A Qualitative Analysis of the Vaccine Intention-Behavior Relationship: Parents’ Descriptions of their Intentions, Decision-making Behavior, and Planning Processes toward HPV Vaccination

Abstract

Objective: Identify factors influencing the vaccine intention-behavior relationship. Design: 445 parents who received a brief intervention to promote HPV vaccination were categorized based on their intentions post-intervention (yes/unsure/eventually/never) and subsequent adolescents’ vaccine status (yes/no). 51 of those parents participated in qualitative interviews. Main Outcome Measures: Parents described their intentions, decision-making, and planning processes toward vaccination. Framework analysis was used to analyze the data. Results: Parents in the “Yes/Yes” category were knowledgeable about HPV/vaccine, described strong, stable intentions, considered themselves the primary decision-makers about vaccination, and said they vaccinated immediately. “Yes/No” parents described strong intentions and thought their adolescent was vaccinated OR described hesitant intentions, seeking advice/agreement from others and noting barriers to vaccination without solutions. “Unsure/Yes” parents described their intentions as strengthening with information from credible sources and identified strategies for overcoming barriers. “Unsure/No” and “Eventually/No” parents had misinformation/negative beliefs regarding vaccination, described being ambivalent or non-supportive of vaccination, and cited barriers to vaccination. “Never/No” parents held negative beliefs about vaccination, described strong, stable intentions to NOT vaccinate, deferring the decision to others, and reported no planning toward vaccination. Conclusions: Intention characteristics and planning processes could moderate the vaccine intention-behavior relationship, potentially serving as targets for future vaccine strategies.