title: Health care decision making by mothers for their adolescent daughters regarding the quadrivalent HPV vaccine.
abstract: OBJECTIVE
  In this study we sought to understand the predictors of a mother's decision (behavior) to vaccinate her daughter with the initial dose of the HPV vaccine.
  
  
  METHODS
  This prospective, cross sectional study involved a convenience sample of 68 mother-daughter dyads recruited to test the hypothesis that the Theory of Planned Behavior (TPB) variables (attitudes toward vaccine, perception of others' opinions, and perceived difficulty in obtaining vaccine) would explain a mother's decision to consent for her daughter to receive the first dose of the HPV vaccine.
  
  
  METHODS
  Mothers and daughters independently completed survey instruments that measure the variables of the TPB (attitude, subjective norms, and perceived behavioral control). Instruments also included measures of parenting style and conflict.
  
  
  RESULTS
  The mother's intention to vaccinate was predicted by her attitude (β = .41, P < .001), subjective norms (β = .33, P = .002), and perceived behavioral control (β = .24, P = .005). The pathway connecting intention to the decision (yes or no) to vaccinate was significant (β = .41, P < .001). Squared multiple correlations for intention and decision, respectively, were .68 and .12. The mothers who chose to vaccinate their daughter did not differ on any of the demographic variables from those who chose not to vaccinate but had significantly different scores on attitude, subjective norms, and intention but not perceived behavioral control.
  
  
  CONCLUSIONS
  The TPB model demonstrates potential influences on a mother's intention to choose to initiate the HPV vaccination series for her daughter. Influences of attitude, subjective norms and perceived control are potential targets for interventions and tailored social marketing to improve vaccine acceptance.
authors.affiliation: Department of Obstetrics, Gynecology & Women's Health, University of Louisville, Louisville, KY 40202, USA. Paige.Hertweck@Nortonhealthcare.org
authors.forename: S Paige
authors.initials: SP
authors.lastname: Hertweck
authors.forename: A Scott
authors.initials: AS
authors.lastname: LaJoie
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Pinto
authors.forename: Laura
authors.initials: L
authors.lastname: Flamini
authors.forename: Tania
authors.initials: T
authors.lastname: Lynch
authors.forename: M Cynthia
authors.initials: MC
authors.lastname: Logsdon
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D006801:Humans; D033182:Intention; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D009679:Nuclear Family; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D011446:Prospective Studies; D011582:Psychological Theory; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000523:psychology*
chemical_list: D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D053918:Papillomavirus Vaccines