Determinants of HPV vaccination decision-making among South Asian mothers for their adolescent daughters in Hong Kong: A mixed methods study.

Objective: Human papillomavirus (HPV) vaccines are effective preventive measures against HPV-related diseases. Mothers play an important role in HPV vaccination decision-making for their daughters. Ethnic inequality in HPV vaccination uptake is a global problem and is expected to affect the South Asian (SA) ethnic population in Hong Kong. This study explored the factors influencing SA mothers' behaviour regarding HPV vaccination for their daughters. Methods: This study used a convergent parallel mixed methods design. Data from a quantitative survey ( Results: The findings of the quantitative strand identified five influential factors, namely age of daughters, awareness of HPV vaccines, perceived benefits of HPV vaccination, perceived barriers (safety concerns), and cues to action. The qualitative data revealed that the mothers' decision to vaccinate their daughters could be hindered by language barriers, religious and cultural influences, and health-information-seeking behaviours. The mixed-methods integration revealed that the mothers' vaccination decision was influenced by the availability of a school-based vaccination programme, their awareness of HPV vaccines, their perceived benefits of and barriers to HPV vaccination, and their receipt of health care professionals' recommendations. Conclusions: The vaccination decisions of SA mothers in Hong Kong are influenced by multiple factors, which should be addressed in future interventions. These interventions could include delivering appropriate contents for health promotion, providing cultural sensitivity training to health care professionals and conducting catch-up vaccination programmes for adolescent daughters not eligible for the current programme.