title: Parental acceptance of human papillomavirus (HPV) vaccination in Indonesia: a cross-sectional study.
abstract: BACKGROUND
  Cervical cancer ranks the second most frequent cancer in Indonesian women. In Indonesia, human papillomavirus (HPV) vaccine acceptance has not been studied before.
  
  
  OBJECTIVE
  To determine parental HPV vaccine acceptance in Indonesia, and factors that influence their decision. Factors include sociodemographic factors, knowledge of HPV, HPV vaccination and cervical cancer, health beliefs about cervical cancer, and attitudes towards vaccination in general.
  
  
  METHODS
  746 parents, with at least 1 daughter aged 0-14, were interviewed using questionnaires based on published and adjusted interviews. Interviews were done in sub district public health centers, general governmental hospitals, and via house-visits, in 5 Indonesian provinces.
  
  
  RESULTS
  Parental HPV vaccine acceptance was 96.1%. Logistic regression revealed that age, beliefs regarding cervical cancer, and attitudes towards vaccination in general were significantly associated with HPV vaccine acceptance. Of the participants, 66.0%, 16.6%, and 15.8% had heard about cervical cancer, HPV, and HPV vaccination respectively. The mean total knowledge score was 1.91(Standard Deviation 2.31) on a 0-8 scale. Health beliefs about cervical cancer and attitudes towards vaccination in general were positive. Participants named the high cost of the vaccine, fear for side-effects, and chosen vaccination locations as possible barriers towards HPV vaccine implementation.
  
  
  CONCLUSIONS
  Parental HPV vaccine acceptance is high, but knowledge about HPV and cervical cancer is low. During HPV vaccination programs, focus should not only be on providing information, but also on existing beliefs and attitudes towards cervical cancer and vaccination in general. If HPV vaccination programs were to be implemented in Indonesia, the indicated barriers should be taken into account.
authors.affiliation: Leiden University Medical Center, Department of Gynaecology & Obstetrics, Postzone K-06-P16, P.O. Box 9600, 2300 RC Leiden, The Netherlands. loesjaspers@gmail.com
authors.forename: L
authors.initials: L
authors.lastname: Jaspers
authors.forename: S
authors.initials: S
authors.lastname: Budiningsih
authors.forename: R
authors.initials: R
authors.lastname: Wolterbeek
authors.forename: F C
authors.initials: FC
authors.lastname: Henderson
authors.forename: A A W
authors.initials: AA
authors.lastname: Peters
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007214:Indonesia; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010290:Parents; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D014611:Vaccination / Q000523:psychology*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines