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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.147876v1 99/6/1137    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Chao, C. Articles by Jacobsen, S. J. Search for Related Content PubMed PubMed Citation Articles by Chao, C. Articles by Jacobsen, S. J. Related Collections Adolescent Health Immunization/Vaccines

Chun Chao, PhD, Jeff M. Slezak, MS, Karen J. Coleman, PhD and Steven J. Jacobsen, PhD

The authors are with the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena.

Correspondence: Requests for reprints should be sent to Chun Chao, PhD, Department of Research and Evaluation, Kaiser Permanente, 100 S Los Robles Ave, 2nd floor, Pasadena, CA 91101 (e-mail: chun.r.chao{at}kp.org).

Objectives. We investigated whether maternal attitude toward prevention, as indicated by history of seeking Papanicolaou (Pap) tests and contracting sexually transmitted infections, influenced human papillomavirus (HPV) vaccine uptake among their adolescent daughters.

Methods. We linked the electronic health records of girls aged 9 to 17 years with their mothers at Kaiser Permanente Southern California (n = 148 350 mother–daughter pairs). Personal identifying information was removed from the data set after the matching of daughters and mothers was completed. We used logistic regression models to detect associations between mothers' history of Pap tests and abnormal results, genital or anal warts, and other sexually transmitted infections and daughters' HPV vaccine initiation and 3-dose regimen completion.

Results. Mothers' testing history was associated with daughters' likelihood for vaccination across ethnic and neighborhood socioeconomic strata (overall odds ratio [OR] = 1.47; 95% confidence interval [CI] = 1.43, 1.52). Mothers' history of sexually transmitted infections was only modestly associated with daughters' vaccination. Mothers' testing history was positively associated with daughters' regimen completion (overall OR = 1.42; 95% CI = 1.31, 1.54).

Conclusions. Mothers' attitude toward prevention may influence HPV vaccine uptake among adolescent girls. The impacts of targeting mothers should be considered by HPV vaccination programs and investigated by further research.

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