| Object:To investigate parents’ cognitive level and decision-making intention of HPV vaccination for girls in junior middle school and explore the influencing factors,which can help provide advice and scientific basis for the implementation of targeted intervention programs.Methods:1.Development of the HPV Vaccination Intent Questionnaire,which includes the following steps:a)Qualitative research.According to the purpose of this study,based on the theoretical framework of protective motivation and literature review,the outline of the interview was determined after external expert evaluation and field test.Using objective sampling,based on the principle of saturated interview data,12 parents of girls in junior high school and 5 experts in preventive medicine,gynecological oncology,health statistics,psychology and other subjects were selected for semi-structured interviews.Colaizzi data analysis method and template analysis method were used to summarize the data,compile the questionnaire items,and establish the entry pool.b)Expert evaluation.Using the purpose sampling method,a total of 16 experts in statistics,psychology,health education,gynecological oncology,and child health care were selected for two rounds of correspondence,and the preliminary questionnaire entries were screened,modified,merged,and deleted to form the first version "HPV Vaccination Intent Questionnaire";c)Pre-investigation.The convenience sampling method was used to apply the preliminary questionnaire to survey eligible parents of junior high school girls.The items were further screened by detecting the discrimination of the items;the validity of the questionnaire was analyzed using exploratory factor analysis,and content validity test;the reliability of the questionnaire was tested using the Cronbach’s α coefficient.Form a formal questionnaire.2.Formal investigation.Using stratified-cluster sampling,a total of 408 parents of three grade girls in four municipal junior middle schools in Bengbu City were selected as the research object.The self-designed general sociodemographic data questionnaire and the HPV Vaccination Intent Questionnaire were used to investigate the current situation.The data processing results were statistically described,confirmatory factor analysis, correlation analysis,and binary logistic regression analysis to determine the effect of each factor on parents’ cognitive level and inoculation intention.Results:1.Through semi-structured interviews and expert assessments,an initial version of the HPV Vaccination Intent Questionnaire was formed,which contains 7 dimensions and 35 items.Questionnaire reliability and validity test results: a)item discrimination: delete entry Sev6(t <3.0);b)EFA: After two rounds of principal component analysis,each entry had a larger load value on the corresponding common factor(0.518?0.863).The explanation rate of cumulative variance was 61.954%,and 6 relatively stable common factors were extracted,which were "perceived severity","perceived susceptibility","delayed rewards","response efficacy","self-efficacy" and "response costs ";c)Content validity: The average content validity of the questionnaires in the two rounds of expert assessment was 0.896 and 0.964,respectively;d)Internal consistency: The Cronbach’s α coefficient of each dimension were 0.816?0.866,and the overall Cronbach’s α coefficient of the questionnaire is 0.905,which showed the internal consistency of the questionnaire was good.Finally,a formal version of the HPV Vaccination Intent Questionnaire was formed,containing 6 dimensions and 33 entries.2.In the formal survey,the reliability and validity of the questionnaire were further tested.a)CFA: ?2/df =2.413,CFI,IFI,and TLI three fitting indexes were 0.875?0.887,RMSEA =0.059,and the factor load of each item was 0.531?0.814,combined reliability 0.733?0.907,overall model adaptability is reasonable;b)Internal consistency: Cronbach’s α coefficient of each dimension is 0.812?0.863,Cronbach’s α coefficient of the overall questionnaire is 0.765,internal consistency good.3.The rate of HPV vaccination among junior high school girls was low(2.7%),and the parents’ intentions for HPV vaccination among junior high school girls were low too(27.5%).The grade,kinship,marital status,family history of malignant tumor and medical insurance category of girls in junior middle school were related to parents’ cognition level of vaccination HPV girls in junior middle school.Logistic regression model showed that the main factors affecting vaccination intention included girls’ age,parents’ education level,occupation,parents’ perception of susceptibility,delayed rewards,response efficacy and response costs,among which perceived susceptibility and response efficacy were the contributing factors to the formation of vaccination intention,and the hindering factors were perceived delayed rewards and response costs.Conclusions:1.The HPV Vaccination Intent Questionnaire based on PMT has good reliability and effectiveness,which can understand parents’ cognition of their daughter’s vaccination from the aspects of perceived severity,susceptibility,delayed rewards,response efficacy,self-efficacy and response costs,and make the related cognitive research both systematic and scientific;2.Parents’ awareness of HPV vaccine is low and biased.Therefore,parents must strengthen their perception of HPV infection susceptibility and benefits of HPV vaccination,reduce misunderstandings,and increase confidence in vaccination;3.The HPV vaccine has a low vaccination rate among junior high school girls.Parents’ decision-making intent to vaccinate this group needs to be improved.Cognitive factors that affect their decision-making intent include perceived susceptibility,response effectiveness,delayed rewards,and response costs;4.The application of the theory of protection motivation in measuring the cognition level of parents of junior high school girls,better explained the influence mechanism of cognitive factors on parental decision-making intentions,and provided a basis for subsequent targeted intervention research. |
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