Table 1:

Interactive educational presentation format/context based on the mothers’ focus group findings

Domain		Focus Group Findings	Presentation format/content	Example presentation quotes
Contextual Factors	Social context	Women exert social influence on one another through shared experiences	Video testimonial from a mother from the community about the importance of vaccination	Now we’re going to hear directly from a mother about why she chose to vaccinate her child against HPV.
	Cultural and religious context	Concerns about pork gelatin in the vaccines	Clarify correct information about HPV vaccine ingredients	HPV vaccine does NOT contain pork gelatin.
Predisposing factors	Knowledge of HPV	- Limited knowledge about HPV	Provide more information about HPV including how it spreads, what diseases it can cause and the difference between HPV and HIV	HPV is spread through sexual contact… That means that EVERYBODY who is or one day will be sexually active is at risk for HPV infection, including both boys and girls.
				HPV can cause serious health problems, most importantly, cancer.
		- Confusion between HPV and HIV		HPV (the one with the P) is not the same thing as HIV.
		- Limited knowledge about HPV vaccine	Provide factual information about HPV vaccine including how may doses of HPV vaccine children need to take, how effective the vaccine is	Your children…don’t have to worry nearly so much about cervical cancer…because we have an extremely effective and safe vaccine.
				Children who get their first dose of HPV vaccine before age 15 only need two doses… Teens who get their first dose on their 15th birthday or after need three doses for long lasting protection.
				HPV vaccine is not only safe but it’s effective.
	Perceptions of vaccines	Concerns about vaccines and associated vaccination with disease risk	Clarify that HPV vaccine is not associated with disease risk	The vaccine PROTECTS you from HPV – you CANNOT get HPV infection or cancer from the vaccine.
	Vaccine side effects	Concerns about side effects	Provide correct information about the HPV vaccine’s side effects	Millions of girls and boys have gotten the HPV vaccine, and there have been no serious side effects linked to the HPV vaccine. In rare cases, people have reported serious conditions that occurred around the same time the vaccine was given, but from what we know, the HPV vaccine didn’t cause these conditions.
Enabling factors	Healthcare provider responsibility	Providers need to engage parents in communicating about the vaccine	A co-ethnic doctor delivered the educational presentation	One way doctors share information about vaccines is by giving parents a written document called a “Vaccine Information Statement,” or VIS for short. On the day of your child’s immunization appointment, your doctor should show you a VIS for every vaccine your child is due to receive. If you need help with reading or translation, your doctor should be able to identify someone to help. It is your right to ask your doctor any questions that you have about HPV vaccine or any other vaccine, and it is your doctor’s responsibility to try to answer all of your questions.
	Community resources	Women shared the need for information from healthcare providers by word of mouth
Need for care factors	Vaccine uptake needs	Women stated that a strong recommendation from a co-ethnic provider elevated their need for vaccination	Providing information about doctors’ opinion of getting the child vaccinated	Doctors agree that HPV is an extremely important vaccine for adolescents.
		Women expressed need for clear vaccine information	Providing information on community resources for finding a pediatrician, and school-based health center locations offering HPV vaccines	If you have a child that is at least eleven-years-old, all you need to do is call your child’s pediatrician and set up an appointment… If your child goes to school in Seattle, she may be able to get vaccinated without even going to the doctor! Most high schools in Seattle and a few middle schools have health centers right on campus.