Background
Methods
Search strategy
Inclusion and exclusion criteria
Study selection
Quality assessment
Data extraction
Thematic synthesis
The socio-ecological model
Results
Study characteristics
Search results
Study and participant characteristics
Study | Year | Country | Aim | Location | Type of setting | Data collection period | Data collection method | Sampling strategy | Analysis | Overall risk of bias |
---|---|---|---|---|---|---|---|---|---|---|
Allen J, et al. [61] | 2011 | USA | To describe parents’ knowledge, attitudes, and decision-making with regard to obtaining the HPV vaccine for their daughters | Health and social service agencies, Boston | Community-based | February 2008 to May 2008 | Focus groups | Convenience | Grounded theory | Medium |
Bair R, et al. [51] | 2008 | USA | To describe Latina mothers’ acceptance of the human papillomavirus vaccine for their daughters and explore their knowledge base regarding HPV-related issues | One urban, paediatric primary care clinic | Healthcare-based | November 2004 to March 2005 | Interviews | Convenience | Thematic analysis | Medium |
Brabin L, et al. [53] | 2007 | UK | To investigate parents’ views on making available HPV vaccination to adolescent minors at sexual health clinics without parental consent | 26 schools, city of Manchester | School-based | Not described | Semi-qualitative, questionnaire data | Convenience | Thematic analysis | Low |
Brown E, et al. [55] | 2009 | UK | To explore GPs’ and practice nurses’ views of HPV vaccination, prior to implementation of the national immunisation programme, with a focus on their role and anticipated difficulties | Two general practices, Hampshire and Wiltshire | Healthcare-based | March 2008 | Interviews | Convenience | Constant comparison and thematic analysis | Medium |
Bynum S, et al. [31] | 2009 | USA | To explore adolescent girls and young women knowledge, beliefs and attitudes regarding HPV infection and vaccination, Pap tests, and cervical intraepithelial neoplasia | One teen clinic, Columbia, South Carolina | Healthcare-based | January 2007 to April 2007 | Interviews | Purposive | Constant comparison | High |
Chan Z, et al. [30] | 2011 | Hong Kong | To explore the experience and attitudes of physicians in clinics, and to facilitate physicians’ promotion of HPV vaccination | One district, Hong Kong | Healthcare-based | May 2010 to June 2010 | Interviews | Convenience | Phenomenological approach | Medium |
Colgrove J, et al. [23] | 2010 | USA | To identify the factors that were most influential in determining how states acted on the issue of mandates | Six states | Government-based | August 2008 to May 2009 | Interviews | Purposive | Thematic content analysis | Medium |
Constantine N, et al. [50] | 2007 | USA | To examine likelihood of parental acceptance of human papillomavirus vaccination for young adolescent girls, together with reasons for acceptance and non acceptance | Households, California | Community-based | March 2006 to September 2006 | Semi-qualitative, questionnaire data | Random-digit-dial | Grounded theory | High |
Cooper Robbins S, et al. [43] | 2010 | Australia | To explore experiences, knowledge, attitudes, decision-making processes, and contextual factors related to consent to vaccination and vaccination completion | Three schools, city of Sydney, New South Wales | School-based | September 2008 to June 2009 | Focus groups, interviews and observations | Purposive | Constant comparison and thematic analysis | Low |
Cooper Robbins S, et al. [64] | 2010 | Australia | To explore experiences, knowledge, attitudes, decision-making processes, and contextual factors related to consent to vaccination and vaccination completion | Three schools, city of Sydney, New South Wales | School-based | September 2008 to June 2009 | Focus groups, interviews and observations | Purposive | Constant comparison and thematic analysis | Low |
Dempsey M, et al. [49] | 2009 | USA | To compare the reasons why mothers do or do not have their adolescent daughters vaccinated against HPV | Outpatient family medicine or paediatrics clinics, University of Michigan’s healthcare system | Healthcare-based | January 2007 to March 2007 | Interviews | Purposive | Content and thematic analysis | Medium |
Do H, et al. [36] | 2009 | USA | To address HPV vaccine knowledge and beliefs among Cambodians living in Seattle, Washington | Seattle, Washington | Community-based | 2008 | Focus groups and interviews | Convenience | Thematic analysis | High |
