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Genital human papillomavirus (HPV) infection is widely recognized as the most common sexually transmitted infection in the U.S.1,2 In June 2006, the US Food and Drug Administration approved an HPV vaccine for use among 9-26 year-old females.3 In recent years, there has been a surge in direct advertising about HPV and the HPV vaccine. In response, parents (who hold the primary responsibility for decision-making for their children's health) have expressed the need for reliable HPV information.4 The purpose of this investigation was to examine the most common sources of HPV information among parents and to compare preferred versus actual HPV information sources.
Participants were drawn from an online research panel through Knowledge Networks (KN) ®, a web-based survey company. KN facilitates access to online panels based on a random-digit dial sample of nationally-representative US households.5 KN provides free internet access via WebTV for those who do not have internet, enabling sampling from diverse segments of the US population, including those without internet access. Eligible participants included those who identified as Black, White or Hispanic, and had at least one 9-17 year-old daughter for whom they were the primary caregiver. Among those assigned the survey (n=836), 536 panelists agreed to participate. Among these, 173 Whites, 137 Hispanics, and 166 Blacks were still eligible after completing the screening questions (total n= 476). Data collection occurred from September 2007 - January 2008. The protocol was approved by the Harvard School of Public Health Institutional Review Board. Participants were asked from which sources they would prefer to receive HPV information and where they first heard of it. Responses included: Health care provider; Friend; Family member; Television/radio; Internet; Newspaper/magazine; Daughter's school; Other (specify). Descriptive statistics were calculated using SAS, version 9.1 (SAS Institute Inc, Cary, North Carolina).
Slightly over half of the respondents (53%) self-identified as Black or Hispanic and had an income level of $50K or less. Less than half (38%) had some college education and 28% had a high school education or less. Average age was 41. Most were female (92.4%) and a sensitivity analysis removing male caregivers did not change results, so they were retained. Most had heard of HPV before taking the survey (90%).
There was a large discrepancy between actual and preferred HPV information source (Figure 1). Most parents (84.8%) preferred to receive HPV information from a health care provider, yet only 5.3% actually did receive it from this source. Half (49.8%) reported that most of their HPV information came from television or radio, even though only 4% preferred to get it from these sources.
The results of this study highlight the mismatch between preferred and actual sources of HPV information for parents. Most parents' first exposure to HPV information was from media sources, particularly TV or radio, suggesting that education of the public about HPV has primarily been driven by industry marketing.6
This study is among the first to compare parents' actual versus preferred HPV information sources. A limitation of the study is that surveys were conducted in English only, thus limiting our ability to survey caregivers who speak only Spanish or other languages. Nevertheless, this study has important implications for future efforts to educate parents about HPV. Specifically, health care providers (who are trusted and credible sources of information) are being called upon to provide parents with complete information about HPV, to help enable them to distinguish factual information from the misinformation that may inadvertently be conveyed to them through the advertising media. Thus, strengthening providers' communication skills and HPV knowledge, and offering strategies on how to best address parental concerns about HPV and the vaccine are needed.
Funding: This research was supported by the Dana-Farber Harvard Cancer Center Nodal Point Award, P30CA006516.
Maria De Jesus, Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA; Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA.
Layla Parast, Department of Biostatistics, Harvard University, Boston, MA; Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA.
Rachel C. Shelton, Department of Oncological Sciences, Division of Cancer Prevention & Control, Mount Sinai School of Medicine, New York, NY.
Kerry Kokkinogenis, Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA.
Megan KD Othus, Department of Biostatistics, Harvard University, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute.
Yi Li, Department of Biostatistics, Dana-Farber Cancer Institute, Department of Biostatistics, Harvard School of Public Health.
Jennifer D. Allen, Center for Community-Based Research, Dana-Farber Cancer Institute. Boston, MA.