Rural parents' willingness to vaccinate male children against human papillomavirus and the effects of an individualized HPV educational program

Human Papillomavirus (HPV) is the most common sexually transmitted infection both internationally and domestically, contributing to over 500,000 cases of cervical cancer and 260,000 cases of HPV related cancers annually. Rural counties tend to be vulnerable to high cervical cancer and HPV rates by both social and economic factors.;Two HPV vaccines are available for both males. To date the majority of literature exploring the use of these vaccines has surrounded parental knowledge and acceptance of HPV vaccines for adolescents in general or females only. Only a paucity of literature exists that explores how parents of males perceive HPV disease and their willingness to vaccinate male children against HPV.;Using constructs of the Health Belief Model and Theory of Planned Behavior, the purpose of this randomized controlled intervention study was to examine rural parents' knowledge and attitudes surrounding HPV infections and the degree to which these constructs influenced their willingness to vaccinate male children against HPV. The sample consisted of parents of boys (N=308), aged 8 - 17, residing in three rural counties of NY and PA. The intervention group participated in an HPV verbal education program after reading the CDC HPV Vaccine Information Statement, as opposed to the control group, which read the CDC Vaccine Information Statement only. Independent t-tests showed that knowledge of HPV vaccines was higher in the intervention than the control group (t = 3.57, df, 274.83, p = <.000), however increased knowledge failed to increase willingness to vaccinate.;A backwards multiple regression procedure identified those significant variables that influenced willingness to vaccinate male children against HPV; perceived susceptibility to their son contracting HPV, perceived barriers to HPV vaccines, and overall perceived benefits of HPV vaccines in general. The monetary amount a parent was willing to pay also predicted willingness to vaccinate, with an out-of-pocket cost of ;These results provide valuable implications for public health nursing HPV education programs, clinical practice and HPV research. The identification of reliable indicators of HPV vaccine acceptance among rural parents of adolescent males can help formulate the development of community and state wide HPV vaccine education programs, both formally and informally, that may perhaps be more meaningful to rural populations. These HPV programs should not only educate, but also frame HPV information more relevantly, from a gender-neutral perspective, positively influencing HPV vaccination rates in those communities that may benefit from them the most.