Dora Samaria, Sintha Fransiske Simanungkalit

Differences In the Intention to Receive the Human Papillomavirus (HPV) Vaccine For Cervical Cancer Prevention Among Women with Different Types of Decision-Making Roles

Introduction

Differences in the intention to receive the human papillomavirus (hpv) vaccine for cervical cancer prevention among women with different types of decision-making roles. This study compares HPV vaccine intention for cervical cancer prevention among women with varied decision roles. Adult women show the highest intent.

Abstract

Despite the availability of cervical cancer prevention programs through Human Papillomavirus (HPV) vaccination in Indonesia, the overall immunization coverage remains limited. One of the main contributing factors is the low intention among the community to receive the HPV vaccine. Low intention may lead to limited vaccination uptake. This study aims to compare differences in intention to get HPV vaccination among three groups of female decision makers, namely, adult women who take their own vaccine decisions, adolescent girls who rely on their parents to decide on vaccination, and parents who help make decisions regarding HPV vaccination for their daughters. This study employed a quantitative approach with a cross-sectional design. Each group of decision makers consisted of 147 people, with a total of 441 respondents. The data collected were analyzed using Kruskal-Wallis test. The statistical analysis confirmed significant differences in intention among the three groups (p<0.001). The highest mean intention rank was in the adult women group (mean-rank=273.55), followed by parents (mean-rank=214.37), and the lowest in adolescent girls (mean-rank=175.09). Women's intention to receive the HPV vaccine is influenced by their level of independence in decision-making. Adult women with full decision-making autonomy demonstrated the highest intention. These findings highlight the need for tailored approaches in promoting HPV vaccination based on decision-making roles to improve vaccination uptake.

Review

This study addresses a crucial public health challenge by investigating the factors influencing Human Papillomavirus (HPV) vaccine intention among different decision-making groups in Indonesia, where coverage remains low. The authors effectively delineate three distinct respondent categories: adult women with full autonomy, adolescent girls reliant on parental decisions, and parents deciding for their daughters. The quantitative cross-sectional design, employing a robust sample size of 441 participants equally distributed across groups, and the use of the Kruskal-Wallis test, are appropriate for comparing intention levels. The clear finding of significant differences in intention, with adult women exhibiting the highest and adolescent girls the lowest intention, provides valuable empirical evidence supporting the hypothesis that decision-making independence correlates with higher intention to receive the HPV vaccine. While the study presents compelling findings, it has certain limitations inherent to its design and scope. The cross-sectional nature precludes the establishment of causality, meaning it cannot fully explain *why* these differences exist, only *that* they do. Further, the abstract provides limited detail on the specific demographics of each group beyond their number, such as age ranges for adults and adolescents, socioeconomic status, or educational attainment, which could influence generalizability. The study's purely quantitative approach, while effective for identifying differences, does not delve into the qualitative factors, beliefs, or perceived barriers and facilitators that underpin the varying intentions within each group, leaving a gap in understanding the underlying mechanisms driving these observed disparities. Despite these limitations, the study offers significant implications for public health policy and intervention strategies aimed at improving HPV vaccination uptake. The finding that intention is strongly linked to decision-making autonomy underscores the necessity for highly tailored public health campaigns. For adolescent girls, interventions should primarily target parents, emphasizing education, addressing concerns, and fostering a supportive decision-making environment. Conversely, campaigns aimed at adult women could focus on reinforcing their autonomy and providing direct information regarding the benefits and accessibility of the vaccine. This research lays a strong foundation for future studies, suggesting a need for qualitative research to explore the nuanced reasons behind intentions in each group, as well as longitudinal studies to track the progression from intention to actual vaccination uptake across different decision-making roles.

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