Human papillomavirus (HPV) vaccination rates among Hispanic adolescents in the USA are far below recommended levels. Using a social marketing theory framework, we assessed the four Ps (product, price, place and promotion) as they relate to efforts to promote HPV vaccine initiation.
Design:
Qualitative study involving in-depth interviews.
Setting:
A large Southern city in the USA.
Method:
Eighty-five in-depth qualitative interviews were conducted with Spanish-speaking Hispanic mothers divided into initiated and uninitiated market segments based on whether or not their adolescent child had received the first dose of the HPV vaccine. Data were analysed using directed qualitative content analysis.
Results:
Results suggest that the desire to prevent illnesses and protect their child drives the decision to vaccinate (product). Most initiated mothers did not experience barriers to vaccination, and market segments described different potential barriers (price). Both marker segments reported that they needed vaccine information before vaccinating (price). Finally, interventions should target clinics, schools and community centres to raise awareness about the importance of vaccinating against HPV (place and promotion).
Conclusion:
Findings from this formative study can inform the development of an intervention to increase HPV vaccine initiation among Hispanic adolescents.
AragonesABrunoDEhrenbergM, et al. (2015) Parental education and text messaging reminders as effective community based tools to increase HPV vaccination rates among Mexican American children. Preventive Medicine Reports2: 554–558.
2.
AragonesAGenoffMGonzalezC, et al. (2016) HPV vaccine and Latino immigrant parents: If they offer it, we will get it. Journal of Immigrant and Minority Health18(5): 1060–1065.
3.
BryantCAGrierS (2005) Social Marketing in Public Health. Annual Review of Public Health26(9): 319–339.
CorcoranN (2007) Communicating Health: Strategies for Health Promotion. London: SAGE, pp. 5–31.
6.
DasAMadhwapathiVDaviesP, et al. (2010) Knowledge and acceptability of the HPV vaccine by school children and their parents in Birmingham. Vaccine28(6): 1440–1446.
7.
DorellCGYankeyDSantibanezTA, et al. (2011) Human papillomavirus vaccination series initiation and completion, 2008–2009. Pediatrics128(5): 830–839.
8.
EmersonR (1976) Social exchange theory. Annual Review of Sociology2(1976): 335–362.
9.
FazekasKIBrewerNTSmithJS (2008) HPV vaccine acceptability in a rural Southern area. Journal of Women’s Health17: 539–548.
ForthoferMSBryantCA (2000) Using audience-segmentation techniques to tailor health behavior change strategies. American Journal of Health Behavior24(1): 36–43.
12.
GaleNKHeathGCameronE, et al. (2013) Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Medical Research Methodology13(1): 117.
13.
GarganoLMUnderwoodNLSalesJM, et al. (2015) Influence of sources of information about influenza vaccine on parental attitudes and adolescent vaccine receipt. Human Vaccines and Immunotherapeutics11(7): 1641–1647.
14.
GibsonDRZhangGCassadyD, et al. (2010) Effectiveness of HIV prevention social marketing with injecting drug users. American Journal of Public Health100(10): 1828–1830.
15.
GlanzKBishopDB (2010) The role of behavioral science theory in development and implementation of public health interventions. Annual Review of Public Health31: 399–418.
16.
GlanzKRimerBKViswanathK (2008) Health Behaviour and Health Education: Theory, Research and Practice 4th Edition. San Francisco, CA: Jossey-Bass.
17.
GrabielMReutzelTWangS, et al. (2013) HPV and HPV vaccines: The knowledge levels, opinions, and behavior of parents. Journal of Community Health: 1015–1021.
18.
HolmanDMBernardVRolandK, et al. (2014) Barriers to human papillomavirus vaccination among US adolescents: A systematic review. JAMA Pediatrics168(1): 76–82.
19.
HsiehHF (2005) Three approaches to qualitative content analysis. Qualitative Health Research15(9): 1277–1288.
20.
JavanbakhtMStahlmanSWalkerS, et al. (2012) Provider perceptions of barriers and facilitators of HPV vaccination in a high-risk community. Vaccine30(30): 4511–4516.
21.
JozkowskiKNGeshnizjaniA (2016) Using a reasoned action approach to examine US college women’s intention to get the HPV vaccine. Health Education Journal75(1): 14–26.
22.
