SavedAdd your journal

Journals / Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Dergisi / 2026 / Volume: 13 Issue: 2

Impact of Turkish Parents' Knowledge on HPV and HPV Vaccination on Attitudes and Beliefs Regarding the HPV Vaccine: A Cross-Sectional Study

Elif Bakır(HACETTEPE ÜNİVERSİTESİ)0000-0002-6032-2867
Handan Özdemir(HACETTEPE ÜNİVERSİTESİ)0009-0005-5933-1343
Tuğçe Torun(HACETTEPE ÜNİVERSİTESİ)0000-0003-2175-7208
Pages
—
Publication Date
2026-08-28
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Targeted interventions that offer personalized approaches may help improve parental confidence, especially among those holding negative attitudes toward vaccination.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objectives: This study aims to evaluate parents’ knowledge of HPV infections and vaccines, their attitudes and beliefs and the relationship between these factors.
📊
Key Findings & Data:Materials and Methods: A descriptive cross-sectional study was conducted in the pediatric clinics of a university hospital, with a total of 206 parents participating.
💡
Conclusion & Impact:Targeted interventions that offer personalized approaches may help improve parental confidence, especially among those holding negative attitudes toward vaccination.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:human papillomavirus · vaccine · parents

Abstract

Objectives: This study aims to evaluate parents’ knowledge of HPV infections and vaccines, their attitudes and beliefs and the relationship between these factors. Materials and Methods: A descriptive cross-sectional study was conducted in the pediatric clinics of a university hospital, with a total of 206 parents participating. The Human Papillomavirus Knowledge Scale and the Carolina HPV Immunization Attitudes and Beliefs Scale were administered to 50 parents who indicated they were knowledgeable about HPV. Results: The majority of parents (75.7%) were unaware of HPV. Among those who were knowledgeable about HPV, most ensured that their children received the vaccinations included in the national schedule; however, only 1.5% had received the HPV vaccine themselves. As HPV knowledge increased, negative attitudes toward HPV vaccination decreased (p < 0.05). Additionally, linear regression analysis indicated that the HPV knowledge score significantly influenced the Carolina HPV Vaccination Attitudes and Beliefs Scale score (p < 0.05). Conclusion: A significant gap in HPV awareness exists among parents, with many also exhibiting negative attitudes toward vaccination. Targeted interventions that offer personalized approaches may help improve parental confidence, especially among those holding negative attitudes toward vaccination.

🔖

Cite This Article

Bakır, E., Özdemir, H., Torun, T. (2026). Impact of Turkish Parents' Knowledge on HPV and HPV Vaccination on Attitudes and Beliefs Regarding the HPV Vaccine: A Cross-Sectional Study. Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, Volume: 13 Issue: 2. https://doi.org/10.21020/husbfd.1755248

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (49)

