title: Factors associated with parents' attitudes to the HPV vaccination of their adolescent sons : A systematic review.
abstract: The objective of the study was to identify factors associated with human papilloma virus (HPV) vaccine acceptability in parents of adolescent boys. This information is critical to the development of approaches to optimise HPV vaccine uptake among this population group.
  
  
  
  We performed a systematic search of the literature in addressing factors influencing parental attitudes to and beliefs about HPV vaccine and its acceptability for use. The findings were organised within the framework of the Health Belief Model (HBM) and summarised using a semi quantitative method.
  
  
  
  Eighteen studies met the inclusion criteria. Parental decisions were predominantly shaped by the perceived benefits of the vaccine; perceived risk of sons contracting the HPV infection, and having recommendations from health care providers. Fear of side effects and uncertainty about vaccine effectiveness, as well as cost and lack of healthcare, were barriers to HPV vaccination. Other factors such as knowledge, family characteristics, parent-child dialogue and egalitarian values appeared to be important when deciding whether to vaccinate boys.
  
  
  
  HPV vaccine uptake among male adolescents is suboptimal. Future programs need to address the predictors of uptake by educating parents about the boys' high susceptibility to infection, the benefits of vaccination, and reduce concerns regarding perceived barriers. Additionally, uptake may be facilitated by encouraging health care provider endorsement, particularly in countries without government-funded immunisation programs.
authors.affiliation: Flinders Centre for Innovation in Cancer, Flinders University, School of Medicine, GPO Box 2100, Adelaide SA 5001, Australia; Cancer Council SA, 202 Greenhill Road, Eastwood, SA 5063, Australia. Electronic address: gorjana.radisic@flinders.edu.au.
authors.forename: Gorjana
authors.initials: G
authors.lastname: Radisic
authors.affiliation: Flinders Centre for Innovation in Cancer, Flinders University, School of Medicine, GPO Box 2100, Adelaide SA 5001, Australia; Cancer Council SA, 202 Greenhill Road, Eastwood, SA 5063, Australia. Electronic address: Janine.chapman@flinders.edu.au.
authors.forename: Janine
authors.initials: J
authors.lastname: Chapman
authors.affiliation: Flinders Centre for Innovation in Cancer, Flinders University, School of Medicine, GPO Box 2100, Adelaide SA 5001, Australia; Cancer Council SA, 202 Greenhill Road, Eastwood, SA 5063, Australia. Electronic address: Ingrid.flight@flinders.edu.au.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Flight
authors.affiliation: Flinders Centre for Innovation in Cancer, Flinders University, School of Medicine, GPO Box 2100, Adelaide SA 5001, Australia; Cancer Council SA, 202 Greenhill Road, Eastwood, SA 5063, Australia. Electronic address: Carlene.wilson@flinders.edu.au.
authors.forename: Carlene
authors.initials: C
authors.lastname: Wilson
mesh_terms: D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs; D009679:Nuclear Family; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010290:Parents / Q000523:psychology*; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D053918:Papillomavirus Vaccines
keywords: Adolescent boys; HPV vaccination; Health behaviour; Parental attitudes and beliefs