  RESULTS
  We surveyed 509 predominantly Hispanic (81%) and African American (16%) parents; 71% responded in Spanish. Overall, 23% reported their daughter had received ≥ 1 dose of HPV vaccine. Although 93% of daughters had seen a doctor in the past year, only 30% reported that a provider recommended HPV vaccine. Characteristics positively associated with odds of having initiated HPV vaccine were having heard of the vaccine (adjusted odds ratio [aOR] 2.6), belief in vaccine effectiveness (aOR 2.9), and doctor recommendation (aOR 48.5). Negative attitudes toward HPV vaccine (aOR 0.2) and needing more information about it (aOR 0.1) were negatively associated with vaccine initiation. Of those with unvaccinated daughters (n=387), 62% said they "probably/definitely will" vaccinate within the next year and 21% were undecided or didn't know; only 11% said they definitely won't.
  
  
  CONCLUSIONS
  About one-quarter of adolescent girls in this at-risk community had initiated HPV vaccine by mid-2008. Provider recommendation was the single most important factor associated with vaccination. Because a substantial proportion of parents remain undecided about HPV vaccine, health care providers can play a key role by providing needed information and offering HPV vaccine to all eligible adolescents.
authors.affiliation: Los Angeles County Department of Public Health, 2615 S. Grand Ave., Los Angeles, CA 90007, USA. sguerry@ph.lacounty.gov
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Guerry
authors.forename: Christine J
authors.initials: CJ
authors.lastname: De Rosa
authors.forename: Lauri E
authors.initials: LE
authors.lastname: Markowitz
authors.forename: Susan
authors.initials: S
authors.lastname: Walker
authors.forename: Nicole
authors.initials: N
authors.lastname: Liddon
authors.forename: Peter R
authors.initials: PR
authors.lastname: Kerndt
authors.forename: Sami L
authors.initials: SL
authors.lastname: Gottlieb
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006306:Health Surveys; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010290:Parents; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011204:Poverty Areas; D012307:Risk Factors; D014611:Vaccination; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines