title: Determinants of HPV vaccination intentions among Dutch girls and their mothers: a cross-sectional study.
abstract: BACKGROUND
  The Dutch government recently added universal Human Papilloma Virus (HPV) vaccination for 12-year-old girls to the existing national immunization program. The participation rate for the initial catch-up campaign for girls aged 13 to 16 years in 2009 was lower (47%) than expected (70%). To inform future HPV information campaigns, this paper examines the social and psychological determinants of the HPV vaccination intentions of girls aged 13 to 16 years and their mothers who were targeted by the Dutch catch-up campaign of 2009.
  
  
  METHODS
  A random sample of girls and their mothers was chosen from the Dutch vaccination register and received a letter inviting them to participate (n = 5,998 mothers and daughters). In addition, a random sample was recruited via an online panel by a marketing research company (n = 650 mothers; n = 350 daughters). Both groups were asked to complete a web-based questionnaire with questions on social demographic characteristics, social-psychological factors and HPV vaccination intention. Backward linear regression analyses were conducted to examine which social-psychological factors were most dominantly associated with vaccination intention.
  
  
  RESULTS
  Data from 952 mothers (14%) and 642 daughters (10%) were available for the intended analyses. The contribution of social demographic variables to the explained variance of HPV vaccination intention was small but significant for mothers (ΔR² = .01; p = .007), but not significant for daughters (ΔR² = .02; p = .17) after controlling for HPV vaccination uptake and the sample. In addition, social-psychological determinants largely contributed to the explained variance of HPV vaccination intention of mothers (ΔR² = .35; p < .001) and daughters (ΔR² = .34; p < .001). Attitudes, beliefs, subjective norms and habit strength were significantly associated with participants' HPV vaccination intentions.
  
  
  CONCLUSIONS
  Because of the large contribution of social-psychological variables to the explained variance of HPV vaccination intentions among the mothers and daughters, future communication strategies targeting HPV vaccination uptake should address attitudes, beliefs, subjective norms and habit strength. There is a need for longitudinal research to confirm the causality of the association between these determinants and HPV vaccination behavior indicated by this study.
authors: TNO (Netherlands Organization for Applied Scientific Research), Expertise Center Life Style, PO Box 2215, Leiden, 2301 CE, the Netherlands. hilde.vankeulen@tno.nl
authors: Hilde M
authors: HM
authors: van Keulen
authors: Wilma
authors: W
authors: Otten
authors: Robert A C
authors: RA
authors: Ruiter
authors: Minne
authors: M
authors: Fekkes
authors: Jim
authors: J
authors: van Steenbergen
authors: Elise
authors: E
authors: Dusseldorp
authors: Theo W G M
authors: TW
authors: Paulussen
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D008875:Middle Aged; D009018:Morocco / Q000208:ethnology; D009035:Mothers / Q000523:psychology*; D009426:Netherlands; D009427:Netherlands Antilles / Q000208:ethnology; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D012067:Religion; D012189:Retrospective Studies; D013532:Suriname / Q000208:ethnology; D011795:Surveys and Questionnaires; D014421:Turkey / Q000208:ethnology; D014611:Vaccination / Q000523:psychology*
chemical_list: D053918:Papillomavirus Vaccines
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