April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: Vaccine-Related Attitudes and Decision-Making in Immigrant Homes: The Influence on Mothers’ Decision to Initiate HPV Vaccination
Immigrants in the United States (US) have a high incidence of HPV infections and mortality rates due to HPV-related diseases. The poor health outcomes are possibly because of their low acceptance and uptake of HPV vaccines. Immigrant parents’ decision-making around HPV vaccination is complex and culture- and context-specific.
Of particular interest is a potential relationship between HPV vaccination and cultural variables, including acculturation and adaptation levels, and who makes decisions to vaccinate in immigrant households. This is because there is evidence that some immigrant mothers in the US rely on their children’s other parent’s opinions in determining whether to vaccinate them (Ko et al., 2019). Therefore, the study examined how factors, including cultural variables (i.e., acculturation orientation toward host country and acculturation orientation toward host country and adaptation), HPV vaccine knowledge, and physician recommendation, may influence immigrant mothers’ vaccination decisions (i.e., vaccination initiation and vaccination refusal).
Methods: We administered an online survey to a convenience sample of 277 immigrant mothers (>= 18 years) with children (ages 9-24 years) living in the US (recruited using Amazon MTurk). Statistical analysis was done using SPSS computer software v27.
Results: The average age of immigrant mothers was 34.5 years (SD=9.8). Nearly half identified as white (45.2%), and the remaining identified as Black (16.2%), Hispanic (8.5%), mixed race (8.5%), Asian (8.5%), or of another ethnicity (7.7%). Most immigrant mothers came from North America (e.g., Canada and Mexico) (23.9%). Also, most have lived in the US for over 10 years (79.8%).
Among other findings from examining HPV vaccination initiation, a logistic regression analysis on insurance coverage, orientation toward home country, and vaccination decision making in homes found that the odds of vaccination initiation occurring for child(ren) decreased by 8 % (95% CI [0.87, 0.98]) for a one -unit increase in orientation toward home country.
Likewise, we found that holding all other predictor variables constant, the odds of HPV vaccination refusal for a child(ren) occurring decreased by 12%] (95% CI [0.78, 1.01]) for a one-unit increase in acculturation to US culture. Also, among others, mothers who relied on their partners for decisions regarding vaccinating their children had a 238% increase in the odds of refusing HPV vaccination for their child(ren) compared to a mother who made the decisions by herself.
Conclusions: The current study indicates that immigrant mothers who held onto their home cultures were less likely to initiate HPV vaccination for their children. Conversely, mothers with increasing acculturation to the US culture reported a lower likelihood of refusing HPV vaccination for their children. Additionally, two new significant findings emerged from this study; first, many mothers relied on their partners to make vaccination decisions. Second, mothers who were less adapted to the US relied more on their partners to make vaccination decisions in their homes.
The results suggest the need for culturally tailored HPV vaccination interventions to improve HPV vaccination coverage in immigrant populations. Furthermore, interventions that target both parents are highly recommended to motivate first-generation immigrants to vaccinate their children against HPV.
Of particular interest is a potential relationship between HPV vaccination and cultural variables, including acculturation and adaptation levels, and who makes decisions to vaccinate in immigrant households. This is because there is evidence that some immigrant mothers in the US rely on their children’s other parent’s opinions in determining whether to vaccinate them (Ko et al., 2019). Therefore, the study examined how factors, including cultural variables (i.e., acculturation orientation toward host country and acculturation orientation toward host country and adaptation), HPV vaccine knowledge, and physician recommendation, may influence immigrant mothers’ vaccination decisions (i.e., vaccination initiation and vaccination refusal).
Methods: We administered an online survey to a convenience sample of 277 immigrant mothers (>= 18 years) with children (ages 9-24 years) living in the US (recruited using Amazon MTurk). Statistical analysis was done using SPSS computer software v27.
Results: The average age of immigrant mothers was 34.5 years (SD=9.8). Nearly half identified as white (45.2%), and the remaining identified as Black (16.2%), Hispanic (8.5%), mixed race (8.5%), Asian (8.5%), or of another ethnicity (7.7%). Most immigrant mothers came from North America (e.g., Canada and Mexico) (23.9%). Also, most have lived in the US for over 10 years (79.8%).
Among other findings from examining HPV vaccination initiation, a logistic regression analysis on insurance coverage, orientation toward home country, and vaccination decision making in homes found that the odds of vaccination initiation occurring for child(ren) decreased by 8 % (95% CI [0.87, 0.98]) for a one -unit increase in orientation toward home country.
Likewise, we found that holding all other predictor variables constant, the odds of HPV vaccination refusal for a child(ren) occurring decreased by 12%] (95% CI [0.78, 1.01]) for a one-unit increase in acculturation to US culture. Also, among others, mothers who relied on their partners for decisions regarding vaccinating their children had a 238% increase in the odds of refusing HPV vaccination for their child(ren) compared to a mother who made the decisions by herself.
Conclusions: The current study indicates that immigrant mothers who held onto their home cultures were less likely to initiate HPV vaccination for their children. Conversely, mothers with increasing acculturation to the US culture reported a lower likelihood of refusing HPV vaccination for their children. Additionally, two new significant findings emerged from this study; first, many mothers relied on their partners to make vaccination decisions. Second, mothers who were less adapted to the US relied more on their partners to make vaccination decisions in their homes.
The results suggest the need for culturally tailored HPV vaccination interventions to improve HPV vaccination coverage in immigrant populations. Furthermore, interventions that target both parents are highly recommended to motivate first-generation immigrants to vaccinate their children against HPV.