  1. AAP. (2024). Human Papillomavirus Vaccines. Retrieved from https://www.aap.org/en/patient-care/immunizations/human-papillomavirus-vaccines/. Accessed November 7, 2024.
  2. Agabekova, B., Özler, N.B., & Luboteni, R. (2021). Review on HPV vaccines in the fight against HPV-related cancers. Turkey Health Literacy Journal, 2(2), 89-98. https://doi.org/10.54247/SOYD.2021.29.
  3. Akca, G., & Akca, U. (2022). Turkish mothers' knowledge and attitude about HPV vaccine. Journal of Pediatric Nursing, 67, 83-87. https://doi.org/10.1016/j.pedn.2022.08.011.
  4. Altınel Açoğlu, E., Oğuz, M. M., & Şenel, S. (2019). Parents’ knowledge and attitudes about HPV vaccination. Turkish Journal of Pediatric Disease, 13(2), 78-82. https://doi.org/10.12956/tchd.515713.
  5. Anandarajah, A., Shato, T., Humble, S., Barnette, A. R., Brandt, H. M., Klesges, L. M….Silver, M. I. (2024). The association of caregiver attitudes, information sources, and trust with HPV vaccine initiation among adolescents. Human Vaccines & Immunotherapeutics, 20(1), 2300879. https://doi.org/10.1080/21645515.2023.2300879.
  6. Atlı, E., & Göl, İ. (2022). Evaluation of parents' attitudes and beliefs on human papilloma virus vaccine. Izmir Democracy University Health Sciences Journal, 5(1), 270-284. https://doi.org/10.52538/iduhes.1087135.
  7. Beavis, A. L., Meek, K., Moran, M. B., Fleszar, L., Adler, S., & Rositch, A. F. (2022). Exploring HPV vaccine hesitant parents’ perspectives on decision-making and motivators for vaccination. Vaccine X, 12, 100231. https://doi.org/10.1016/j.jvacx.2022.100231.
  8. Brewer, N. T., Kahn, B. Z., Kritikos, K. I., Heisler-MacKinnon, J. A., Young, J. D., & Gilkey, M. B. (2023). How to make effective HPV vaccine recommendations starting at age 9. Human Vaccines & Immunotherapeutics, 19(2), 2216117. https://doi.org/10.1080/21645515.2023.2216117.
  9. Bruni, L., Albero, G., Serrano, B., Mena, M., Collado, J. J., Gómez, D…… de Sanjosé, S. (2023). ICO/IARC Information Centre on HPV and Cancer.Human Papillomavirus and Related Diseases in the World. Retrieved from https://hpvcentre.net/statistics/reports/XWX.pdf Accessed November 7, 2024.
  10. CDC. (2024). HPV Vaccine Safety and Effectiveness Data Retrieved from https://www.cdc.gov/hpv/hcp/vaccination-considerations/safety-and-effectiveness-data.html. Accessed November 7, 2024.
  11. Charakorn, C., Rattanasiri, S., Lertkhachonsuk, A., Thanapprapasr, D., Chittithaworn, S., & Wilailak, S. (2011). Knowledge of Pap smear, HPV and the HPV vaccine and the acceptability of the HPV vaccine by Thai women. Asia‐Pacific Journal of Clinical Oncology, 7(2), 160-167. https://doi.org/10.1111/j.1743-7563.2011.01392.x.
  12. Constantine, N. A., & Jerman, P.(2007). Acceptance of human papillomavirus vaccination among Californian parents of daughters: a representative statewide analysis. Journal of Adolescent Health, 40(2), 108-115. https://doi.org/https://doi.org/10.1016/j.jadohealth.2006.10.007.
  13. Çelik, P., & İncesoy Özdemir, S. (2021). Awareness, knowledge, attitudes, and behaviors of the parents of 9-18 year-old children about HPV ınfection and HPV vaccine in a developing country. Journal of Pediatric Infection, 15(2):e80-e87. https://doi.org/10.5578/ced.202119815.
  14. Demir Bozkurt, F., & Özdemir, S. (2023). Validity and reliability of a Turkish version of the human papillomavirus knowledge scale: a methodological study. Journal of the Turkish-German Gynecological Association, 24(3), 177-186. https://doi.org/10.4274/jtgga.galenos.2023.2022-10-9.
  15. Ferlay, J., Ervik, M., Lam, F., Laversanne, M., Colombet, M., Mery, L….Bray, F.(2024). Global Cancer Observatory: Cancer Today. Retrieved from https://gco.iarc.who.int/media/globocan/factsheets/cancers/23-cervix-uteri-fact-sheet.pdf. Accessed November 7, 2024.
  16. Gargano, J., Meites, E., Watson, M., Unger, E., & Markowitz, L. (2017). Human papillomavirus. In Centers for Disease Control and Prevention, Manual for the surveillance of vaccine-preventable diseases.
  17. Goodman, E., Felsher, M., Wang, D., Yao, L., & Chen, Y. T. (2023). Early initiation of HPV vaccination and series completion in early and mid-adolescence. Pediatrics, 151(3), e2022058794. https://doi.org/10.1542/peds.2022-058794.
  18. Grandahl, M., Paek, S. C., Grisurapong, S., Sherer, P., Tydén, T., & Lundberg, P. (2018). Parents' knowledge, beliefs, and acceptance of the HPV vaccination in relation to their socio-demographics and religious beliefs: A cross-sectional study in Thailand. Plos One, 13(2), e0193054. https://doi.org/10.1371/journal.pone.0193054.
