Skip to main content

Advertisement

Log in

Using Social Marketing Theory as a Framework for Understanding and Increasing HPV Vaccine Series Completion Among Hispanic Adolescents: A Qualitative Study

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

HPV vaccine series completion rates among adolescent Hispanic females and males (~39 and 21 %, respectively) are far below the Healthy People 80 % coverage goal. Completion of the 3-dose vaccine series is critical to reducing the incidence of HPV-associated cancers. This formative study applies social marketing theory to assess the needs and preferences of Hispanic mothers in order to guide the development of interventions to increase HPV vaccine completion. We conducted 51 in-depth interviews with Hispanic mothers of adolescents to identify the key concepts of social marketing theory (i.e., the four P’s: product, price, place and promotion). Results suggest that a desire complete the vaccine series, vaccine reminders and preventing illnesses and protecting their children against illnesses and HPV all influence vaccination (product). The majority of Completed mothers did not experience barriers that prevented vaccine series completion and Initiated mothers perceived a lack of health insurance and the cost of the vaccine as potential barriers. Informational barriers were prevalent across both market segments (price). Clinics are important locations for deciding to complete the vaccine series (place). They are the preferred sources to obtain information about the HPV vaccine thus making them ideal locations to deliver intervention messages, followed by television, the child’s school and brochures (promotion). Increasing HPV vaccine coverage among Hispanic adolescents will reduce the rates of HPV-associated cancers and the cervical cancer health disparity among Hispanic women. This research can inform the development of an intervention to increase HPV vaccine series completion in this population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Markowitz, L. E., Dunne, E. F., Saraiya, M., Chesson, H. W., Curtis, C. R., Gee, J., et al.; Centers for Disease Control and Prevention (CDC). (2014). Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report, 63(RR-05), 1–30. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25167164.

  2. Administration, F. and D. (2014). Highlights of prescribing information. Gardasil 9 (human papillomavirus 9-valent vaccine, recombinant). Silver Spring, MD.

    Google Scholar 

  3. Saraiya, M. (2015). Population-based HPV genotype attribution in HPV-associated cancers. Presented at Anal Intraepithelial Neoplasia Society Conference, March 13–15. Atlanta.

  4. Chaturvedi, A. K., Engels, E. A., Pfeiffer, R. M., Hernandez, B. Y., Xiao, W., Kim, E., et al. (2011). Human papillomavirus and rising oropharyngeal cancer incidence in the United States. Journal of Clinical Oncology, 29(32), 4294–4301. doi:10.1200/JCO.2011.36.4596.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Jemal, A., Simard, E. P., Dorell, C., Noone, A. M., Markowitz, L. E., Kohler, B., et al. (2013). Annual report to the nation on the status of cancer, 1975–2009, featuring the burden and trends in human papillomavirus (HPV)-associated cancers and HPV vaccination coverage levels. Journal of the National Cancer Institute, 105(3), 175–201. doi:10.1093/jnci/djs491.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Howlader, N., Noone, A. M., Krapcho, M., et al. (2011). SEER cancer statistics review, 1975–2008. Bethesda. Retrieved from http://seer.cancer.gov/csr/1975_2008/.

  7. U.S. Department of Health and Human Services,, O. of D. P. and H. P. (n.d.). Healthy People 2020 [Internet]. D.C. Retrieved from http://www.healthypeople.gov/node/3527/objectives#4654.

  8. Centers for Disease Control and Prevention. (2014). National Immunization Survey, 2014. Atlanta. Retrieved from http://www.cdc.gov/vaccines/imz-managers/coverage/nis/teen/data/tables-2014.html#race.

  9. Bryant, C. A., & Grier, S. (2005). Social marketing in public health. Annual Review of Public Health, 26(9), 319–339. doi:10.1146/annurev.publhealth.26.021304.144610.

    PubMed  Google Scholar 

  10. Glanz, K., Rimer, B. K., & Viswanath. (2008). Health behaviour and health education: theory, research and practice. doi:10.1016/S0033-3506(49)81524-1.

  11. Glanz, K., & Bishop, D. B. (2010). The role of behavioral science theory in development and implementation of public health interventions. Annual Review of Public Health, 31, 399–418. doi:10.1146/annurev.publhealth.012809.103604.

    Article  PubMed  Google Scholar 

  12. Francis, S. L., & Taylor, M. L. (2009). A social marketing theory-based diet-education program for women ages 54 to 83 Years improved dietary status. Journal of the American Dietetic Association, 109(12), 2052–2056. doi:10.1016/j.jada.2009.09.002.

    Article  PubMed  Google Scholar 

  13. Alaimo, K., Carlson, J. J., Pfeiffer, K. A., Eisenmann, J. C., Paek, H. J., Betz, H. H., et al. (2015). Project FIT: A school, community and social marketing intervention improves healthy eating among low-income elementary school children. Journal of Community Health, 40(4), 815–826. doi:10.1007/s10900-015-0005-5.

    Article  PubMed  Google Scholar 

  14. Pérez-Escamilla, R. (2012). Breastfeeding social marketing: Lessons learned from USDA’s “loving support” campaign. Breastfeeding Medicine, 7(5), 358–363. doi:10.1089/bfm.2012.0063.

    Article  PubMed  Google Scholar 

  15. Mack, N., Woodsong, C., McQueen, K. M., Guest, G., & Namey, E. (2005). Qualitative research methods: A data collector’s field guide. doi:10.1108/eb020723.

