Knowledge, perception, and decision-making about human papillomavirus (HPV) vaccination among Korean American women

Background: As one of the fastest-growing ethnic minority groups in the United States, Korean American (KA) women have disproportionately higher cervical cancer (CC) incidence and mortality rates compared to non-Hispanic whites. The advent of human papillomavirus (HPV) vaccine offers an unprecedented opportunity to eliminate CC disparity among KA women. Yet, the uptake of HPV vaccine in KA adolescents has been suboptimal. Little is known about how KA women perceive and make decisions about HPV vaccination. Objective: To explore knowledge, perception, and decision-making about HPV vaccination in KA women. Methods: We used a focus group study design with qualitative content analysis. Twenty-six KA women that participated in a community-based randomized controlled trial designed to test the effect of a health literacy-focused intervention to promote breast and CC screening joined semi-structured focus group interviews. Focus group data were transcribed verbatim and were analyzed using inductive coding. Results: Four themes emerged from four focus groups: 1) limited knowledge and information about HPV vaccine; 2) perceptions about HPV vaccinations (acceptance, refusal, irrelevance, ambivalence); 3) decision-making about HPV vaccination (types of decision making, influential sources, delays in making a decision); and 4) ways to promote HPV vaccination (recommendations from trustworthy sources [i.e., school and pediatricians], education and information-sharing, and financial support). Conclusions: As one of the primary decision-makers for their children’s health, KA women in the focus groups were generally favorable toward HPV vaccination. However, they acknowledged lack of knowledge and limited information about HPV vaccine in the KA community. Common sources of information as well as their decision-making processes need to be considered when developing targeted interventions for underserved KA women. Policy implications to promote HPV vaccination in KAs include: culturally tailored education program and information-sharing in the Korean community; recommendations from school, and financial support.