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Pediatrics. 2014 Oct;134(4):e1049-56. doi: 10.1542/peds.2013-3454. Epub 2014 Sep 15.

Parent and adolescent knowledge of HPV and subsequent vaccination.

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Departments of Psychiatry, Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania
Biostatistics, and.
Medicine, Perelman School of Medicine; and.



Human papillomavirus (HPV) vaccination has been shown to have important health benefits, but vaccination rates are low. Parental and adolescent knowledge could possibly promote vaccination, but the relationship between knowledge and subsequent vaccination is unclear. This study examines how strongly HPV vaccination among high-risk adolescents is related to their or their parents' previous knowledge.


A longitudinal cohort study enrolled participants from low-income, predominantly African American neighborhoods. Baseline questionnaires measuring knowledge of HPV and HPV vaccination, as well other variables, were completed by 211 adolescents and 149 parents of another adolescent sample. Adolescent vaccination was tracked prospectively for 12 months after baseline by using clinic reporting data. Analyses tested if parent or adolescent knowledge was associated with or predictive of adolescent HPV vaccination.


On average, parents and adolescents answered slightly less than 50% of knowledge items correctly at baseline, with 5% of parents and 10% of adolescents not answering any knowledge items correctly. Within 12 months, 20 of 149 (13.4%) of the parents' daughters received an HPV vaccination and 32 of 211 (15.2%) of the other adolescent sample did so. Neither parental nor adolescent knowledge was associated with or predictive of adolescent vaccination. For example, when testing the relationship between adolescent vaccination and parental knowledge scores, all R(2) values were <0.005. Results were independent of available potential confounders.


Those with higher levels of knowledge were not more likely to obtain vaccination for themselves or their daughters. Ideally, future interventions will target factors related to vaccination.


HPV; behavior change; beliefs; human papillomavirus; immunization; implementation science; knowledge; prediction; theory-based behavioral interventions; vaccination

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