Development of the Carolina HPV Immunization Attitudes Scale (CHIAS)

BACKGROUND:Despite a growing body of research on HPV vaccine acceptability, no standardized instruments, to our knowledge, exist to assess attitudes toward the vaccine. We developed the Carolina HPV Immunization Attitudes Scale (CHIAS) to address this gap.

METHODS: We interviewed parents (n=783) who had not vaccinated their adolescent daughters against HPV. We conducted a principal components analysis of 16 HPV vaccine attitude items to develop the CHIAS and assessed the scale's internal reliability. The relationship between CHIAS factors and vaccination intentions was examined with multivariate linear regression using standardized coefficients. One year later, we assessed CHIAS test-retest reliability among parents (n=420) who had still not vaccinated their daughters.

RESULTS: Analyses identified four CHIAS factors, all of which had acceptable reliability (Cronbach's α>.60) and were associated with higher intentions to vaccinate: believing HPV vaccine is effective (ß=0.06) or has fewer harms (ß=-0.47), perceiving more barriers to access (ß=0.18), and having less uncertainty about the vaccine (ß=-0.23) (all p<.05). CHIAS factor scores had good one-year test-retest reliabilities (p<.001).

CONCLUSIONS: Study findings suggest that the CHIAS is a reliable scale to assess parent attitudes about HPV vaccine that are important to their intentions to vaccinate their adolescent daughters. Perceived effectiveness and barriers played only a small role in HPV vaccination intentions. Beliefs about harms and uncertainty were stronger correlates. The CHIAS may be useful in studying HPV vaccine attitudes among other populations and in identifying potential strategies for intervention.

This study was supported by the CDC and ACS.