Parental Acceptance of the Human Papillomavirus Vaccination Among South Asian Immigrants

104 Pages·2017·2.48 MB·English

by  Samina Shams Khan

Purdue University
Purdue e-Pubs
Open Access Theses Theses and Dissertations
Summer 2014
Parental Acceptance of the Human Papillomavirus
Vaccination Among South Asian Immigrants
Living in the Midwest USA
Samina Shams Khan
Purdue University
Follow this and additional works at:https://docs.lib.purdue.edu/open_access_theses
Part of theHealth Policy Commons
Recommended Citation
Khan, Samina Shams, "Parental Acceptance of the Human Papillomavirus Vaccination Among South Asian Immigrants Living in the
Midwest USA" (2014).Open Access Theses. 446.
https://docs.lib.purdue.edu/open_access_theses/446
This document has been made available through Purdue e-Pubs, a service of the Purdue University Libraries. Please contact [email protected] for
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PURDUE UNIVERSITY
GRADUATE SCHOOL
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i
PARENTAL ACCEPTANCE OF THE HUMAN PAPILLOMAVIRUS VACCINATION
AMONG SOUTH ASIAN IMMIGRANTS LIVING IN THE MIDWEST USA
A Thesis
Submitted to the Faculty
of
Purdue University
by
Samina Shams Khan
In Partial Fulfillment of the
Requirements for the Degree
of
Master of Public Health
August 2014
Purdue University
West Lafayette, Indiana
ii
For my loving parents
Md. Shamsur Rahman Khan and Tahera Khan,
and my dearest son and husband
Nawaf Rayan Bhuiyan and Aizaz Bhuiyan
iii
ACKNOWLEDGEMENTS
I am thankful to my academic advisors Dr. Titilayo Okoror and Dr. Gerald Hyner
for their endless guidance and support to make this research a success. My gratitude goes
to them for being accommodating and easily accessible at several times when their
support was necessary. Their positive attitude always kept me motivated and without
their astute thoughts and constructive suggestions this work would not have been possible.
I also express my sincere gratitude to Dr. Roseann Lyle for her valuable time and
important suggestions to make this thesis complete.
I thankfully acknowledge the people and organizations that were behind the main
driving force of this research, the data collection. I am grateful to my wonderful friends
who disseminated the survey links to the potential participants. I am equally thankful to
the members of the South Asian organizations who completed the surveys and provided
data for my research. Special thanks go to Bithi Islam and Pooja Sharma, for working so
hard for getting the survey participants for this study.
My deepest gratitude goes to the people of the graduate Health and Kinesiology
Department for their support. I appreciate my wonderful friend Haijuan Gao and Tahira
Yeasmin for extending helpful hands on several occasions. I specially appreciate the
service of Lisa Duncan from the very first day of my graduate school. It is for the
department staffs my journey was so smooth.
iv
I am indebted to my parents, Md. Shamsur Rahman Khan and Mrs. Tahera Khan
for their continuous inspiration in any academic work of my entire life. The sacrifice they
have made for my graduate work is unsurpassable. I feel proud to have such supportive
and cooperative parents. I am also grateful to my husband, Dr. Aizaz Bhuiyan for his
constant love, support, and care.
Finally, a true inspiration of my graduate studies was my son’s glowing smile. My
all source of energy for this degree was this heavenly kid. A million thanks to Nawaf for
the priceless moments you shared with me throughout the whole journey.
v
TABLE OF CONTENTS
Page
LIST OF TABLES ............................................................................................................ vii 
LIST OF FIGURES ........................................................................................................... ix 
ABSTRACT……….. .......................................................................................................... x 
CHAPTER 1.  INTRODUCTION ................................................................................. 1 
1.1  Introduction ............................................................................................... 1 
1.2  Background ............................................................................................... 2 
1.3  Research Questions ................................................................................... 4 
1.4  Significance of the study ........................................................................... 4 
CHAPTER 2.  LITERATURE REVIEW ...................................................................... 6 
2.1  Burden of HPV Infection in South Asia.................................................... 6 
2.2  Prevention strategy .................................................................................... 8 
2.3  HPV vaccine and South Asian Parents ..................................................... 9 
2.4  South Asian Immigrants and Cancer Prevention Strategy ...................... 12 
CHAPTER 3.  RESEARCH METHOD ...................................................................... 16 
3.1  Participants .............................................................................................. 16 
3.2  Research Procedure ................................................................................. 17 
3.3  Measures .................................................................................................. 17 
3.3.1  Dependent Variables .........................................................................17 
3.3.2  Independent Variables .......................................................................18 
