Elsevier

Vaccine

Volume 30, Issue 25, 28 May 2012, Pages 3757-3762
Vaccine

Parents’ Internet use for information about HPV vaccine

https://doi.org/10.1016/j.vaccine.2011.11.113Get rights and content

Abstract

Purpose

The Internet is an increasingly common source of health-related information. We sought to examine associations between parents’ Internet information-seeking and their knowledge, attitudes and beliefs about human papillomavirus (HPV) vaccine.

Methods

We interviewed parents within a year after approval of HPV vaccine for females and males. Participants were North Carolina parents with daughters ages 10–18 surveyed by telephone in Fall 2007 (n = 773); and a national sample of parents with sons ages 11–17 surveyed online in Fall 2010 (n = 115). We used multivariate regression to examine associations of past and intended Internet seeking for HPV vaccine information with knowledge and health belief model-related constructs.

Results

Among parents of daughters, having heard of HPV vaccine through the Internet (8%) was associated with higher HPV knowledge, perceived likelihood of HPV, and vaccination willingness, and with receiving a doctor's recommendation. It was also associated with lower perceived vaccine harms, uncertainty, and anticipated regret. Parents of sons who heard of HPV vaccine through the Internet (10%) perceived greater barriers to vaccination than parents who learned about HPV vaccine for males through other sources. Intended future Internet information-seeking among parents of daughters (69%) was more likely if they perceived a lower likelihood that their daughters would get HPV if they were vaccinated (all p < .05).

Conclusions

Our findings suggest a positive influence of accessing information on the Internet about HPV vaccine. It was associated with higher knowledge and mostly positive parental attitudes and beliefs.

Highlights

► We used data from 2 studies with parents of adolescents. ► We examined parents’ Internet information-seeking and HPV vaccine attitudes. ► Internet use was associated with higher knowledge and mostly positive perceptions.

Introduction

The Internet is an increasingly common source of health-related information. On the one hand, the Internet can provide high quality information that is widely disseminated. It has become the “go to” resource for health information for many people. On the other hand, while the quality of the information is often high, it can vary widely. Sites often have missing or incomplete information [1] or, more rarely, inaccurate information [2]. Furthermore, the Internet may draw people who perceive that they are unhealthy [3], [4], who have serious or stigmatized health needs [5], [6], or who experience barriers to traditional care [5].

All of these issues may be at hand with human papillomavirus (HPV) vaccine information on the Internet [7], [8], [9]. High quality information about HPV vaccine is available from public agencies, but some sites, especially those opposing HPV vaccine, provide information that is of more mixed quality or presented in a misleading fashion [8], [9]. Online news stories reveal a similar mix of quality and gaps [7]. Though the Internet is an important source of information for parents about HPV vaccine [10], we know of no research examining whether obtaining information about HPV vaccine on the Internet is associated with better or poorer knowledge. Low quality information on the web might engender poor knowledge, but then it could be that exposure to the large store of information across many sites instead increases knowledge.

Internet use might also affect key attitudes and beliefs which, in turn, may shape parents’ intentions to get their children vaccinated against HPV [11], [12]. The health belief model [13], a widely used theoretical model of health behavior, provides a practical conceptual basis for this work. As we have described the relevance of this conceptualization to HPV vaccination previously [11], [14], we summarize it here only in brief. The health belief model suggests that people are more likely to engage in health-related behaviors, like getting vaccinated, if they believe a threat is likely (perceived risk of HPV infection) or severe (perceived severity of the consequences of HPV infection), if they perceive the preventive effort is safe (perceived harms from HPV vaccine) and effective (perceived benefits/effectiveness of HPV vaccine), and if a doctor recommends it (cue to action). We also sought to understand how health belief model constructs might influence subsequent Internet searching, as this is a kind of health behavior and a logical consequence of the change in such beliefs [15], [16].

Thus, our paper has three goals. First, we examined whether Internet use was associated with better or poorer HPV knowledge. Second, we examined whether Internet use was associated with beliefs about HPV-related diseases and HPV vaccine that prompt vaccination. Finally, we examined whether these beliefs prompted intentions to gather information on the web. To address these questions, we analyzed data from two large studies of parents of children in the recommended age range to receive HPV vaccine.

Section snippets

Study design

We used data from 2 of our research studies, the Carolina HPV Immunization Measurement and Evaluation (CHIME) parent study and the HPV Immunization in Sons (HIS) study. This allowed us to gain unique insight into the online information-seeking behaviors of parents regarding HPV vaccine about a year after the vaccine was licensed for females (licensed in 2006 [17]) and males (licensed in 2009 [18]). The CHIME and HIS studies are described in detail elsewhere [10], [19], [20] and briefly here.

Demographic characteristics

In the CHIME study of parents of adolescent girls, most parents were female (96%; Table 1), older than 45 years of age (72%), non-Hispanic white (74%) or non-Hispanic Black (20%), and had at least some college education (82%). Parents included in our analyses (aware of HPV vaccine prior to the study) were more likely to be female, be non-Hispanic white, have at least some college education, and have a household income of $60,000 or over, compared to parents who were not aware (all p < .05). For

Findings

In this study, we found that accessing information on the Internet was associated with higher knowledge and mostly positive parental perceptions about HPV vaccine. Consistent with previous research that found greater health knowledge among those who search the Internet for information [23], parents in the CHIME study who heard about HPV vaccine through the Internet had greater knowledge about HPV. Individuals who search for information on the Internet tend to be more health-oriented [24], so it

Conclusion

Our findings suggest that the Internet is not only an important source of information about HPV vaccine for parents of adolescents, but that it can also be a positive one. Future research is needed to understand how to capitalize on the Internet as a source of information and monitor temporal trends in parents’ use of the Internet for HPV vaccine information as time since vaccine licensure increases. This may be particularly important for parents with adolescent sons, as more information on HPV

Conflict of Interest

A research grant to NTB and PLR from Merck Sharp & Dohme Corp. funded the HIS Study. Merck Sharp & Dohme Corp. played no role in the study design, planning, implementation, analysis, or reporting of the findings. NTB has also received grants and/or honoraria from GlaxoSmithKline and Merck Sharp & Dohme Corp. PLR has not received honoraria or consulting fees from these companies.

Acknowledgements

This research was supported in part by grants from the Centers for Disease Control and Prevention (S3715-25/25) and the Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp. The views and findings in this manuscript are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or those of Merck Sharp & Dohme Corp. Additional support was provided by the American Cancer Society (MSRG-06-259-01-CPPB), and the Cancer

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