Psychosocial determinants of HPV vaccination initiation and intention among Central American immigrant parents in the United States

This cross-sectional study explored psychosocial factors influencing HPV vaccine initiation and intentions among Central American parents in the United States (U.S.). Only 20 % of children had initiated vaccination, and 23 % of parents of unvaccinated children intended to vaccinate within 12 months. Parents whose children had initiated vaccination had significantly higher HPV knowledge ( p < 0.001), perceived susceptibility ( p = 0.001), vaccine beliefs ( p = 0.004), self-efficacy ( p < 0.01), and social support (Community OR = 40.95, p < 0.001; Peer OR = 88.50, p < 0.001). Healthcare provider (HCP) recommendations were more common among parents whose children had initiated vaccination ( p < 0.001) and reported fewer access barriers (OR = 16.30, p < 0.001). Factors associated with vaccine initiation included maternal gender (OR = 2.55, p = 0.02), HPV knowledge (OR = 159.83, p < 0.001), perceived benefits (OR = 45.03, p < 0.001), and community support (OR = 40.95, p < 0.001). In multivariable analysis, U.S.-born children (AOR = 11.11, p = 0.03) and higher perceived vaccine accessibility (AOR = 150.05, p = 0.01) were significant predictors of vaccine initiation. In bivariate analysis, factors associated with vaccine intention included maternal gender (OR = 2.82, p = 0.02), parental age (OR = 0.95, p = 0.02), U.S. residency length (OR = 0.95, p = 0.02), acculturation (OR = 7.48, p = 0.02), peer norms (OR = 3.74, p = 0.02), lower safety concerns ( p = 0.04), higher self-efficacy ( p = 0.03), and HCP recommendation (OR = 13.64, p < 0.001). In multivariate analysis, HCP recommendation was the main predictor of vaccine intention (AOR = 11.66, p = 0.002). This study identified key psychosocial factors influencing HPV vaccine initiation and intentions among Central American parents. Interventions should focus on enhancing HPV knowledge, addressing safety concerns, strengthening support, and promoting tailored recommendations.