D’Souza C, et al. [37] | 2011 | Australia | To examine the development and delivery of a message targeting voluntary behaviour change | Northern Metropolitan local government region of Melbourne | Community-based | Not described | Focus groups | Not described | Health belief model | High |
Friedman A, et al. [62] | 2007 | USA | To collect data on the general public’s knowledge, attitudes and beliefs regarding HPV and a hypothetical HPV vaccine and to explore their communication preferences | Six geographically dispersed sites. | Community-based | 2003 | Focus groups | Randomly selected | Thematic analysis | High |
Gordon D, et al. [44] | 2011 | UK | To explore attitudes to human papillomavirus vaccination and reasons for accepting or declining the vaccine in the British Jewish community | Two Jewish schools, North London | School-based | June 2010 to September 2010 | Interviews | Purposive | Framework analysis | Low |
Gottvall M, et al. [39] | 2011 | Sweden | To investigate school nurses’ perceptions of HPV immunisation, and their task of administering the vaccine in a planned school-based program in Sweden | Five strategically chosen municipalities, Sweden | School-based | April 2010 to June 2010 | Focus groups | Convenience | Content analysis | Medium |
Hilton S, et al. [58] | 2011 | UK | To offer insights into adolescent girls’ understanding of HPV, its link with cervical cancer, and experiences of vaccination | Two regions in Scotland (Strathclyde and Lothian) and one region in England (London) | Community-based | December 2009 to May 2010 | Focus groups | Convenience | Framework analysis | Low |
Hilton S, et al. [42] | 2011 | UK | To offer insights from school nurses’ perspectives and experiences of delivering this new vaccination programme | National | Healthcare-based | September 2008 to May 2009 | Interviews | Convenience and snowballing | Constant comparison | Low |
Hughes C, et al. [41] | 2011 | USA | To generate hypotheses to inform interventions to increase vaccine receipt | Multi-state, hospital-owned, primary care practice based research network | Healthcare-based | March 2010 and June 2010 | Interviews | Convenience | Grounded theory approach | Low |
Humiston S, et al. [25] | 2009 | USA | To assess health care providers’ attitudes and practices regarding adolescent immunizations, including factors that either impede or facilitate vaccination | Monroe County, New York | Healthcare-based | 2005 | Focus groups and interviews | Not described | Grounded theory | Medium |
Hutson S, et al. [60] | 2011 | USA | To investigate communication and cultural issues that may influence vaccine uptake among southern Appalachian women and explore their perceptions of HPV, cervical cancer and vaccination | Southern Appalachia | Community-based | October 2007 to August 2008 | Interviews and focus groups | Convenience | Content analysis | Medium |
Javanbakht M, et al. [28] | 2012 | USA | To explore healthcare providers perspectives on factors influencing HPV vaccination among adolescent girls in a community with high cervical cancer rates | Two clinics in Los Angeles | Healthcare-based | March 2009 to May 2009 | Interviews | Convenience | Grounded theory approach | Medium |
Kahn J, et al. [40] | 2007 | USA | To describe the range of pediatricians’ attitudes about human papillomavirus vaccines and to explore factors influencing their intention to recommend HPV vaccines | Three states of the United States (Ohio, Kentucky, and Indiana) | Healthcare-based | 2005 | Interviews | Purposive | Framework analysis | Low |
Katz M, et al. [34] | 2009 | USA | To assess HPV vaccine acceptability | Ohio Appalachia counties | Community-based | Summer 2007 | Focus groups and interviews | Convenience | Thematic analysis | Medium |
Kwan C, et al. [32] | 2008 | Hong Kong | To explore perceptions towards cervical cancer, human papillomavirus infection and HPV vaccination and to identify factors affecting the acceptability of HPV vaccination among Chinese adolescent girls in Hong Kong | Community youth centre and secondary school | School and community-based | Not described | Focus groups | Purposive | Thematic analysis | Low |
Marlow L, et al. [45] | 2009 | UK | To explore attitudes to HPV vaccination among black and Asian mothers living in Britain | Community health fairs and community groups | Community-based | April 2008 to August 2008 | Interviews | Convenience and snowballing | Framework analysis | Medium |
Mays R, et al. [47] | 2004 | USA | To elicit attitudes from parents on vaccinating children against sexually transmitted infections | Two paediatric clinics, Marion County, Indiana | Healthcare-based | January 2000 to June 2000 | Interviews | Purposive | Content analysis | Medium |