KatzITBogartLFuC, et al. (2016) Barriers to HPV immunization among Blacks and Latinos: A qualitative analysis of caregivers, adolescents, and providers. BMC Public Health16: 1–10.
23.
KepkaDLUlrichAKCoronadoGD (2012) Low knowledge of the three-dose HPV vaccine series among mothers of rural Hispanic adolescents. Journal of Health Care for the Poor and Underserved23(2): 626–635.
24.
LeaderAEWeinerJKellyB, et al. (2009) Effects of information framing on human papillomavirus vaccination. Journal of Women’s Health18: 225–233.
25.
LowryRJBillettABuchananC, et al. (2009) Increasing breastfeeding and reducing smoking in pregnancy: A social marketing success improving life chances for children. Perspectives in Public Health129(6): 277–280.
26.
McAlisterA (1995) Behavioral journalism: Beyond the marketing model for health communication. American Journal of Health Promotion9(6): 417–420.
27.
McCauslandKLAllenJDukeJ, et al. (2009) Piloting EX, a social marketing campaign to prompt smoking cessation. Social Marketing Quarterly15(Suppl. 1): 80–101.
28.
MackNWoodsongCMcQueenK, et al. (2005) Qualitative Research Methods: A Data Collectors Field Guide, Qualitative Research Methods: A Data Collectors Field Guide. Research Triangle Park, NC: Family Health International.
29.
MaconachieMLewendonG (2004) Immunising children in Primary Care in the UK – What are the concerns of principal immunisers?Health Education Journal63(1): 40–49.
30.
MarkowitzLEDunneESaraiyaM, et al. (2014) Human papillomavirus vaccination: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report63(RR-05): 1–30.
31.
MeitesEKempeAMarkowitzLE (2016) Use of a 2-dose schedule for human papillomavirus vaccination – Updated recommendations of the advisory committee on immunization practices. Morbidity and Mortality Weekly Report65(49): 1405–1408.
32.
MiddlestadtSEBhattacharyyaKRosenbaumJ, et al. (1996) The use of theory based semistructured elicitation questionnaires: Formative research for CDC’s prevention marketing initiative. Public Health Reports111(Suppl. 1): 18–27.
33.
MillsLAHeadKJVanderpoolRC (2013) HPV vaccination among young adult women: A perspective from Appalachian Kentucky. Preventing Chronic Disease10: E17.
34.
ParsonsNPMcCormack BrownKR (2004) Formative research: The bedrock of social marketing. The Health Education Monograph Series21(1): 1–5.
35.
PhillippiJLauderdaleJ (2018) A guide to field notes for qualitative research: Context and conversation. Qualitative Health Research28(3): 381–388.
36.
RoncancioAMWardKKCarmackCC, et al. (2017) Using social marketing theory as a framework for understanding and increasing HPV vaccine series completion among Hispanic adolescents: A qualitative study. Journal of Community Health42(1): 169–178.
37.
SaraiyaM (2015) Population-based HPV Genotype Attribution in HPV-associated Cancers. In: Proceedings presented at anal intraepithelial neoplasia society conference, Atlanta, GA, March 13–15.
38.
SingerDSJacksTJaffeeE (2016) A U.S. Cancer ‘Moonshot’ to accelerate cancer research. Science353(6304): 1105–1106.
39.
SperberNRBrewerNTSmithJS (2008) Influence of parent characteristics and disease outcome framing on HPV vaccine acceptability among rural, southern women. Cancer Causes and Control19(1): 115–118.
WalhartT (2012) Parents, adolescents, children and the human papillomavirus vaccine: A review. International Nursing Review59(3): 305–311.
42.
WeiCHerrickARaymondH, et al. (2011) Social marketing interventions to increase HIV/STI testing uptake among men who have sex with men and male-to-female transgender women. Cochrane Database of Systematic Reviews9(9): CD009337.
43.
WongFHuhmanMHeitzlerC, et al. (2004) VERB – a social marketing campaign to increase physical activity among youth. Preventing Chronic Disease1(3): A10.
44.
YeganehNCurtisDKuoA (2010) Factors influencing HPV vaccination status in a Latino population and parental attitudes towards vaccine mandates. Vaccine28(25): 4186–4191.
45.
YoungLAndersonJBeckstromL, et al. (2004) Using social marketing principles to guide the development of a nutrition education initiative for preschool-aged children. Journal of Nutrition Education and Behavior36(5): 250–257.
