未成年女儿接种HPV疫苗的母亲意愿及其影响因素:基于Logistic回归及决策树模型的分析

Mothers' willingness to vaccinate underage daughters against HPV and the influencing factors: analysis based on Logistic regression and decision tree model

摘要

目的 探讨昆明市母亲接受未成年女儿接种人乳头瘤病毒(HPV)疫苗意愿的影响因素.方法 2023年6至9月,在昆明医科大学附属延安医院预防保健科依据便利抽样原则选取符合条件的1478名母亲进行问卷调查,通过构建决策树模型和Logistic回归模型,探讨母亲对未成年女儿接种HPV疫苗意愿的影响因素.结果 1478位母亲中,愿意接受女儿接种HPV疫苗的占74.5%.Logistic回归分析显示,母亲年龄小于25岁(OR=0.301,95%CI:0.155~0.586)、文化程度低(OR=0.613,95%CI:0.393~0.956;OR=0.405,95%CI:0.174~0.944)、职业(OR=0.424,95%CI:0.203~0.888;OR=0.422,95%CI:0.214~0.833)、家庭人均年收入低(OR=0.153,95%CI:0.038~0.616;OR=0.159,95%CI:0.039~0.644)、可接受疫苗的价格偏低(OR=0.527,95%CI:0.310~0.897)可能降低其接受女儿接种HPV疫苗的意愿(P<0.05).汉族(OR=1.862,95%CI:1.351~2.566)、知道HPV疫苗可预防宫颈癌(OR=1.790,95%CI:1.237~2.592)、咨询过HPV疫苗相关信息(OR=3.563,95%CI:2.594~4.894)、自身愿意接种HPV疫苗(OR=7.778,95%CI:5.699~10.616)、认为接种HPV疫苗的最佳时机是第一次性行为以前(OR=1.631,95%CI:1.102~2.413)的母亲接受女儿接种HPV疫苗的意愿更高(P<0.05).CHAID决策树模型分析显示,母亲自身接种HPV疫苗意愿、可接受疫苗的价格、咨询过HPV疫苗相关信息、知道HPV疫苗可预防宫颈癌、家庭人均年收入可影响母亲接受未成年女儿接种HPV疫苗的意愿,其中母亲自身接种意愿是最为重要的影响因素.结论 未成年女孩母亲对HPV疫苗知晓率较低,但为女儿接种意愿较为强烈.通过提高母亲HPV疫苗接种健康知识水平、自身接种意愿等措施,提高适龄女性的HPV疫苗覆盖率有助于实现群体免疫并加速消除宫颈癌的战略目标.

Abstract

Objective To explore the factors influencing mothers' willingness to have their underage daughters receive the human papillomavirus (HPV) vaccine in Kunming. Methods A total of 1478 eligible mothers were selected through convenience sampling at the Department of Preventive Healthcare, Yan'an Hospital affiliated with Kunming Medical University, for a questionnaire survey, from June to September 2023. A decision tree model and a logistic regression model were constructed to analyze the factors affecting mothers' willingness to have their daughters vaccinated against HPV. Results Among the 1478 mothers surveyed, 74.5% were willing to have their daughters receive the HPV vaccine. Logistic regression analysis showed that mothers younger than 25 years old (OR=0.301, 95%CI: 0.155-0.586), those with lower education levels (OR=0.613, 95%CI: 0.393-0.956; OR=0.405, 95%CI: 0.174-0.944), certain occupations (OR=0.424, 95%CI: 0.203-0.888; OR=0.422, 95%CI: 0.214-0.833), lower annual per capita household income (OR=0.153, 95%CI: 0.038-0.616; OR=0.159, 95%CI: 0.039-0.644), and a lower acceptable vaccine price (OR=0.527, 95%CI: 0.310-0.897) were less willing to have their daughters vaccinated against HPV (P<0.05). Conversely, mothers who were of Han ethnicity (OR=1.862, 95%CI: 1.351-2.566), aware that the HPV vaccine can prevent cervical cancer (OR=1.790, 95%CI: 1.237-2.592), had consulted about HPV vaccination (OR=3.563, 95%CI: 2.594-4.894), were willing to receive the HPV vaccine themselves (OR=7.778, 95%CI: 5.699-10.616), or believed that the best time for HPV vaccination is before the first sexual activity (OR=1.631, 95%CI: 1.102-2.413) showed higher willingness to have their daughters vaccinated (P<0.05). The Chi-square automatic interaction detector (CHAID) decision tree model analysis revealed that mothers' willingness to receive the HPV vaccine themselves, acceptable vaccine price, prior consultation about HPV vaccination, knowledge that the HPV vaccine can prevent cervical cancer, and annual per capita household income influenced their willingness to have their underage daughters vaccinated, with maternal willingness to receive the HPV vaccine being the most critical factor. Conclusion Although the awareness rate of the HPV vaccine among mothers of underage girls is relatively low, their willingness to have their daughters vaccinated is relatively strong. Enhancing mothers' knowledge about HPV vaccination and increasing their own willingness to get vaccinated may help improve HPV vaccine coverage among eligible females, contributing to herd immunity and accelerating the strategic goal of eliminating cervical cancer.

关键词

母亲 / 未成年女性 / 人乳头瘤病毒 / 疫苗接种 / Logistic回归 / 决策树

Key words

mother / underage female / human papillomavirus / vaccination / Logistic regression / decision tree

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基金资助

云南省教育厅科学研究基金项目(2023J0380)