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中小学生家长为女儿接种HPV疫苗意愿影响因素:一项2024年基于IMB模型的横断面调查

Factors influencing parents′ intention to vaccinate their daughters against HPV: a cross-sectional analysis among primary and secondary school students based on the IMB model, 2024

  • 摘要:
    目的 基于信息–动机–行为技能(IMB)模型,探讨中小学生家长为女儿接种宫颈癌(HPV)疫苗意愿的影响因素,为提高女性青少年HPV疫苗接种率提供参考依据。
    方法 于2024年11月,采用横断面调查研究设计,运用多阶段分层整群随机抽样方法,在苏州市相城区抽取1 276名至少有1名9~14岁女儿的学生家长为研究对象,调查其为女儿接种HPV疫苗的意愿及其影响因素,按家长性别进行亚组分析。
    结果 调查的1 276名家长中89.0%为母亲。64.42%的家长愿意为女儿接种HPV疫苗,但实际接种率仅为14.73%。在不同模型中,母亲自身接种意愿均为其为女儿接种HPV疫苗意愿的最显著预测因素,总人群(OR=14.85,95%CI=9.95~22.16);母亲组(OR=14.22,95%CI=9.35~21.62);父亲组(OR=69.08,95%CI=9.78~488.01)。性别分层分析显示,HPV知识水平仅在父亲组中显著影响其为女儿接种HPV疫苗的意愿(OR=1.59,95%CI=1.08~2.32),而感知易感性(OR=1.31,95%CI=1.02~1.67)、社会规范(OR=1.84,95%CI=1.28~2.66)、预期后悔(OR=1.66,95%CI=1.26~2.18)和自我效能感(OR=2.86,95%CI=1.67~4.90)主要在母亲组中发挥作用。感知障碍在所有组别中均为重要的负向预测因子,总人群(OR=0.41,95%CI=0.30~0.55);母亲组(OR=0.41,95%CI=0.30~0.57);父亲组(OR=0.23,95%CI=0.06~0.89)。IMB模型对家长为女儿接种HPV意愿具有良好的解释力。
    结论 家长为女儿接种HPV疫苗的意愿受多种因素影响,且存在显著的性别差异。IMB模型为理解家长为女儿接种HPV疫苗的决策及影响因素提供了有效的理论框架。

     

    Abstract:
    Objective To explore the factors influencing parents′ intention to vaccinate their daughters against HPV among primary and secondary school students based on the Information-Motivation-Behavioral Skills (IMB) model, thus providing evidence for improving the HPV vaccination rate among adolescent girls.
    Methods This cross-sectional study was conducted in November 2024. A multi-stage stratified cluster random sampling method was employed to select 1 276 parents with at least one daughter aged 9 to 14 from Xiangcheng district, Suzhou city. Data on parents′ intention to vaccinate their daughters against HPV and associated influencing factors were collected, with subgroup analyses performed according to parents′ gender.
    Results Among the 1 276 participants, 89.0% were mothers. Although 64.42% of parents expressed intention to vaccinate their daughters against HPV, the actual vaccination rate was only 14.73%. Maternal own intention to be vaccinated emerged as the strongest associated factor of their daughters′ HPV vaccination across all models (total population: OR = 14.85, 95%CI: 9.95–22.16; mothers: OR = 14.22, 95%CI: 9.35–21.62; fathers: OR = 69.08, 95%CI: 9.78–488.01). Gender-stratified analyses revealed that HPV knowledge significantly influenced vaccination intention only among fathers (OR = 1.59, 95%CI: 1.08–2.32), while perceived susceptibility (OR = 1.31, 95%CI: 1.02–1.67), social norms (OR = 1.84, 95%CI: 1.28–2.66), anticipated regret (OR = 1.66, 95%CI: 1.26–2.18), and self-efficacy (OR = 2.86, 95%CI: 1.67–4.90) were significant predictors among mothers. Perceived barriers were a significant negative predictor across all groups (total population: OR = 0.41, 95%CI: 0.30–0.55; mothers: OR = 0.41, 95%CI: 0.30–0.57; fathers: OR = 0.23, 95%CI: 0.06–0.89). The IMB model demonstrated good explanatory power for parents′ intention of HPV vaccination for their daughters.
    Conclusions Parents′ intention to vaccinate their daughters against HPV is influenced by multiple factors and exhibits significant gender differences. The IMB model offers an effective theoretical framework for understanding the influencing factors in parents′ decision-making regarding HPV vaccination for their daughters.

     

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