Using the Health Belief Model to Examine Parental Knowledge and Health Beliefs About Human Papilloma Virus (HPV) and iHPV Vaccine in Kuwait: Cross-Sectional Survey Study.
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BACKGROUND: Cervical cancer (CC) is a major public health issue, accounting for approximately 350,000 deaths, around 7.5% of all female cancer deaths worldwide, in 2018. Human papillomavirus (HPV) is the most common virus infecting the reproductive system. Despite the high number of diagnosed cases of CC globally, prevention is possible. Vaccination against HPV is considered to be a primary prevention strategy, while cervical screening can also play a secondary prevention role. OBJECTIVE: This study aimed to examine the knowledge and health beliefs of parents in Kuwait towards HPV and HPV vaccination in order to prepare for the development of a national policy on CC. METHODS: A cross-sectional survey was conducted among a representative multistage sample of 538 parents and guardians of eligible children aged 12-17 years in Kuwait, yielding a response rate of 89%. The survey was structured using the health belief model. Analysis showed statistically significant links between knowledge, health beliefs, concepts, and vaccination intention. RESULTS: Knowledge of HPV and HPV vaccination was low in our study population: 55.6% (n=297), 24.9% (n=133), and 19.5% (n=104) for poor, fair, and good knowledge, respectively. Parents of daughters scored lower on perceived susceptibility to HPV and were more likely to have a higher perception of barriers to HPV vaccination, even though fathers were more likely to believe their daughters were at risk. HPV vaccination has the stigma of promiscuity attached, even though half of the parents are willing to accept HPV vaccination if that recommendation comes from Uhealth officials or relatives. A greater proportion of parents with female children had a low perception of the severity of HPV infection compared to those with male children (n=154, 58.6% vs n=134, 49.4%; P=.043). Around 52% (n=278) of parents perceived a high benefit of HPV vaccination. Parents with a female child had a lower perception of HPV vaccine benefits compared to parents with a male child. The findings demonstrated that parents with higher levels of education were better informed about the use of HPV vaccines in controlling the illness. Parents with female children were 1.34 times more likely to act on the recommendation for HPV vaccination compared to parents with male children after a recommendation from an official source, such as doctors or healthcare professionals. CONCLUSIONS: Recommendations for a Kuwaiti vaccination policy for HPV must take into consideration different knowledge levels of parents for groups with different educational levels, as well as the stigma of promiscuity and other barriers, and various health beliefs regarding susceptibility for daughters and sons, respectively.