  19. ICO/IARC. (2023). Human Papillomavirus and Related Cancers. Retrieved from https://hpvcentre.net/statistics/reports/TUR_FS.pdf. Accessed November 7, 2025.
  20. Jaspers, L., Budiningsih, S., Wolterbeek, R., Henderson, F. C., & Peters, A. A. (2011). Parental acceptance of human papillomavirus (HPV) vaccination in Indonesia: A cross-sectional study. Vaccine, 29(44), 7785-7793. https://doi.org/10.1016/j.vaccine.2011.07.107.
  21. Krawczyk, A., Knäuper, B., Gilca, V., Dubé, E., Perez, S., Joyal-Desmarais, K., & Rosberger, Z. (2015). Parents' decision-making about the human papillomavirus vaccine for their daughters: I. Quantitative results. Human Vaccines & Immunotherapeutics, 11(2), 322-329. https://doi.org/10.1080/21645515.2014.1004030.
  22. Lei, J., Ploner, A., Elfström, K. M., Wang, J., Roth, A., Fang, F….Sparén, P. (2020). HPV Vaccination and the Risk of Invasive Cervical Cancer. The New England Journal of Medicine, 383(14), 1340-1348. https://doi.org/10.1056/NEJMoa1917338.
  23. McRee, A. L., Brewer, N. T., Reiter, P. L., Gottlieb, S. L., & Smith, J. S. (2010). The Carolina HPV immunization attitudes and beliefs scale (CHIAS): Scale development and associations with intentions to vaccinate. Sexually Transmitted Diseases, 37(4), 234-239. https://doi.org/10.1097/OLQ.0b013e3181c37e15.
  24. Mendes Lobão, W., Duarte, F. G., Burns, J. D., de Souza Teles Santos, C. A., Chagas de Almeida, M. C., Reingold, A., & Duarte Moreira, E. J. (2018). Low coverage of HPV vaccination in the national immunization programme in Brazil: Parental vaccine refusal or barriers in health-service based vaccine delivery? Plos One, 13(11), e0206726. https://doi.org/10.1371/journal.pone.0206726.
  25. Mete, B., Utuk, F., Demirhindi, H., Inaltekin, A., Tanır, F., Kara, E., & Nazlıcan, E. (2023). Human papillomavirus vaccine administration among women in the Eastern Mediterranean region of Turkey: Prevalence and barriers. European Review for Medical & Pharmacological Sciences, 27(8), 3526-3533. https://doi.org/10.26355/eurrev_202304_32126.
  26. Nguyen, K. H., Santibanez, T. A., Stokley, S., Lindley, M. C., Fisher, A., Kim, D….Singleton, J. (2021). Parental vaccine hesitancy and its association with adolescent HPV vaccination. Vaccine, 39(17), 2416-2423. https://doi.org/10.1016/j.vaccine.2021.03.048.
  27. O’Leary, S. T. (2022). Why the American Academy of Pediatrics recommends initiating HPV vaccine at age 9. Human Vaccines & Immunotherapeutics, 18(6), 2146434. https://doi.org/10.1080/21645515.2022.2146434.
  28. Rositch, A. F., Liu, T., Chao, C., Moran, M., & Beavis, A. L. (2022). Levels of parental human papillomavirus vaccine hesitancy and their reasons for not intending to vaccinate: insights from the 2019 National Immunization Survey-Teen. Journal of Adolescent Health, 71(1), 39-46. https://doi.org/10.1016/j.jadohealth.2022.01.223.
  29. Saslow, D., Andrews, K. S., Manassaram-Baptiste, D., Smith, R. A., & Fontham, E. T. H. (2020). Human papillomavirus vaccination 2020 guideline update: American Cancer Society guideline adaptation. CA: A Cancer Journal for Clinicians, 70(4), 274-280. https://doi.org/10.3322/caac.21616.
  30. Satapathy, P., Khatib, M. N., Neyazi, A., Qanawezi, L., Said, S., Gaidhane, S….Rabaan, A. A. (2024). Prevalence of human papilloma virus among cervical cancer patients in India: A systematic review and meta-analysis. Medicine (Baltimore), 103(31), e38827. https://doi.org/10.1097/md.0000000000038827.
  31. Shato, T., Humble, S., Anandarajah, A., Barnette, A., Brandt, H., Garbutt, J….Silver, M. (2023). Influences of sociodemographic characteristics and parental HPV vaccination hesitancy on HPV vaccination coverage in five US states. Vaccine, 41(25), 3772-3781. https://doi.org/10.1016/j.vaccine.2023.04.082.
  32. Smolarczyk, K., Duszewska, A., Drozd, S., & Majewski, S. (2022). Parents' knowledge and attitude towards HPV and HPV vaccination in Poland. Vaccines (Basel), 10, 228. https://doi.org/10.3390/vaccines10020228.
  33. Sunar, S., & Kahyaoğlu Süt, H. (2019). The Turkish validity and reliability study of the Carolina HPV immunization attitudes and beliefs scale. The Journal of Gynecology-Obstetrics and Neonatology, 16(2), 82-88. https://dergipark.org.tr/tr/pub/jgon/issue/51866/675110.
  34. VanWormer, J. J., Bendixsen, C. G., Vickers, E. R., Stokley, S., McNeil, M. M., Gee, J…. McLean, H. Q. (2017). Association between parent attitudes and receipt of human papillomavirus vaccine in adolescents. BMC Public Health, 17. https://doi.org/10.1186/s12889-017-4787-5.
