title: 'I didn't even know boys could get the vaccine': Parents' reasons for human papillomavirus (HPV) vaccination decision making for their sons.
abstract: OBJECTIVE
  The study's objective was to examine parents' reasons for their decision to vaccinate their 9-16-year-old sons with the human papillomavirus (HPV) vaccine.
  
  
  METHODS
  Using the precaution adoption process model (PAPM), parents were classified according to one of six stages of decision making: unaware, unengaged, undecided, decided not to vaccinate, decided to vaccinate, or vaccinated. Parents responded to an open-ended question: 'What would influence your decision to have your son vaccinated or not against HPV?'
  
  
  RESULTS
  Three thousand one hundred and seventeen parents provided 2,874 interpretable narrative responses that were coded using thematic content analyses. The majority of parents were in the earlier precaution adoption process model stages, that is, unaware that the HPV vaccine could be given to boys (57.0%), unengaged (20.9%), or undecided (9.1%). Needing more information, vaccine cost, risks associated with vaccination, and wanting a doctor's recommendation influenced these earlier-staged parents' decisions. Parents who decided not to vaccinate their sons (6.8%) reported their decision was due to the risks, insufficient research, lack of confidence in vaccines, and/or no need for the vaccine (as their sons are not sexually active and/or too young). Parents who had decided to vaccinate their sons (5.0%) or who had vaccinated their sons (1.1%) reported that their decisions were based on protecting their sons' health and preventing disease.
  
  
  CONCLUSIONS
  There are important differences in the factors that influence parents' decision depending on where they are along the decision-making trajectory. Assuring that parents are well informed about the importance of male vaccination, reducing vaccine cost, accurately communicating vaccine safety, and improving patient-provider communication may augment vaccine coverage and prevent HPV-associated cancers in Canada. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Psychology, McGill University, Montreal, QC, Canada.|Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.
authors.forename: Samara
authors.initials: S
authors.lastname: Perez
authors.affiliation: Department of Psychology, McGill University, Montreal, QC, Canada.|Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.
authors.forename: Gilla K
authors.initials: GK
authors.lastname: Shapiro
authors.affiliation: Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Brown
authors.affiliation: Institut National de Santé Publique du Québec, Québec, QC, Canada.
authors.forename: Eve
authors.initials: E
authors.lastname: Dube
authors.affiliation: Clinical Prevention Services, BC Centre for Disease Control, Vancouver, BC, Canada.|School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Gina
authors.initials: G
authors.lastname: Ogilvie
authors.affiliation: Department of Psychology, McGill University, Montreal, QC, Canada.|Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.|Louise Granofsky Psychosocial Oncology Program, Segal Cancer Center, Jewish General Hospital, Montreal, QC, Canada.|Department of Psychiatry, McGill University, Montreal, QC, Canada.|Department of Oncology, McGill University, Montreal, QC, Canada.
authors.forename: Zeev
authors.initials: Z
authors.lastname: Rosberger