{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T08:45:48Z","timestamp":1782463548870,"version":"3.54.5"},"reference-count":37,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Institutes of Health\/National Cancer Institute","award":["U01\/R01-CA190366"],"award-info":[{"award-number":["U01\/R01-CA190366"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Educ Behav"],"abstract":"<jats:p>Cervical cancer remains a leading cause of mortality among women worldwide, particularly in low- and middle-income countries, yet human papillomavirus (HPV) vaccination\u2014the most effective method of prevention\u2014faces variable uptake and acceptance. This study addresses the problem of suboptimal HPV vaccination by examining the factors associated with parental consent for HPV vaccination of adolescent girls in two distinct Peruvian cities, the capital city of Lima and a large city in the Peruvian Amazon, Iquitos. Cross-sectional survey data were collected in 2017 from 986 women attending public health centers, and the Capability, Opportunity, Motivation, Behavior model was applied to categorize behavioral factors associated with women\u2019s willingness to vaccine their daughters for HPV. Overall, 90.1% of women reported willingness to vaccinate their daughters, with higher support in Iquitos (94.2%) than in Lima (84.7%). Women who were willing to vaccinate tended to be younger and were more likely to believe the vaccine was safe (Capability), know that it was free and be willing to pay for it (Opportunity), and know someone who had been vaccinated (Motivation). This study contributes to the literature on parental willingness to vaccinate daughters against HPV in a Latin American context applying a validated behavioral framework. Findings provide insight into psychosocial and contextual factors associated with self-reported parental willingness to vaccinate daughters against HPV. The results have implications for public health research and practice by identifying modifiable barriers and facilitators that can inform targeted vaccine promotion strategies in Peru and similar settings, particularly in informing future vaccine promotion strategies in contexts where vaccine confidence may have shifted following the COVID-19 pandemic.<\/jats:p>","DOI":"10.1177\/10901981261455312","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T11:53:51Z","timestamp":1782215631000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated With Parental Willingness to Vaccinate Daughters Against Human Papillomavirus in Peru"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8529-6465","authenticated-orcid":false,"given":"Astrid","family":"Wagner","sequence":"first","affiliation":[{"name":"Asociaci\u00f3n Ben\u00e9fica PRISMA, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily J.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Tulane University Celia Scott Weatherhead School of Public Health and Tropical Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Montes","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n Ben\u00e9fica PRISMA, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jhonny J.","family":"C\u00f3rdova L\u00f3pez","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n Ben\u00e9fica PRISMA, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Brown","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n Ben\u00e9fica PRISMA, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patti E.","family":"Gravitt","sequence":"additional","affiliation":[{"name":"Horizon Praxis, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1065-4919","authenticated-orcid":false,"given":"Valerie A.","family":"Paz-Soldan","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n Ben\u00e9fica PRISMA, Lima, Peru"},{"name":"Tulane University Celia Scott Weatherhead School of Public Health and Tropical Medicine, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"Asmelash D. 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(2025). Parental and guardian attitudes and knowledge toward HPV for children in Peru: A cross-sectional study. Journal of South Asian Federation of Obstetrics and Gynaecology 17(S1) S17\u2013S22. https:\/\/doi.org\/10.5005\/jp-journals-10006-2613","DOI":"10.5005\/jp-journals-10006-2613"},{"key":"e_1_3_3_5_1","doi-asserted-by":"crossref","unstructured":"Bartolini R. M. Winkler J. L. Penny M. E. LaMontagne D. S. (2012). Parental acceptance of HPV vaccine in Peru: A decision framework. PLOS ONE 7(10) Article e48017. https:\/\/doi.org\/10.1371\/journal.pone.0048017","DOI":"10.1371\/journal.pone.0048017"},{"key":"e_1_3_3_6_1","doi-asserted-by":"crossref","unstructured":"Chaupis-Zevallos J. Ramirez-Angel F. D\u00e1maso-Mata B. Panduro-Correa V. Rodriguez-Morales A. J. Arteaga-Livias K. (2020). Factores asociados a la aceptabilidad de la vacuna contra el virus del papiloma humano Hu\u00e1nuco Per\u00fa [Factors associated with HPV vaccine acceptability in Huanuco Peru]. 