Mishra A, et al. [56] | 2012 | Canada | To illustrate the clinical, political and practical complexities of introducing an new and controversial vaccine | Not described | Healthcare-based | September 2009 to January 2010 | Interviews | Convenience | Thematic analysis | High |
Olshen E, et al. [46] | 2005 | USA | To explore parental views on the human papillomavirus vaccine | One urban, academic adolescent clinic and one suburban, private paediatric practice | Healthcare-based | September 2003 to March 2004 | Focus groups and interviews | Convenience | Content analysis | Medium |
Oscarsson M, et al. [38] | 2011 | Sweden | To explore youth clinic midwives role in cervical cancer prevention and their attitude to HPV vaccination | Two counties, Sweden | Healthcare-based | September 2010 to October 2010 | Interviews | Convenience | Content analysis | Medium |
Perkins R, et al. [29] | 2010 | USA | To explore parents’ opinions of school-entry requirements for human papillomavirus (HPV) vaccination | One urban, academic medical centre and an affiliated community health centre, Boston | Healthcare-based | June 2007 to February 2008 | Interviews | Purposive | Content analysis and grounded theory | Medium |
Perkins R, et al. [35] | 2010 | USA | To explore low-income minority parents’ attitudes, intentions, and actions with regard to human papillomavirus vaccination for their daughters | One urban, academic medical centre and an affiliated community health centre, Boston | Healthcare-based | June 2007 to February 2008 | Interviews | Purposive | Content analysis and grounded theory | Low |
Quinn T, et al. [27] | 2012 | USA | To conduct a qualitative examination of free text provider comments from a national survey of U.S. Physicians | National | Healthcare-based | 2009 | Semi-qualitative, questionnaire data | Not described | Grounded theory | Medium |
Stretch R, et al. [57] | 2009 | UK | To seek the views of school nurses on vaccinating girls who did not have parental consent | Two primary care trusts, northern England | Healthcare-based | July 2008 | Interviews | Convenience | Thematic analysis | Low |
Shafer A, et al. [63] | 2011 | USA | To develop HPV vaccine messages for a campaign targeting racially diverse mothers of nonvaccinated 11 to 12 year olds | Rural Southeastern United States | Community-based | Not described | Focus groups | Not described | Constant comparison | High |
Sussman A, et al. [59] | 2007 | USA | To better understand the implications for counselling about cervical cancer prevention by primary care clinicians who care for adolescents | New Mexico | Healthcare-based | July 2004 to May 2005 | Focus groups | Purposive | Thematic analysis | Medium |
Teitelman A, et al. [33] | 2011 | USA | To identify common beliefs about HPV vaccine initiation and describe the relationship between attitudes, norms, perceived control, and intention to receive HPV vaccine | Family planning, prenatal, or paediatric outpatient site for predominantly low-income patients. | Healthcare-based | Not described | Focus groups | Convenience | Content analysis | High |
Tissot A, et al. [26] | 2007 | USA | To examine pediatricians’ views about key issues related to HPV vaccine delivery and identify their strategies for effective vaccine delivery | Three states of the United States (Ohio, Kentucky, and Indiana) | Healthcare-based | Summer 2005 | Interviews | Purposive | Framework analysis | Low |
Toffolon-Weiss M, et al. [48] | 2008 | USA | To describe Alaska Native parents’ knowledge of and attitudes towards cervical cancer, the human papillomavirus and the HPV vaccine | Three Alaskan communities | Community-based | January 2007 to March 2007 | Focus groups | Convenience | Not described | High |
Waller J, et al. [52] | 2006 | UK | To investigate responses to information about the HPV vaccine among mothers of daughters aged 8 to 14 years | Not described | Community-based | August and November 2005 | Focus groups | Convenience and snowballing | Framework analysis | Medium |
Williams K, et al. [54] | 2010 | UK | To explore knowledge about human papillomavirus and attitudes towards HPV vaccination among girls who were part of the ‘catch-up’ vaccination programme | One further education college and one state school | School-based | March 2009 to May 2009 | Interviews | Purposive | Framework analysis | Medium |
