title: Facilitators and barriers HPV unvaccinated girls after 5 years of program implementation.
abstract: Understanding perceptions and characteristics of human papillomavirus (HPV) vaccinated and non-vaccinated girls can inform communication activities and vaccine delivery strategies. The purpose of this study was to evaluate knowledge and factors associated with HPV unvaccinated girls after five years of vaccination program implementation in Sicily, an Italian region with low vaccination coverage (<50.0%). A cross-sectional study was conducted through a questionnaire designed to assess knowledge and vaccination status of girls of 1997, 1998, 1999, and 2000 birth cohorts. The sample consisted of 350 girls who attended three high schools. Multivariable logistic regression analysis was conducted to examine predictors of vaccine refusal. The survey sample of girls shows that the 43.1% were HPV unvaccinated. A significant increased risk of being unvaccinated originated from the belief that the vaccine was too new (AdjOR = 21.08, CI95% = 2.57-172.97) and that it may cause cervical cancer (AdjOR = 4.36, CI95% = 1.26-15.07), along with having friends as a source of information on the vaccine (AdjOR = 3.67, CI95% = 1.63-8.25). A significant inverse association was observed between being unvaccinated and having Pediatrician/General practitioner as a source of information on HPV vaccine (AdjOR = 0.40, CI95% = 0.24-0.68). Many girls lack the fundamental knowledge about the HPV vaccine. The key issue is the promotion and implementation of information programs to raise awareness of girls on the importance of the vaccine.
authors.affiliation: a Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro"; University of Palermo; Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Firenze
authors.forename: Maria Grazia Laura
authors.initials: MG
authors.lastname: Marsala
authors.forename: Valentina
authors.initials: V
authors.lastname: Bonanno
authors.forename: Marianna
authors.initials: M
authors.lastname: Maranto
authors.forename: Clara
authors.initials: C
authors.lastname: Ferrara
authors.forename: Lucia
authors.initials: L
authors.lastname: Giovannelli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Restivo
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012802:Sicily; D013334:Students; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV infection knowledge; HPV vaccination barriers; HPV vaccination knowledge; HPV vaccine efficacy; HPV vaccine security; Pediatrician/General Practitioner as source of information; friends as source of information