Exploring mother-daughter communication and social media influence on HPV vaccine refusal for daughters aged 9-17 years in a cross-sectional survey of 11,728 mothers in China

ABSTRACT

This study investigated the influences of mother-daughter communication and social media on mothers’ HPV vaccine refusal for their daughters aged 9–17. A cross-sectional online survey among 11,728 mothers of girls aged 9–17 in Shenzhen, China was implemented between July and October 2023. Multi-level logistic regression models were fitted. Among 11,728 participants, 43.2% refused to have their daughters receive an HPV vaccination. In multivariate analysis, more openness in the mother-daughter communication (AOR: 0.99, 95%CI: 0.98, 0.99), perceived more positive outcomes of mother-daughter communication (AOR: 0.77, 95%CI: 0.75, 0.79), higher frequency of exposure to testimonials about daughters’ HPV vaccination (AOR: 0.81, 95%CI: 0.78, 0.85) and information encouraging parents to vaccinate their daughters against HPV on social media (AOR: 0.76, 95%CI: 0.73, 0.79), and thoughtful consideration of the veracity of the information specific to HPV vaccines (AOR: 0.80, 95%CI: 0.77, 0.83) were associated with lower vaccine refusal. Mothers who were not the main decision-makers of daughters’ HPV vaccination (AOR: 1.28 to 1.46), negative outcome expectancies of mother-daughter communication (AOR: 1.06, 95%CI: 1.04, 1.08), and mothers’ HPV vaccine refusal (AOR: 2.81, 95%CI: 2.58, 3.06) were associated with higher vaccine refusal for their daughters. The level of mothers’ HPV vaccine refusal for their daughters was high in China. Openness and outcome expectancies of mother-daughter communication and information exposure on social media were considered key determinants of HPV vaccine refusal for daughters. Future HPV vaccination programs should consider these interpersonal factors.

KEYWORDS:

• HPV vaccine refusal
• mothers of girls
• mother-daughter communication
• social media influence
• China

Author’s contributions

Conceptualization: Z.L., S.C., L.S., H.C., Z.W.; methodology: Z.L., S.C., L.S., H.C., Y.F., X.L., K.F.C., Z.W.; data curation: Z.L., L.S., H.C., J.C., B.L., C.W.; project administration: Z.L., L.S., H.C., J.C., B.L., C.W.; writing-original draft preparation: S.C., Z.L., L.S., H.C., Y.F., X.L., K.F.C., Z.W.; writing-review and editing: S.C., Y.F., X.L., K.F.C., Z.W. All authors have read and agreed to the published version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets generated and/or analyzed during the current study are not publicly available as they contain sensitive personal behaviors but are available from the corresponding author on reasonable request.

Institutional review board statement

This study was conducted following the guidelines of the Declaration of Helsinki. Ethics approval was obtained from the Ethics Committee of the Shenzhen Longhua District Maternity and Child Healthcare Hospital (ref: 2022122201).

Informed consent statement

Prospective participants were informed that the survey was anonymous, their information will be kept strictly confidential, and they had the right to refuse to participate or withdraw from the study at any time. Refusal and withdrawal would not affect their access to any services. Electronic informed consent was obtained.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website at https://doi.org/10.1080/21645515.2024.2333111.

Additional information

Funding

This study was funded by the Scientific Research Project of Medical and Health Institutions in Longhua District [Grant number: 2021162], the Social Welfare Research Grant in Longhua District [Grant number: 2548A20210414BA70D4A].