title: Factors influencing adolescent girls' decision in initiation for human papillomavirus vaccination: a cross-sectional study in Hong Kong.
abstract: BACKGROUND
  Cervical cancer is one of the common cancers among women worldwide. Despite HPV vaccination being one of the effective preventive measures, it is not included in government vaccination programme in Hong Kong. This study aimed to assess the knowledge of and attitude towards cervical cancer prevention among Chinese adolescent girls in Hong Kong, and to identify factors influencing the initiation of HPV vaccination.
  
  
  METHODS
  This was a cross-sectional study conducted in Hong Kong during the period of October 2010 to November 2010. A self-administered questionnaire was used, with 1,416 girls from 8 secondary schools completing the questionnaire. Knowledge scores were composited and initiation of HPV vaccination was staged based on stage of change. Analyses were conducted to identify the association of initiation of HPV vaccination with participant's personal and family factors as well as their knowledge and attitude towards cervical cancer prevention.
  
  
  RESULTS
  The uptake rate of HPV vaccination was low (7%) with 58% respondents in pre-contemplation and contemplation stage. The survey identified a significant gap in knowledge on cervical cancer prevention. The main channels of information were from media and very few from schools or parents. However, 70% expressed their wishes to have more information on cancer prevention, and 78% stated that they were willing to change their lifestyles if they knew the ways of prevention. Multivariate analysis identified three independent significant factors for initiation of vaccination (action and intention): perceived cancer as terrifying disease, school should provide more information on cancer prevention, and comments from relatives and friends having received the vaccine. The cost of vaccination and socio-economic background were not found to be significant.
  
  
  CONCLUSIONS
  Public education on cervical cancer needs to be well penetrated into the community for more sharing among friends and relatives. School as setting to provide source of information would facilitate uptake rate of HPV vaccine as students have expressed their wishes that school should provide more information on prevention of cancer. School and community education on cancer prevention would help adolescents to have better understanding of the seriousness of cancer.
authors.affiliation: Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, 4th Floor Lek Yuen Health Centre, Shatin, New Territory, Hong Kong. alee@cuhk.edu.hk.
authors.forename: Albert
authors.initials: A
authors.lastname: Lee
authors.forename: Mandy
authors.initials: M
authors.lastname: Ho
authors.forename: Calvin Ka Man
authors.initials: CK
authors.lastname: Cheung
authors.forename: Vera Mei Wen
authors.initials: VM
authors.lastname: Keung
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D044466:Asian People / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D017589:Immunization Programs; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012574:Schools; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D053918:Papillomavirus Vaccines