Milkie Vu1, Minh Luu2, Regine Haardörfer2, Carla J Berg3, Cam Escoffery3, Robert A Bednarczyk4. 1. Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: milkie.vu@emory.edu. 2. Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA. 3. Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Winship Cancer Institute, Emory University, Atlanta, GA, USA. 4. Winship Cancer Institute, Emory University, Atlanta, GA, USA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Abstract
BACKGROUND: Parental reports are commonly used for adolescent HPV vaccination status but may be subjected to bias. Guided by the Socioecological Framework, our study explores potential multilevel factors influencing the inaccuracy of parental reports of adolescent HPV vaccination status. METHODS: Data from parents of 19,683 adolescents with provider-verified data were analyzed using multilevel modeling. Correlates included adolescent characteristics, parent/household factors, number of providers seen, state-level median income, and state-level HPV vaccine policy. Outcomes included inaccuracy in reporting: vaccine initiation (≥1 dose), completion (3 doses), and number of doses. RESULTS: 24% and 25% of parents reported initiation and completion inaccurately; 28% under-reported and 11% over-reported number of doses. All adolescent characteristics, parent/household factors, and number of healthcare providers seen were associated with the outcomes. Of note, compared to parents of White adolescents, parents of racial/ethnic minority adolescents were more likely to inaccurately report all outcomes (aOR ranges from 1.43 to 1.76 for initiation, 1.45-1.75 for completion, 1.98-2.05 for under-reporting, and 1.17-1.41 for over-reporting). Households with higher maternal education (aOR = 0.70, 0.92, 0.79, and 0.80) and income (aOR = 0.54, 0.62, 0.50, and 0.70) were less likely to inaccurately report initiation, report completion, under-report, and over-report, respectively. Those having seen more providers were less likely to inaccurately report initiation and completion but more likely to over-report number of vaccine doses. DISCUSSION: Being parents of females, older adolescents, and racial/ethnic minority adolescents, having lower material education, and poverty status were associated with higher odds of inaccurately reporting HPV vaccination status. These results have implications for estimates drawn from self-reports. Future research can examine sources of inaccuracies (e.g., social desirability or health literacy); they could also explore solutions (e.g., access to vaccine records) that can help parents accurately report vaccination status. State policy does not appear to have an impact on report accuracy.
BACKGROUND: Parental reports are commonly used for adolescent HPV vaccination status but may be subjected to bias. Guided by the Socioecological Framework, our study explores potential multilevel factors influencing the inaccuracy of parental reports of adolescent HPV vaccination status. METHODS: Data from parents of 19,683 adolescents with provider-verified data were analyzed using multilevel modeling. Correlates included adolescent characteristics, parent/household factors, number of providers seen, state-level median income, and state-level HPV vaccine policy. Outcomes included inaccuracy in reporting: vaccine initiation (≥1 dose), completion (3 doses), and number of doses. RESULTS: 24% and 25% of parents reported initiation and completion inaccurately; 28% under-reported and 11% over-reported number of doses. All adolescent characteristics, parent/household factors, and number of healthcare providers seen were associated with the outcomes. Of note, compared to parents of White adolescents, parents of racial/ethnic minority adolescents were more likely to inaccurately report all outcomes (aOR ranges from 1.43 to 1.76 for initiation, 1.45-1.75 for completion, 1.98-2.05 for under-reporting, and 1.17-1.41 for over-reporting). Households with higher maternal education (aOR = 0.70, 0.92, 0.79, and 0.80) and income (aOR = 0.54, 0.62, 0.50, and 0.70) were less likely to inaccurately report initiation, report completion, under-report, and over-report, respectively. Those having seen more providers were less likely to inaccurately report initiation and completion but more likely to over-report number of vaccine doses. DISCUSSION: Being parents of females, older adolescents, and racial/ethnic minority adolescents, having lower material education, and poverty status were associated with higher odds of inaccurately reporting HPV vaccination status. These results have implications for estimates drawn from self-reports. Future research can examine sources of inaccuracies (e.g., social desirability or health literacy); they could also explore solutions (e.g., access to vaccine records) that can help parents accurately report vaccination status. State policy does not appear to have an impact on report accuracy.
Authors: Miriam J Laugesen; Ritesh Mistry; Kelley A Carameli; Kurt M Ribisl; Jack Needleman; Roshan Bastani Journal: J Adolesc Health Date: 2014-06-10 Impact factor: 5.012
Authors: Jennifer D Allen; Megan K D Othus; Rachel C Shelton; Yi Li; Nancy Norman; Laura Tom; Marcela G del Carmen Journal: Cancer Epidemiol Biomarkers Prev Date: 2010-09 Impact factor: 4.254
Authors: Rohit P Ojha; Joseph E Tota; Tabatha N Offutt-Powell; James L Klosky; Ramkumar Ashokkumar; James G Gurney Journal: Ann Epidemiol Date: 2013-02-27 Impact factor: 3.797
Authors: Kathy L MacLaughlin; Robert M Jacobson; Jennifer L St Sauver; Debra J Jacobson; Chun Fan; Chung-Il Wi; Lila J Finney Rutten Journal: Vaccine Date: 2020-07-24 Impact factor: 3.641
Authors: Trisha L Amboree; Jane R Montealegre; Paige Padgett Wermuth; Osaro Mgbere; Kayo Fujimoto; Charles Darkoh Journal: Prev Med Rep Date: 2022-06-10
Authors: Trisha L Amboree; Jane R Montealegre; Kayo Fujimoto; Osaro Mgbere; Charles Darkoh; Paige Padgett Wermuth Journal: Int J Environ Res Public Health Date: 2022-04-08 Impact factor: 4.614