Study | Year | Participants | Participant age (years) | Sample size | Vaccination Status of Young Women | Pre-licensure or Post-licensure period | Socioeconomic | Race/ethnicity | Sex | Religion |
---|---|---|---|---|---|---|---|---|---|---|
Allen J, et al. [61] | 2011 | Parents of daughters aged 9 to 17 years old | Not described | 64 | Mixed | Post-licensure | Health insurance: 98% | Black: 59%, Hispanic: 19%, White: 23% | Female: 72% | Not described |
Bair R, et al. [51] | 2008 | Latina mothers of daughters aged 7 to 14 years | Range: 24 to 40 | 40 | N/A | Pre-licensure | Parental education: 38% reached 12th to 14th grade | Latina: 100% | Female: 100% | Not described |
Brabin L, et al. [53] | 2007 | Parents of Year 7 (11 to 12 years old) students | 46.6% aged 40 to 49 | 244 | N/A | Pre-licensure | Free school meals: 26.4% | White: 67.6%; Black Caribbean: 9.4%; Black African: 7.4%; India sub-continent: 11.5% | Not described | None: 17.1%; Protestant: 47.1%; Catholic: 20.4%; Muslim: 7.5% |
Brown E, et al. [55] | 2009 | General practitioners and practice nurses | Range: 28 to 56 | 17 | N/A | Pre-licensure | General practices: one deprived area, two affluent area | Not described | Not described | Not described |
Bynum S, et al. [31] | 2009 | Young women aged 14 to 20 | Range: 14 to 20 | 68 | Not vaccinated | Post-licensure | Public insurance: 64.6% | African American: 80.3% | Female: 100% | Not described |
Chan Z, et al. [30] | 2011 | Physicians and general practitioners | Not described | 12 | N/A | Post-licensure | Not described | Not described | Not described | Not described |
Colgrove J, et al. [23] | 2010 | Key stakeholders | Not described | 73 | N/A | Post-licensure | Not described | Not described | Not described | Not described |
Constantine N, et al. [50] | 2007 | Parents with one or more daughter aged less than 18 | 70% of sample aged 30 to 49 | 522 | N/A | Pre-licensure | Household income > $60,000: 43% | Non-Hispanic white: 41%, White: 38%, African-American: 7% Asian: 7% | Female: 73.4% | Catholic: 38.2%; Protestant: 14.0%; Other Christian: 17.7%; None: 13.6%. |
Cooper Robbins S, et al. [43] | 2010 | Parents, teachers, vaccination nurses, and adolescents | Not described | 185 | Mixed | Post-licensure | Not described | Not described | All female, except one | Not described |
Cooper Robbins S, et al. [64] | 2010 | Parents, teachers, vaccination nurses, and adolescents | Not described | 185 | Mixed | Post-licensure | Not described | Not described | All female, except one | Not described |
Dempsey M, et al. [49] | 2009 | Mothers of vaccine eligible young women | Mean (vaccine declined): 41. Mean (vaccine received): 45 | 52 | Mixed | Post-licensure | Some college/4-year degree: vaccine declined: 58%; vaccine received: 67%. | Not described | Female: 100% | Not described |
Do H, et al. [36] | 2009 | Key informants and parents of at least one daughter eligible for HPV vaccine | 70% of the sample aged > 40 | 50 | Mixed | Post-licensure | Education < 12 years: 59% | American-Cambodian: 100% | Female: 51% | Not described |
D’Souza C, et al. [37] | 2011 | School-age girls, youth centre attendees, and university participants | Not described | Not described | Vaccinated | Post-licensure | Not described | Australian: 80% | Female: 100% | Not described |
Friedman A, et al. [62] | 2007 | Adults aged 25 to 45 | Range: 25 to 45 | 314 | N/A | Pre-licensure | Not described | Caucasian: 33%, Hispanic: 33%, African American: 33% | Female: 50% | Not described |
Gordon D, et al. [44] | 2011 | Jewish mothers of vaccine eligible daughters | 85% of sample aged 40 to 49 | 20 | Mixed | Post-licensure | Degree education: 65% | Not described | Female: 100% | Jewish: 100% |
Gottvall M, et al. [39] | 2011 | School nurses | Range: 35 to 60 | 30 | N/A | Pre-licensure | Not described | Not described | Not described | Not described |
Hilton S, et al. [58] | 2011 | Young women aged 12 to 18 | Range: 12 to 18 | 87 | Mixed | Post-licensure | High and low areas of deprivation | Not described | Female: 100% | Not described |
Hilton S, et al. [42] | 2011 | School nurses | Not described | 30 | N/A | Post-licensure | Not described | Not described | Not described | Not described |
Hughes C, et al. [41] | 2011 | Mother-daughter-physician triads | Young women range: 11 to 18 | 60 | Mixed | Post-licensure | Mothers: education high school or less: 45% | Mothers: Black 60%, White 40%. Clinicians: Black 10%, White 75%. | Female: Clinicians 80% | Not described |
Humiston S, et al. [25] | 2009 | Primary care practitioners | Not described | 35 | N/A | Pre-licensure | Not described | Not described | Not described | Not described |
