Interviews with Kuwaiti parents regarding knowledge and health beliefs about HPV infection and HPV vaccination

Introduction:To design a human papillomavirus (HPV) vaccination promotion campaign as a basis for introducing a national HPV vaccination programme in Kuwait, 20 Kuwaiti parents of children eligible for vaccination were individually interviewed on their health beliefs.Methods: Based on the Health Belief Model (HBM) (Abraham & Sheeran, 2005), semi-structured interviews were held.The data were thematically analysed using an induction approach on a semantic level to the most common themes and categories.Results: The analysis generated seven themes.(1) Knowledge and awareness, with sub-themes about the view of HPV and the HPV vaccine, the importance of HPV vaccine for both sexes, transmission ways, and factors' effects.(2) Perceived susceptibility, with sub-themes infection risk based on the child's gender and overall parents' perspective on the risk of contracting HPV.(3) Perceived barriers, with several sub-themes, such as lifelong stigma, social customs, negative vaccination uptake, religious and societal influences, fear of complications, trust in the health system, and lack of reliable information about HPV vaccination.(4) Perceived benefits, with a sub-theme of HPV vaccination as protection and prevention from the virus and related cancer diseases.(5) Perceived severity, with sub-themes of fear of HPV as a cause of cervical cancer and fear of HPV as the cause of venereal warts.(6) Self-efficacy, with sub-themes of parental preferences of vaccination and experiences of lack of availability in government hospitals.(7) Cues-to-action, with sub-themes of the role of the Ministry of Health and awareness through campaigns, healthcare professionals, and schools.Surprisingly, no differences in themes were found between male and female interviewees and between interviewees with low and high educational attainment.The analysis showed that perceived barriers to HPV vaccination were important obstacles for the interviewees.Discussion: No prior qualitative studies have been conducted on this topic with parents in Kuwait.In UAE and Saudi Arabia, studies have shown a lack of knowledge and awareness, societal norms and religious beliefs that discourage premarital sex, leading to assumptions that HPV vaccination is unnecessary due to low perceived risk (Jradi and Bawazir, 2019; Al Shdefat et al.2021; Alkalash et al., 2022; Gari et al., 2023).These studies, however, even though they were limited in scope and did not use the HBM, also found that parents are willing to consider the benefits of HPV vaccination for the prevention of cervical cancer and that they are open to advice from healthcare providers.These findings are close to those of this study. Conclusion:The concepts of HBM are a useful framework for developing an HPV vaccination campaign for Kuwait.This study has shown that positive cues-to-action from healthcare providers, together with education about the benefits of vaccination, can overcome perceived barriers among parents related to stigma and religion.