A qualitative analysis of the vaccine intention–behaviour relationship: parents’ descriptions of their intentions, decision-making behaviour and planning processes towards HPV vaccination

Objective: The objective of this study is to identify factors influencing the vaccine intention–behaviour relationship. Design: A total of 445 parents who received a brief intervention to promote HPV vaccination were categorized based on their intentions post-intervention (yes/unsure/eventually/never) and subsequent adolescents’ vaccine status (yes/no). Fifty-one of these parents participated in qualitative interviews. Main Outcome Measures: Parents described their intentions, decision-making and planning processes towards vaccination. Framework analysis was used to analyse the data. Results: Parents in the ‘Yes/Yes’ category were knowledgeable about HPV/vaccine, described strong, stable intentions, considered themselves the primary decision-makers about vaccination and said they vaccinated immediately. ‘Yes/No’ parents described strong intentions and thought their adolescent was vaccinated OR described hesitant intentions, seeking advice/agreement from others and noting barriers to vaccination without solutions. ‘Unsure/Yes’ parents described their intentions as strengthening with information from credible sources and identified strategies for overcoming barriers. ‘Unsure/No’ and ‘Eventually/No’ parents had misinformation/negative beliefs regarding vaccination, described being ambivalent or non-supportive of vaccination and cited barriers to vaccination. ‘Never/No’ parents held negative beliefs about vaccination, described strong, stable intentions to NOT vaccinate, deferring the decision to others, and reported no planning towards vaccination. Conclusions: Intention characteristics and planning processes could moderate the vaccine intention–behaviour relationship, potentially serving as targets for future vaccine strategies.