Hutson S, et al. [60] | 2012 | Women aged 18 to 50 | Range: 18 to 49 | 39 | Mixed | Post-licensure | Not described | Appalachian community | Female: 100% | Not described |
Javanbakht M, et al. [28] | 2012 | Healthcare professionals | Not described | 21 | N/A | Post-licensure | Not described | Not described | Not described | Not described |
Kahn J, et al. [40] | 2007 | Paediatricians | Range: 30 to 78 | 31 | N/A | Pre-licensure | Not described | White: 58%, Black: 29%, Latino: 13% | Female: 55% | Not described |
Katz M, et al. [34] | 2009 | Parents, community leaders, and healthcare providers | Range: 21 to 69 | 114 | N/A | Pre-licensure | Various | White:106, Non-Hispanic: 111 | Not described | Not described |
Kwan C, et al. [32] | 2008 | Girls aged 13 to 20 | Range: 13 to 20 | 64 | N/A | Pre-licensure | Parental education: Secondary 64% | Chinese: 100% | Female: 100% | Not described |
Marlow L, et al. [45] | 2009 | Black/Black British and Asian/Asian British mothers | Not described | 20 | N/A | Pre-licensure | Degree education: 50% | Asian: 50% Black: 50% | Female: 100% | Christian: 40%; Hindu: 10%; Muslim: 30%, no religion: 10% |
Mays R, et al. [47] | 2004 | Parents with children aged 8 to 17 | Range: 26 to 55 | 34 | N/A | Pre-licensure | College: 50% | Not described | Female: 85% | Not described |
Mishra A, et al. [56] | 2012 | Vaccine scientists and healthcare providers | Not described | 15 | N/A | Post-licensure | Not described | Not described | Not described | Not described |
Olshen E, et al. [46] | 2005 | Parents | Mean: Urban participants; 40.5 Suburban participants; 44.7 | 25 | N/A | Pre-licensure | Completed college: 32% | White: 44%, Black: 28%, Hispanic:16% | Female: 88% | Not described |
Oscarsson M, et al. [38] | 2011 | Midwives | Range: 38 to 62 | 13 | N/A | Post-licensure | Not described | Not described | Not described | Not described |
Perkins R, et al. [29] | 2010 | Parents of vaccine eligible girls aged 11 to 18 | Range: 31 to 60 | 73 | Mixed | Post-licensure | Years of education: mean; 13 | Caucasian: 26%, African-American: 25%, Afro-Caribbean or African: 21%, Latin; 29% | Females: 92% | Expressed religious affiliation: 82% |
Perkins R, et al. [35] | 2010 | Low income parents | Range: 31 to 60 | 76 | Mixed | Post-licensure | Years of education: mean; 13 | Caucasian: 26%, African-American: 25%, Afro-Caribbean or African: 21%, Latin; 29% | Females: 92% | Expressed religious affiliation: 82% |
Quinn T, et al. [27] | 2012 | Physicians | Not described | 112 | N/A | Post-licensure | Not described | Not described | Not described | Not described |
Shafer A, et al. [63] | 2011 | Female caregivers of 11 to 12 year old girls | Not described | 40 | Not vaccinated | Post-licensure | Not described | African American: 58%, American Indian: 23%, Caucasian: 18% | Female: 100% | Not described |
Stretch R, et al. [57] | 2009 | School nurses | Not described | 15 | N/A | Post-licensure | Not described | Not described | Not described | Not described |
Sussman A, et al. [59] | 2007 | Paediatricians | Not described | 37 | N/A | Pre-licensure | Not described | Not described | Female: 86% | Not described |
Teitelman A, et al. [33] | 2011 | Girls aged 13 to 26 | Range: 13 to 26 | 34 | Mixed | Post-licensure | Low income population | Black: 74% | Female: 100% | Not described |
Tissot A, et al. [26] | 2007 | Paediatricians | Mean: 46.9 | 31 | N/A | Pre-licensure | Not described | White: 58%, Black: 29%, Asian American: 7% | Female: 55% | Not described |
Toffolon-Weiss M, et al. [48] | 2008 | Native Alaskan parents of adolescents aged 9 to 18 | 38% aged between 41 and 50 | 80 | Mixed | Post-licensure | Not described | Alaskan natives | Female: 81% | Not described |
Waller J, et al. [52] | 2006 | Mothers of girls aged 8 to 14 | Range: 31 to 48 | 24 | N/A | Pre-licensure | Degree level: 50%, | Not described | Female: 100% | Not described |
Williams K, et al. [54] | 2010 | Girls aged 17 to 18 | Range: 17 to 18 | 10 | Mixed | Post-licensure | Not described | White British: 80%; British Asian: 20% | Female: 100% | None: 80%; Muslim: 20% |
The socio-ecological model and cross cutting themes
Level | Key issues | Cross cutting themes | ||||
---|---|---|---|---|---|---|
Policy | Vaccine availability, cost and delivery | Mandate | Finance | Sexual mores | Trust | Consent |
Community | Social norms and values | |||||
Organisational | Healthcare professional recommendation and provision | |||||
Interpersonal | Parental decision-making and consent | |||||
Intrapersonal | Young women’s characteristics and consent |