  35. Vielot, N. A., Lane, R. M., Loefstedt, K., Cunningham, J. L., Everson, J., Tiller, E.…. & Smith, J. S. (2023). Acceptability and readiness to promote human papillomavirus vaccination at ages 9–10 years: A feasibility study among North Carolina clinics. Pilot and Feasibility Studies, 9. https://doi.org/10.1186/s40814-023-01379-y.
  36. Villarroel, M. A., Galinsky, A. M., Lu, P. J., & Pingali, C. (2024). Human Papillomavirus Vaccination Coverage in Children Ages 9-17 Years: United States, 2022. NCHS Data Brief. 495:1-8. https://dx.doi.org/10.15620/cdc:145593.
  37. Waller, J., Ostini, R., Marlow, L.A., McCaffery, K., & Zimet, G. (2013). Validation of a measure of knowledge about human papillomavirus (HPV) using item response theory and classical test theory. Preventive Medicine, 56(1), 35-40. https://doi.org/10.1016/j.ypmed.2012.10.028.
  38. WHO. (2016). Guide to introducing HPV vaccine into national immunization programmes. Retrieved from https://iris.who.int/handle/10665/253123. Accessed November 7, 2024.
  39. Willis, D. E., Moore, R., Selig, J. P., Amin, N. S., Li, J., Watson, D., Brimberry, R. K., & McElfish, P. A. (2024). Pediatric HPV vaccination: Provider recommendations matter among hesitant parents. Vaccine, 42(25), 126166. https://doi.org/10.1016/j.vaccine.2024.126166.
  40. Yüksel, F., & Kara Uzun, A. (2021). Knowledge, behavior and attitude of parents’ about childhood ımmunization. Turkish Journal of Pediatric Disease, 15(1), 35-42. https://doi.org/10.12956/tchd.825092.
  41. Zhu, X., Jacobson, R. M., MacLaughlin, K. L., Sauver, J. S., Griffin, J. M., & Finney Rutten, L. J. (2023). Parent-reported barriers and parental beliefs associated with intentions to obtain HPV vaccination for children in a primary care patient population in Minnesota, USA. Journal of Community Health, 48(4), 678-686. https://doi.org/10.1007/s10900-023-01205-9.
  42. Zorn, S., Darville-Sanders, G., Vu, T., Carter, A., Treend, K., Raunio, C., & Vasavada, A. (2023). Multi-level quality improvement strategies to optimize HPV vaccination starting at the 9-year well child visit: Success stories from two private pediatric clinics. Human Vaccines & Immunotherapeutics, 19(1), 2163807. https://doi.org/10.1080/21645515.2022.2163807.
  43. Anandarajah, A., Shato, T., Humble, S., Barnette, A. R., Brandt, H. M., Klesges, L. M….Silver, M. I. (2024). The association of caregiver attitudes, information sources, and trust with HPV vaccine initiation among adolescents. Human Vaccines & Immunotherapeutics, 20(1), 2300879. https://doi.org/10.1080/21645515.2023.2300879.
  44. Ferlay, J., Ervik, M., Lam, F., Laversanne, M., Colombet, M., Mery, L….Bray, F.(2024). Global Cancer Observatory: Cancer Today. Retrieved from https://gco.iarc.who.int/media/globocan/factsheets/cancers/23-cervix-uteri-fact-sheet.pdf. Accessed November 7, 2024.
  45. Nguyen, K. H., Santibanez, T. A., Stokley, S., Lindley, M. C., Fisher, A., Kim, D….Singleton, J. (2021). Parental vaccine hesitancy and its association with adolescent HPV vaccination. Vaccine, 39(17), 2416-2423. https://doi.org/10.1016/j.vaccine.2021.03.048.
  46. Satapathy, P., Khatib, M. N., Neyazi, A., Qanawezi, L., Said, S., Gaidhane, S….Rabaan, A. A. (2024). Prevalence of human papilloma virus among cervical cancer patients in India: A systematic review and meta-analysis. Medicine (Baltimore), 103(31), e38827. https://doi.org/10.1097/md.0000000000038827.
  47. Shato, T., Humble, S., Anandarajah, A., Barnette, A., Brandt, H., Garbutt, J….Silver, M. (2023). Influences of sociodemographic characteristics and parental HPV vaccination hesitancy on HPV vaccination coverage in five US states. Vaccine, 41(25), 3772-3781. https://doi.org/10.1016/j.vaccine.2023.04.082.
  48. VanWormer, J. J., Bendixsen, C. G., Vickers, E. R., Stokley, S., McNeil, M. M., Gee, J…. McLean, H. Q. (2017). Association between parent attitudes and receipt of human papillomavirus vaccine in adolescents. BMC Public Health, 17. https://doi.org/10.1186/s12889-017-4787-5.
  49. Vielot, N. A., Lane, R. M., Loefstedt, K., Cunningham, J. L., Everson, J., Tiller, E.…. & Smith, J. S. (2023). Acceptability and readiness to promote human papillomavirus vaccination at ages 9–10 years: A feasibility study among North Carolina clinics. Pilot and Feasibility Studies, 9. https://doi.org/10.1186/s40814-023-01379-y.