Academic journal article Journal of Nursing Measurement

Parental Human Papillomavirus Vaccine Survey (PHPVS): Nurse-Led Instrument Development and Psychometric Testing for Use in Research and Primary Care Screening

Academic journal article Journal of Nursing Measurement

Parental Human Papillomavirus Vaccine Survey (PHPVS): Nurse-Led Instrument Development and Psychometric Testing for Use in Research and Primary Care Screening

Article excerpt

Background and Purpose: Human papillomavirus (HPV) vaccine was approved for girls aged 9-24 years in 2006 to prevent HPV infection and cervical cancer. The Parental Human Papillomavirus Survey (PHPVS) was framed on theoretical constructs of the health belief model (HBM) and developed to survey parents regarding their HPV knowledge, attitudes, and intent to vaccinate. Methods: We evaluated the psychometric properties of the PHPVS using classical item analysis and exploratory factor analysis (EFA) among a sample of 200 parents/caregivers. Results: The EFA yielded a 4-factor unidimensional model that explained between 62% and 68% of the total variance depending on the extraction method used. The estimated Cronbach's alpha for the PHPVS was .96. Conclusions: The PHPVS is a reliable measure of HPV knowledge, attitudes, and intent to vaccinate.

Keywords: HPV vaccines; health surveys; health care disparities; pediatrics; adolescents; parents

Human papillomavirus (HPV) infection is etiologically linked to cancers of the cervix, anus, oropharynx, penis, vagina, and vulva (Parkin & Bray, 2006). The HPV vaccine is a health care breakthrough and an essential element of health promotion in pediatric and adolescent health care for boys and girls (Chaturvedi, 2010). The Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) recommends vaccinating girls and boys from the age of 9 to 26 years (CDC, 2010). To eliminate HPV-related cancers through HPV vaccination, it is essential to recognize the factors involved in parents' decision whether to permit their children to get the HPV vaccine (Harper et al., 2006). Indeed, the prevalence of HPV infection and cervical cancer rates continue to increase in African American and Latina women (Kobetz et al., 2010). So, the primary author sought to develop a theory-based survey that was short and simple to use with items that could identify intervention points to address HPV vaccination in populations of children and adolescents with low vaccine rates and those experiencing health disparities.


The purpose of this article is to describe the development and results of the psychometric evaluation of the Parental HPV Survey (PHPVS). The PHPVS was developed in 2007 in response to the debut of the HPV vaccine and the controversy that followed. During the spring of 2007, nurses and other health care providers discussed with policy makers and public health officials which parents would or would not vaccinate their child or adolescent with the HPV vaccine. The PHPVS was developed and then psychometrically tested so researchers would have an instrument to use in health promotion research. The PHPVS instrument can assist health promotion researchers to explore and describe parental perceptions of HPV infection and vaccination by measuring the perceived severity of HPV infection, parental perceived vulnerability of their child to HPV infection, the perceived benefits of HPV vaccination, and the subsequent barriers to vaccinating their child with the HPV vaccine.


This survey development was rooted in the construct of primary prevention from Neuman's Systems Model (NSM) and then developed after further literature review on social psychology theory and the health belief model (HBM; Neuman, 1990, 1996; Rosenstock, 1975; Rosenstock, Strecher, & Becker, 1988). By using this theory, the PHPVS could be used to collect descriptive data to develop primary prevention interventions to reduce HPV-related cancers in populations experiencing health disparities and to begin to use the PHPVS in primary care to elicit parental attitudes and knowledge about HPV and the HPV vaccine.


A Healthcare Breakthrough and a Controversy

Current research findings indicate that parents and caregivers of elementary and middle school children are often misinformed and subsequently filled with anxiety, mistrust, and doubt about reproductive health issues, such as HPV vaccination (Foster, 2007; Moseley, Freed, Bullard, & Goold, 2007; Shafii, Stovel, Davis, & Holmes, 2004). …

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