1. A Systematic Review of Measures to Assess Factors associated with Acceptability of the HPV Vaccine Jennifer Allen, DFCI/Harvard Gloria Coronado, University of Washington Cam Escoffery, Emory University Maria Fernandez, University of Texas Beth Glenn, University of California, LA Pat Mullen, University of Texas Raegan Tuff, Morehouse School of Medicine Rebecca Williams, University of North Carolina Kathi Wilson, Centers for Disease Control & Prevention

2. Background & Rationale Causal association between HPV & cervical cancer known since ~1995 First vaccine approved for use in U.S. June 2006 Proliferation of studies examining vaccine acceptability or intention to vaccinate Extent to which use of standardized, validated measures is unknown

3. Goals of Review 1.Review measures used in published studies of knowledge, attitudes and behaviors related to HPV vaccine; 2.Describe characteristics & performance of measures; 3.Provide recommendations for measurement that may improve quality of future studies.

4. Methods Database search –PubMed, PsychINFO, CINAHL (1995 through January 2008) Inclusion criteria –English language –Primary source –Developed country Exclusion criteria –Provider studies –Qualitative studies Data extraction –Standardized on-line coding form –Two independent coders –Discrepancies resolved by group consensus 1741 titles/abstracts reviewed; 80 eligible

5. Characteristics of Studies (n=80) Study Design% RCT5 Pre/post one group8 Cross-sectional86 Location U.S.51 Non-U.S.45 Setting Population-based21 Health care41 Community/school52 Location U.S.51 Non-U.S.45

6. Characteristics of Studies (n=80) Sample% Parents21 Adult women58 Adolescent girls (<18)28 Men5 Women & men18 Sample Size <10013 101-50058 501-100015 >100015 Sampling Method Random24 Convenience64 Other13

7. Constructs Measured & Frequency

8. Conclusions & Recommendations Development & use of validated measures Greater use & application of theoretical or conceptual frameworks Testing of measures across age, gender, literacy level, cultural groups Psychometric properties of measures used in most studies unknown or not reported Theoretical or conceptual frameworks used in most studies unknown or not reported Few measures developed for population subgroups