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McLaughlin M. (2024). Applying the COM-B behaviour model to understand factors which impact 15\u201316 year old students\u2019 ability to protect themselves against acquirement of Human Papilloma virus (HPV) in Northern Ireland UK. PLOS Global Public Health 4(4) Article e0003100. https:\/\/doi.org\/10.1371\/journal.pgph.0003100","DOI":"10.1371\/journal.pgph.0003100"},{"key":"e_1_3_3_10_1","doi-asserted-by":"crossref","unstructured":"Fuady A. Setiawan D. Man I. de Kok I. M. C. M. Baussano I. (2024). Toward a framework to assess the financial and economic burden of cervical cancer in low- and middle-income countries: A systematic review. JCO Global Oncology 10 Article e2400066. https:\/\/doi.org\/10.1200\/GO.24.00066","DOI":"10.1200\/GO.24.00066"},{"key":"e_1_3_3_11_1","doi-asserted-by":"crossref","unstructured":"Gray A. Fisher C. B. (2023). Factors associated with HPV vaccine acceptability and hesitancy among Black mothers with young daughters in the United States. 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A. Ybaseta-Medina J. Aza\u00f1edo D. Torres-Rom\u00e1n J. S. (2025). Factors associated with parental acceptance of the HPV vaccine in girls from metropolitan Lima Peru. BMC Public Health 25(1) Article 2334. https:\/\/doi.org\/10.1186\/s12889-025-23228-8","DOI":"10.1186\/s12889-025-23228-8"},{"key":"e_1_3_3_15_1","doi-asserted-by":"crossref","unstructured":"Lei J. Ploner A. Elfstr\u00f6m K. M. Wang J. Roth A. Fang F. Sundstr\u00f6m K. Dillner J. Spar\u00e9n P. (2020). HPV vaccination and the risk of invasive cervical cancer. New England Journal of Medicine 383(14) 1340\u20131348. https:\/\/doi.org\/10.1056\/NEJMoa1917338","DOI":"10.1056\/NEJMoa1917338"},{"key":"e_1_3_3_16_1","doi-asserted-by":"crossref","unstructured":"Marshall S. Fleming A. Sahm L. J. Moore A. C. (2023). Identifying intervention strategies to improve HPV vaccine decision-making using behaviour change theory. 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Seguro Integral de Salud [Integral Health Insurance - public health insurance]. https:\/\/www.gob.pe\/institucion\/sis\/institucional"},{"key":"e_1_3_3_23_1","doi-asserted-by":"crossref","unstructured":"Morse R. M. Jurczuk M. Brown J. Jara L. E. C. Meza G. L\u00f3pez E. J. R. Tracy J. K. Gravitt P. E. Paz-Soldan V. A. Del Carpio-Morgan M. Grandez H. D. Escudero M. F. Garcia Satalay E. Y. Gilman S. D. D\u00edaz K. G. Jer\u00f3nimo J. Jorges A. Kohler-Smith A. Kosek M. . . . the Proyecto Precancer Study Group. (2023). \u201cDay or night no matter what I will go\u201d: Women\u2019s perspectives on challenges with follow-up care after cervical cancer screening in Iquitos Peru: A qualitative study. BMC Women\u2019s Health 23(1) Article 293. https:\/\/doi.org\/10.1186\/s12905-023-02414-z","DOI":"10.1186\/s12905-023-02414-z"},{"key":"e_1_3_3_24_1","doi-asserted-by":"crossref","unstructured":"Nogueira-Rodrigues A. Flores M. G. Macedo Neto A. O. Braga L. A. C. Vieira C. M. de Sousa-Lima R. 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Lessons learned from HPV vaccine delivery in low-resource settings and opportunities for HIV prevention treatment and care among adolescents. JAIDS Journal of Acquired Immune Deficiency Syndromes 66 S209. https:\/\/doi.org\/10.1097\/QAI.0000000000000175","DOI":"10.1097\/QAI.0000000000000175"},{"key":"e_1_3_3_32_1","doi-asserted-by":"crossref","unstructured":"V\u00e1zquez-Rowe I. Gandolfi A. (2020). Peruvian efforts to contain COVID-19 fail to protect vulnerable population groups. Public Health in Practice 1 100020. https:\/\/doi.org\/10.1016\/j.puhip.2020.100020","DOI":"10.1016\/j.puhip.2020.100020"},{"key":"e_1_3_3_33_1","doi-asserted-by":"crossref","unstructured":"Venegas Rodr\u00edguez G. Jorges Nimer A. Galdos Kajatt O. (2020). Vacuna del papilomavirus en el Per\u00fa [HPV Vaccine in Peru]. 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