title: Mothers' screening histories influence daughters' vaccination uptake: an analysis of linked cervical screening and human papillomavirus vaccination records in the North West of England.
abstract: OBJECTIVE
  Achieving high human papillomavirus (HPV) vaccine coverage is important because cervical screening coverage is declining. As key decision makers, mothers' experiences of, and participation in, the cervical screening programme could affect vaccination consent. We investigate whether mother's screening history influences daughter's participation in the HPV vaccination programme.
  
  
  METHODS
  Mothers' cervical screening records from the National Health Authority Information System were linked to the daughters' HPV vaccination records from the Child Health System in North West England by address. Odds ratios for daughter's vaccination were computed using Logistic Regression, adjusting for age, Primary Care Trust and vaccine cohort (AOR).
  
  
  RESULTS
  Daughters in both the routine and catch up programmes were more likely to have initiated vaccination and completed the course if their mothers had attended screening. The association was strongest when mothers had attended within the last 5 years (AOR in routine group: 3.5 (95% confidence interval (CI) 3.1-4.0) for initiation and 2.2 (1.6-2.9) for retention). Mothers who had personally decided to cease screening were less likely to have vaccinated daughters than those who had ceased for medical indications. Daughters were more likely to have been vaccinated if their mothers had received an abnormal smear result.
  
  
  CONCLUSIONS
  Daughter's HPV vaccination uptake was associated with mother's cervical screening attendance. Daughters of mothers who are not engaged with preventive services are less likely to be vaccinated and may be less likely to engage with screening. This makes mothers central to health interventions to promote both cervical screening and HPV vaccination.
authors.affiliation: Manchester Urban Collaboration on Health, Institute of Population Health, Manchester Academic Health Sciences Centre, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, United Kingdom. angela.pilkington@manchester.ac.uk
authors.forename: Angela M
authors.initials: AM
authors.lastname: Spencer Nee Pilkington
authors.forename: Loretta
authors.initials: L
authors.lastname: Brabin
authors.forename: Arpana
authors.initials: A
authors.lastname: Verma
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Roberts
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004739:England; D005260:Female; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D009313:National Health Programs / Q000706:statistics & numerical data; D009679:Nuclear Family / Q000523:psychology*; D027383:Papillomaviridae / Q000276:immunology; D030361:Papillomavirus Infections / Q000276:immunology* / Q000517:prevention & control / Q000821:virology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage / Q000276:immunology*; D010342:Patient Acceptance of Health Care / Q000523:psychology; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000517:prevention & control / Q000821:virology; D014611:Vaccination / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D053918:Papillomavirus Vaccines