Chinese parents' perspectives regarding present and later life diseases prevention through vaccination

Abstract

Objectives: (1) Explore how Chinese new immigrant parents make decisions on various vaccines for children’s present and later life diseases prevention. (2) Explore Chinese new immigrant parents’ perspectives about adult-onset non-communicable diseases (NCDs) prevention during childhood. (3) Update understanding on how Chinese families make human Papillomavirus (HPV) vaccination decisions for adolescent girls. (4) Examine factors affecting Chinese parental HPV vaccination decision making (VDM) for adolescent girls.

Methods: Three independent research projects consisting of 4 sub-studies designed for each objective were conducted. Project-1 consisted of a qualitative study on 23 new immigrant mothers of children aged ≤14 years who migrated from mainland China to Hong Kong no more than 7 years earlier completed in-depths interviews designed to study Objective 1 and 2. Project-2 was also a qualitative study involving 36 Hong Kong Chinese parents and 15 adolescent daughters aged 10-18 years who completed in-depth interviews designed to study Objective 3. Project-3 consisted of a prospective longitudinal study on a random sample of 2000 Hong Kong Chinese parents of girls aged 12-17 years and who completed telephone survey designed to study Objective 4. Due to time constraints, for this thesis purposes only a subset (N=368) of the baseline data of 2000 were used.

Analysis and Findings: Grounded theory analysis were performed on narrative data in Studies 1-3. Mulitiple linear regression analyses were performed for Study 4.

Study 1 indicated that the role of social norms appeared overwhelmingly salient in influencing Chinese new immigrant parental VDM. Fear of vaccine-targeted diseases was a key motivating factor for parents adopting vaccination. Insufficient knowledge about vaccines and targeted diseases, lack of advice from health professionals and, if provided, suspicions regarding the motivations for such advice were common issues. Vaccination cost was a major barrier for many new immigrant parents.

Study 2 showed new immigrant mothers generally lacked awareness regarding early prevention of adult diseases. Unhealthy lifestyle, contaminated food and environment pollution were perceived as the primary causes of NCDs. Most expressed helplessness towards NCDs prevention due to lack of knowledge of prevention or perceiving prevention to be beyond individual control.

Study 3: Again, social influences significantly impact Chinese parents and adolescent girls’ HPV VDM. Government involvement and recommendation from trusted healthcare professionals were important facilitators for VDM. Doubts about necessity, safety, efficacy, and high cost of HPV vaccination were major barriers.

Study 4: Parental intention to vaccinate daughter against HPV was significantly associated with anticipated worry about cervical cancer, anticipated anxiety reduction resulting from HPV vaccination, proneness to peer influence, children’s private health insurance status, perceived daughter’s vulnerability to cervical cancer, number of daughters, perceived cervical cancer as behaviour-preventable disease, and descriptive norms about vaccinating daughters against HPV. Cervical cancer related worry/anxiety was the most important predictor of Chinese parental HPV vaccination intention.

Conclusions: The studies revealed several important factors influencing Chinese parental perspectives about children’s present and later life diseases prevention through vaccination, providing new insights of how an understanding on these issues might help to inform future vaccination campaign to optimize childhood and adolescent vaccination uptake.