title: Attitudes towards human papillomavirus vaccination among Arab ethnic minority in Denmark: A qualitative study.
abstract: BACKGROUND
  Knowledge regarding the human papillomavirus (HPV) and HPV vaccine uptake among ethnic minorities is poorly explored in Denmark. The objective of this study was to explore attitudes and knowledge towards HPV vaccination among Arab mothers and their daughters.
  
  
  METHODS
  Five Arabic-speaking focus groups with mothers of vaccine-eligible girls and three focus groups with daughters were conducted. The participants were recruited through different social clubs. A phenomenological approach was used to investigate attitudes and knowledge of HPV vaccination. Meaning condensation inspired by Amedeo Giorgi was used to analyse the transcribed material.
  
  
  RESULTS
  A total of 23 women and 13 daughters were included in this study. The mothers' knowledge regarding HPV was limited to the fact that HPV can cause cervical cancer. Two focus groups mentioned that HPV is a sexually transmitted disease and none of the mothers knew that HPV also causes genital warts. Both mothers and daughters acknowledged that the daughters have deeper insight into health-related issues. A gap of knowledge between generations was identified, as mothers and daughters obtained health information from different sources: mothers used the Arabic TV channels as a source of knowledge and daughters had a range of sources, e.g. school, internet, and Western TV channels. The consequence of these differences in obtaining knowledge is that mothers and daughters lack a common language to discuss health issues. Mothers were influenced by Arabic society, while daughters had created a hybrid of Arabic and Danish. Each generation had its own reasons for accepting the vaccine. The level of HPV knowledge and awareness did not affect their uptake decision in that all the participating mothers had accepted the vaccine for their daughters.
  
  
  CONCLUSIONS
  Educational programs should target both mothers and daughters because mothers have an inadequate knowledge about HPV. This is likely to bridge the gap of knowledge between mothers and daughters, which constitutes a barrier between the generations.
authors.affiliation: Migrant Health Clinic, Odense University Hospital, Denmark Center for Global Health, University of Southern Denmark, Odense, Denmark Lina.zeraiq@rsyd.dk.
authors.forename: Lina
authors.initials: L
authors.lastname: Zeraiq
authors.affiliation: Migrant Health Clinic, Odense University Hospital, Denmark Center for Global Health, University of Southern Denmark, Odense, Denmark.
authors.forename: Dorthe
authors.initials: D
authors.lastname: Nielsen
authors.affiliation: Migrant Health Clinic, Odense University Hospital, Denmark Center for Global Health, University of Southern Denmark, Odense, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Sodemann
mesh_terms: D000293:Adolescent; D018912:Arabs / Q000523:psychology* / Q000706:statistics & numerical data; D002648:Child; D003718:Denmark; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D008913:Minority Groups / Q000523:psychology* / Q000706:statistics & numerical data; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D009679:Nuclear Family / Q000208:ethnology* / Q000523:psychology; D030361:Papillomavirus Infections / Q000208:ethnology* / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D036301:Qualitative Research
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV vaccination; Human papillomavirus; cervical cancer; ethnic minorities; knowledge