3.4  Statistical Analysis .................................................................................. 19 
3.5  Socio-ecological Model ........................................................................... 20 
CHAPTER 4.  RESULTS ............................................................................................ 22 
4.1  Socio-demographic Information ............................................................. 22
vi
Page
4.2  Awareness of HPV, Cervical Cancer, Genital Warts, and HPV
Vaccination…. .............................................................................................................. 26 
4.3  HPV Knowledge ..................................................................................... 33 
4.4  Source of Information ............................................................................. 38 
4.5  Attitude Toward Vaccination In General ................................................ 39 
4.6  Parental Willingness to HPV Vaccination .............................................. 42 
4.7  Reasons in Support of and Against Vaccination ..................................... 47 
CHAPTER 5.  DISCUSSION ...................................................................................... 55 
5.1  Introduction ............................................................................................. 55 
5.2  Awareness and Knowledge of HPV ........................................................ 55 
5.3  Willingness .............................................................................................. 58 
5.3.1  Difference in Acceptance Across Sex of the Children ......................59 
5.3.2  Difference in Acceptance Across the Sex of the Parents ..................60 
5.3.3  Other Factors .....................................................................................60 
5.4  Supporting Factors and Barriers Toward HPV Vaccination Decision .... 61 
5.5  Physicians’ Role in Parental Vaccine Decision ...................................... 62 
5.6  Strengths of the Study ............................................................................. 63 
5.7  Limitations of the Study .......................................................................... 63 
5.8  Future Research ....................................................................................... 64 
5.9  Conclusion ............................................................................................... 64 
LIST OF REFERENCES .................................................................................................. 67
APPENDICES
Appendix A  Email Invitation ....................................................................................... 72 
Appendix B  Online Participant Information Sheet ...................................................... 73 
Appendix C  Survey Questionnaire .............................................................................. 75 
Appendix D  Email Reminder ....................................................................................... 88
vii
LIST OF TABLES
Table .............................................................................................................................. Page
Table 4.1: Socio-demographic information of the study population (n=136). ................. 23 
Table 4.2: Awareness of HPV, cervical cancer, genital warts, and HPV vaccination. ..... 26 
Table 4.3: Awareness of HPV across different socio-demographic variables. ................. 27 
Table 4.4: Awareness of cervical cancer across different socio-demographic variables. 28 
Table 4.5: Awareness of genital warts across different socio-demographic variables. .... 29 
Table 4.6: Awareness of HPV vaccine across different socio-demographic variables. ... 30 
Table 4.7: Regression analysis of HPV, cervical cancer, genital warts, and HPV
vaccination awareness ....................................................................................................... 32 
Table 4.8: Individual knowledge on HPV. ....................................................................... 34 
Table 4.9: Average score on knowledge questions. .......................................................... 35 
Table 4.10: Frequency distribution of knowledge scores. ................................................ 35 
Table 4.11: Variation of knowledge across socio demographic variables. ....................... 37 
Table 4.12: Logistic regression analysis of knowledge. ................................................... 38 
Table 4.13: Source of information (n=136). ..................................................................... 39 
Table 4.14: Attitude towards vaccination in general in valid percentages. ...................... 41 
Table 4.15: Variation of parents’ willingness to vaccinate daughters across different
socio-demographic variables. ........................................................................................... 43
viii

Table .............................................................................................................................. Page
Table 4.16: Variation of parents’ willingness to vaccinate sons across different socio-
demographic variables. ..................................................................................................... 44 
Table 4.17: Logistic regression analysis of parents’ willingness to vaccinate daughters. 46 
Table 4.18: Logistic regression analysis of parents’ willingness to vaccinate sons. ........ 47 
Table 4.19: Reason for accepting HPV vaccination. ........................................................ 50 
Table 4.20: Reasons for not accepting HPV vaccination. ................................................ 51