A Physician’s Recommendation for HPV Vaccination: What Makes African American Mothers Compliant?

Document Type


Publication Date


Publication Title

Pediatric Infectious Disease Journal






Background: Improving human papillomavirus (HPV) vaccination among African–American (AA) female adolescents to reduce the cervical cancer burden is important and cost-effective. The study objective is to identify factors most influential to AA mothers’ likelihood to comply with a physician’s recommendation to get their daughters the HPV vaccine.

Methods: We conducted a cross-sectional survey. Participants were recruited through online and community sites (ie, schools, community centers, etc.) in Alabama. A total of 280 AA mothers and their adolescent daughters completed the survey. A binary logistic regression was used to determine factors influencing mother’s likelihood to adhere with a physician’s recommendation to get their daughters the HPV vaccine.

Results: The most significant factors influencing mother’s likelihood to comply with physician’s recommendation were culture: future-time orientation (P = 0.001), perceived barriers of HPV vaccination (P = 0.007), perceived susceptibility to HPV (P = 0.047) and perceived benefits of HPV vaccination (P = 0.002). Further exploration of perceived barriers and perceived benefits found mother’s perception that the HPV vaccine is a good way to protect my daughter’s health as the only significant benefit. No measures of perceived barriers were significant.

Conclusions: A physician’s recommendation should advise AA mothers on the risk of HPV and the importance of HPV vaccination at an early age to reduce cervical cancer risk. It should further address mothers’ perceived disadvantages of HPV vaccination (eg, side effects). Incorporating this information in physician recommendation practices could increase HPV vaccination rates with implications in reducing the cervical cancer burden among this high-risk population.