Human papillomavirus vaccine awareness, uptake, and parental and health care provider communication among 11- to 18-year-old adolescents in a rural Appalachian Ohio county in the United States

J Rural Health. 2015 Winter;31(1):67-75. doi: 10.1111/jrh.12079. Epub 2014 Jul 8.


Purpose: This study examined human papillomavirus (HPV) vaccine awareness and uptake, and communication with a parent and/or a health care provider among 11- to 18-year-old male and female adolescents in an Appalachian Ohio county.

Methods: Five questions regarding the HPV vaccine were added to the 2012 Youth Risk Behavior Surveillance System (YRBSS) surveys administered to middle and high school students in the county. The YRBSS surveys are school-based, anonymous, and voluntary. The questions added were about vaccine awareness and uptake, and communication with a parent or health care provider about the vaccine.

Results: Of the 1,299 participants, 51.9% were male and 90.3% were white. Overall, 49.2%, 23.5%, 19.2%, and 24.6%, respectively, reported vaccine awareness, uptake of at least 1 dose of the HPV vaccine, communication with a parent, and communication with a health care provider. Females and adolescents ≥ 15 years were significantly more likely to report awareness, uptake, and parental and provider communication than males and adolescents ≤ 14 years. Adolescents receiving any dose of the vaccine were significantly more likely to have had a parent (OR: 3.74; 95% CI: 2.30-6.06) or a health care provider (OR: 10.91; 95% CI: 6.42-18.6) discuss the vaccine than those who had not received any dose.

Conclusions: Despite the strong link between parental and health care provider communication and HPV vaccine uptake, the levels of communication remain low in this Appalachian population. These findings suggest the need for public health education programs targeting the health care providers, the parents, and the adolescents to improve awareness, knowledge, and HPV vaccine uptake.

Keywords: HPV vaccine awareness; adolescents; parental or health care provider communication; rural Appalachia; uptake.

MeSH terms

  • Adolescent
  • Appalachian Region
  • Child
  • Communication*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Ohio
  • Papillomavirus Vaccines / therapeutic use*
  • Parents / psychology*
  • Rural Population / statistics & numerical data
  • Students / psychology
  • Students / statistics & numerical data
  • Surveys and Questionnaires


  • Papillomavirus Vaccines