title: Motivational and contextual determinants of HPV-vaccination uptake: A longitudinal study among mothers of girls invited for the HPV-vaccination.
abstract: BACKGROUND
  In the Netherlands, HPV-vaccination uptake among 12-year-old girls remains to be lower (61% in 2016) than expected. The present study is about 1) replicating the extent to which social-psychological determinants found in earlier cross-sectional studies explain HPV-vaccination intention, and 2) testing whether HPV-vaccination intention, as well as other social-psychological determinants, are good predictors of future HPV-vaccination uptake in a longitudinal design.
  
  
  METHODS
  A random sample of mothers of girls invited for the vaccination in 2015 was drawn from the Dutch vaccination register (Praeventis) (N=36,000) and from three online panels (N=2483). Two months prior to the vaccination of girls, their mothers were requested to complete a web-based questionnaire by letter (Praeventis sample) or by e-mail (panel samples). HPV-vaccination uptake was derived from Praeventis. Backward linear and logistic regression analyses were conducted to examine most dominant predictors of HPV-vaccination intention and uptake, respectively. The total sample used for data analyses consisted of 8062 mothers. Response rates were 18% for the Praeventis sample and 47% for the panel samples.
  
  
  RESULTS
  HPV-vaccination intention was best explained by attitude, beliefs, subjective norms, habit, and perceived relative effectiveness of the vaccination; they explained 83% of the variance in HPV-vaccination intention. Intention appeared to be the only stable predictor of HPV-vaccination uptake and explained 43% of the variance in HPV-vaccination uptake.
  
  
  CONCLUSIONS
  These results confirm what was found by earlier cross-sectional studies, and provide strong leads for selecting relevant targets in the planning of future communication strategies aiming to improve HPV-vaccination uptake.
authors.affiliation: Maastricht University, Department of Work & Social Psychology, P.O. Box 616, 6200 MD Maastricht, The Netherlands; TNO Child Health, Netherlands Organization for Applied Scientific Research, P.O. Box 3005, 2316 ZL Leiden, The Netherlands. Electronic address: mirjam.pot@tno.nl.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Pot
authors.affiliation: TNO Child Health, Netherlands Organization for Applied Scientific Research, P.O. Box 3005, 2316 ZL Leiden, The Netherlands.
authors.forename: Hilde M
authors.initials: HM
authors.lastname: van Keulen
authors.affiliation: Maastricht University, Department of Work & Social Psychology, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Robert A C
authors.initials: RAC
authors.lastname: Ruiter
authors.affiliation: TNO Child Health, Netherlands Organization for Applied Scientific Research, P.O. Box 3005, 2316 ZL Leiden, The Netherlands.
authors.forename: Iris
authors.initials: I
authors.lastname: Eekhout
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Mollema
authors.affiliation: TNO Child Health, Netherlands Organization for Applied Scientific Research, P.O. Box 3005, 2316 ZL Leiden, The Netherlands.
authors.forename: Theo W G M
authors.initials: TWGM
authors.lastname: Paulussen
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D033182:Intention; D008137:Longitudinal Studies; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data; D009042:Motivation; D009426:Netherlands; D009679:Nuclear Family; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000523:psychology
chemical_list: D053918:Papillomavirus Vaccines
keywords: Cancer; HPV; HPV-vaccination uptake; Social-psychological determinants