  16. Middlestadt, S. E., Bhattacharyya, K., Rosenbaum, J., Fishbein, M., & Shepherd, M. (1996). The use of theory based semistructured elicitation questionnaires: formative research for CDC’s Prevention Marketing Initiative. Public Health Reports, 111 (Suppl 1), 18–27.

    PubMed  PubMed Central  Google Scholar 

  17. Parsons, N. P., & McCormack Brown, K. R. (2004). Formative research: The bedrock of social marketing. The Health Education Monograph Series, 21(1), 1–5.

    Google Scholar 

  18. Hsieh, H.-F. (2005). Three Approaches to Qualitative Content Analysis. Qualitative Health Research, 15(9), 1277–1288. doi:10.1177/1049732305276687.

    Article  PubMed  Google Scholar 

  19. Perkins, R. B., Tipton, H., Shu, E., Marquez, C., Belizaire, M., Porter, C., et al. (2013). Attitudes toward HPV vaccination among low-income and minority parents of sons: A qualitative analysis. Clinical Pediatrics, 52(3), 231–240. doi:10.1177/0009922812473775.

    Article  PubMed  Google Scholar 

  20. Reiter, P. L., McRee, A. L., Pepper, J. K., Gilkey, M. B., Galbraith, K. V., & Brewer, N. T. (2013). Longitudinal predictors of human papillomavirus vaccination among a national sample of adolescent males. American Journal of Public Health, 103(8), 1419–1427. doi:10.2105/AJPH.2012.301189.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Dorell, C. G., Stokley, S., Yankey, D., & Markowitz, L. E. (2012). Compliance with recommended dosing intervals for HPV vaccination among females, 13–17 years, National Immunization Survey-Teen, 2008–2009. Vaccine, 30(3), 503–505. doi:10.1016/j.vaccine.2011.11.042.

    Article  PubMed  Google Scholar 

  22. Jacobson Vann, J. C., & Szilagyi, P. (2005). Patient reminder and recall systems to improve immunization rates. Cochrane Database of Systematic Reviews, 2005(3), CD003941. doi:10.1002/14651858.CD003941.pub2.

  23. Kharbanda, E. O., Stockwell, M. S., Fox, H. W., Andres, R., Lara, M., & Rickert, V. I. (2011). Text message reminders to promote human papillomavirus vaccination. Vaccine, 29(14), 2537–2541. doi:10.1016/j.vaccine.2011.01.065.

    Article  PubMed  Google Scholar 

  24. Liddon, N. C., Hood, J. E., & Leichliter, J. S. (2012). Intent to receive HPV vaccine and reasons for not vaccinating among unvaccinated adolescent and young women: Findings from the 2006–2008 National Survey of Family Growth. Vaccine, 30(16), 2676–2682. doi:10.1016/j.vaccine.2012.02.007.

    Article  PubMed  Google Scholar 

  25. Brewer, N. T., & Fazekas, K. I. (2007). Predictors of HPV vaccine acceptability: A theory-informed, systematic review. Preventive Medicine, 45(2–3), 107–114. doi:10.1016/j.ypmed.2007.05.013.

    Article  PubMed  Google Scholar 

  26. Reiter, P. L., Gupta, K., Brewer, N. T., Gilkey, M. B., Katz, M. L., Paskett, E. D., & Smith, J. S. (2014). Provider-verified HPV vaccine coverage among a national sample of hispanic adolescent females. Cancer Epidemiology Biomarkers and Prevention, 23(5), 742–754. doi:10.1158/1055-9965.EPI-13-0979.

    Article  Google Scholar 

  27. Mills, a. L., Head, K. J., & Vanderpool, R. C. (2013). HPV vaccination among young adult women: a perspective from Appalachian Kentucky. Preventing Chronic Disease, 10, E17. doi:10.5888/pcd10.120183.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Corcoran, N. (2007). Communicating health. Strategies for health promotion. London: SAGE Publications, 5–31. doi:10.1212/01.CON.0000443830.87636.9a.

    Google Scholar 

  29. Rahman, M., Laz, T. H., McGrath, C. J., & Berenson, A. B. (2015). Provider Recommendation Mediates the Relationship Between Parental Human Papillomavirus (HPV) Vaccine Awareness and HPV Vaccine Initiation and Completion Among 13- to 17-Year-Old US Adolescent Children. Clinical Pediatrics, 54(4), 371–375. doi:10.1177/0009922814551135.

    Article  PubMed  Google Scholar 

  30. McRee, A.-L., Reiter, P. L., & Brewer, N. T. (2012). Parents’ internet use for information about HPV vaccine. Vaccine, 30(25), 3757–3762. doi:10.1016/j.vaccine.2011.11.113.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Research for this publication was supported by NIH/NCI Grant K01CA181437.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Angelica M. Roncancio.

Ethics declarations

Conflict of Interest

The authors report no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Roncancio, A.M., Ward, K.K., Carmack, C.C. et al. Using Social Marketing Theory as a Framework for Understanding and Increasing HPV Vaccine Series Completion Among Hispanic Adolescents: A Qualitative Study. J Community Health 42, 169–178 (2017). https://doi.org/10.1007/s10900-016-0244-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-016-0244-0

Keywords

Navigation