Parents' decision-making about the human papillomavirus vaccine for their daughters: II. Qualitative results.

The goal of the study was to examine the reasons given by parents who accepted or refused the HPV vaccine for their daughters in the context of a free provincial school-based vaccination program. A random sample of parents of 9-10 y old girls completed a mail-in questionnaire. Parents' responses to 2 open-ended questions were assessed using content analysis. Coding themes were derived from the Health Belief Model. 806 parents returned and answered the relevant items. 88% of these parents decided to vaccinate their daughter. The primary reasons for parents' acceptance was the perceived benefits (e.g., health protection, cancer/HPV prevention) and cues to action (e.g., physician recommendation, trusting the school vaccine program). Reasons for parental refusal included barriers (e.g., fear of side effects) and low susceptibility (e.g., their daughter is not at risk). Both groups of parents had unanswered questions, doubts and often inaccurate information. This study provides unique insight into parents' perspectives concerning the decision making process for their daughter. There appears to be a need for accurate and complete information to assure informed HPV vaccine decision-making by parents and to increase HPV vaccine uptake.

Parents' decision-making about the human papillomavirus vaccine for their daughters: I. Quantitative results.

Vaccination against the human papillomavirus (HPV) is an effective primary prevention measure for HPV-related diseases. For children and young adolescents, the uptake of the vaccine is contingent on parental consent. This study sought to identify key differences between parents who obtain (acceptors) and parents who refuse (non-acceptors) the HPV vaccine for their daughters. In the context of a free, universal, school-based HPV vaccination program in Québec, 774 parents of 9-10 year-old girls completed and returned a questionnaire by mail. The questionnaire was based on the theoretical constructs of the Health Belief Model (HBM), along with constructs from other theoretical frameworks. Of the 774 parents, 88.2% reported their daughter having received the HPV vaccine. Perceived susceptibility of daughters to HPV infection, perceived benefits of the vaccine, perceived barriers (including safety of the vaccine), and cues to action significantly distinguished between parents whose daughters had received the HPV vaccine and those whose daughters had not. Other significant factors associated with daughter vaccine uptake were parents' general vaccination attitudes, anticipated regret, adherence to other routinely recommended vaccines, social norms, and positive media influence. The results of this study identify a number of important correlates related to parents' decisions to accept or refuse the HPV vaccine uptake for their daughters. Future work may benefit from targeting such factors and incorporating other health behavior theories in the design of effective HPV vaccine uptake interventions.

Access to drinking water and health of populations in Sub-Saharan Africa.

Water is at the center of the plant and animal life, the foundation upon which the health of human settlement and development of civilizations rely on. In tropical regions, 80% of diseases are transmitted either by germs in the water, or by vectors staying in it. In Sub-Saharan Africa, statistics show particularly high levels of unmet needs of populations in access to drinking water in a context of socioeconomic development. For this purpose, this study aims to determine the influence of access to drinking water on the health of populations in Sub-Saharan Africa. Using data from Demographic and Health Surveys (DHS) from Cameroon, Senegal and Chad, it is clear from the descriptive analysis that 60% (Cameroon), and 59% (Chad) of the cases of childhood diarrhea in these two countries are due to the consumption of dirty water. In terms of explanatory analysis, we note that when a household in Cameroon, Senegal or Chad does not have access to drinking water, children under 5 years old residing there are respectively 1.29, 1.27 and 1.03 times more likely to have diarrhea than those residing in households with easy access to drinking water. In view of these results, it is recommended to increase access to drinking water in particular by reducing disparities between the rich and poor people.

[Obstetric epidural: focus on French information's quality on the Internet in 2009 and 2010]. / Péridurale obstétricale : qualité de l'information médicale en français sur Internet en 2009 et 2010.

OBJECTIVE: The variability of the medical information available on the Internet (MedInfoWeb) raises concern about its quality. There is no data about the quality of MedInfoWeb concerning epidural analgesia for labour (EAL). Our aims were to assess the quality of MedInfoWeb concerning EAL and to study the stability of MedInfoWeb and the ranking of website into search engine (SE) during 1year. STUDY DESIGN: Observational study. MATERIALS AND METHODS: We created our own data form to analyse the firsts 40 Google(®), Alta Vista(®) and Yahoo(®) websites. In 2009 and 2010, two independent assessors assessed the quality of the website structure (structure score noted out of 25) and the quality of medical information (medical score noted out of 30). The global score (noted on 55) was the addition of structure and medical scores. A HONcode labelling was noted. RESULTS: Between 2009 and 2010, the average global (23 vs. 22), structure (11 vs. 11) and medical (12 vs. 12) Scores were stable. The SE's quality was comparable. A SE website's rank was not related to its global score. The labelling HONcode websites were the best (26 vs. 21, P=0.048). The best website in 2009 and 2010 was doctissimo.fr. In 2010, only 58% of the websites were still presents. CONCLUSION: The quality of MedInfoWeb concerning EAL is poor and did not improve between 2009 and 2010. The MedInfoWeb is unstable: 42% of the websites disappeared in 1year. No website or SE is currently able to give reliable medical information concerning EAL.