TY - JOUR
T1 - A multilevel analysis of factors influencing the inaccuracy of parental reports of adolescent HPV vaccination status
AU - Vu, Milkie
AU - Luu, Minh
AU - Haardörfer, Regine
AU - Berg, Carla J.
AU - Escoffery, Cam
AU - Bednarczyk, Robert A.
N1 - Funding Information:
Dr. Bednarczyk is supported by a grant ( K01AI106961 ) from the National Institute for Allergy and Infectious Diseases, National Institutes of Health. Any analyses , interpretations, or conclusions reached are those of the authors and not to the National Center for Immunization and Respiratory Diseases , which is responsible only for the initial data.
Funding Information:
Dr. Bednarczyk is supported by a grant (K01AI106961) from the National Institute for Allergy and Infectious Diseases, National Institutes of Health. Any analyses, interpretations, or conclusions reached are those of the authors and not to the National Center for Immunization and Respiratory Diseases, which is responsible only for the initial data.
Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2019/2/4
Y1 - 2019/2/4
N2 - 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.
AB - 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.
KW - Adolescent health
KW - HPV vaccine
KW - Health disparities
KW - Vaccine policy
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U2 - 10.1016/j.vaccine.2018.12.032
DO - 10.1016/j.vaccine.2018.12.032
M3 - Article
C2 - 30626532
AN - SCOPUS:85059449763
SN - 0264-410X
VL - 37
SP - 869
EP - 876
JO - Vaccine
JF - Vaccine
IS - 6
ER -
