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Despite the availability and benefits of the Human papillomavirus (HPV) vaccine, parental acceptance remains low in the eastern mediterranean region (EMR). Therefore, this meta-analysis aimed to estimate the pooled proportion of parental uptake and willingness to vaccinate their children with the HPV vaccine and their determinants in the EMR. We searched PubMed Central, PubMed Medline, Scopus, Web of Science, ProQuest, Google Scholar, and medRxiv according to PRISMA guidelines until the 5th of April 2024. We included all papers discussing parental uptake and willingness to vaccinate their children with the HPV vaccine in EMR without time or language limitations. The study risk of bias was assessed using the Newcastle–Ottawa Scale quality assessment tool. We pooled data using the random effect model. Leave one sensitivity analysis, subgroup analysis, and meta-regression were used to address heterogeneity. Out of 1551 screened studies, thirty-three studies of 18,455 parents from 12 countries fully met the inclusion criteria and were eligible for meta-analysis. The pooled proportion of parental willingness for future HPV vaccination, based on 32 studies involving 17,815 parents was 61 % (95 % CI: 54–68 %, I2 = 99 %). Using meta-regression, the proportion of working parents, study quality, and geographical region explained approximately 52.46% of the observed heterogeneity. In contrast, based on 9 studies involving 5029 parents, the pooled proportion of parental uptake was 7 % (95 % CI: 5–10 %, I2 = 91 %). Using meta-regression, study quality and geographical region explained 71.42% of the observed heterogeneity. Despite the high parental willingness for HPV vaccination, the uptake of the vaccine in EMR remains critically suboptimal and far behind the goal of the World Health Organization's cervical cancer elimination strategy. Urgent interventions are needed, including adding the vaccine to the national vaccination programs (NVPs) and tailoring parents–targeted awareness campaigns to improve knowledge and address barriers to vaccine uptake.

Introduction Despite the global vaccination campaign to prevent HPV-related morbidity, HPV vaccination uptake remains unacceptably low in the developing world, like Ethiopia. For strong interventional measures, compiled data in the field is required which is otherwise missed in the Ethiopian context. Therefore, this systematic review aimed to provide an estimate of the HPV vaccination uptake, mothers‘ willingness to vaccinate their adolescent girls, and associated factors in Ethiopia. Methods Articles were systematically searched using comprehensive search strings from PubMed/Medline, SCOPUS, and grey literature from Google Scholar. Two reviewers assessed study eligibility, extracted data, and assessed the risk of bias independently. Meta-analysis was performed using STATA v 14 to pool the vaccination uptake and mothers‘ willingness toward HPV vaccination in Ethiopia. Results We included 10 articles published between 2019 and 2022 covering reports of 3,388 adolescent girls and 2,741 parents. All the included articles had good methodological quality. The pooled estimate of the proportion of good knowledge about HPV vaccination and the agreement of girls to get the vaccine was 60% (95%CI: 59–62) and 65% (95%CI: 64–67), respectively. The pooled estimate of vaccination uptake of at least one dose of HPV vaccine among girls was 55% (95%CI: 53–57). Positive attitudes to the vaccine, higher maternal education, and having knowledge about HPV and its vaccine were reported as statistically significant predictors. On the contrary, not having adequate information about the vaccine and concerns about possible side effects were reported as reasons to reject the vaccine. Likewise, the pooled estimate of mothers who were knowledgeable about HPV vaccination, who had a positive attitude, and willing to vaccinate their children were 38% (95%CI: 36–40) 58% (95%CI: 56–60), and 74% (95%CI: 72–75), respectively. Conclusions Knowledge about the HPV vaccine among girls and their vaccination uptake is suboptimal that falls short of the 2030 WHO targets. Therefore, stakeholders need major efforts in rolling out vaccination programs and monitoring their uptake. Social mobilization towards primary prevention of HPV infection should focus on adolescents. The existing strategies need to address the predictors of uptake by educating girls and parents.

Objectives: The present study aimed to investigate parents’ willingness to vaccinate their children under the age of 18 with a COVID-19 vaccine. Methods: This cross-sectional study was conducted in Saudi Arabia from January 2021 to March 2021. The univariate analysis using Mann–Whitney U-test, t-test, and chi-squared/Fisher’s exact test was performed to identify sociodemographic factors associated with the acceptance of COVID-19 vaccine in children. Factors with statistical significance (p < 0.05) were analyzed using multivariate regression analysis to determine the variables affecting parents’ decisions to vaccinate children. Results: Overall, 44% (167) of parents reported that they would accept vaccinating their children with a COVID-19 vaccine. Young (86; 22.7%), married (135; 35.6%), and Saudi (114; 30%) parents seemed to be more concerned about their children being infected. Parents who intended to vaccinate themselves (OR: 0.599, 95% CI: 0.367–0.980) and who trust the healthcare system (OR: 0.527, 95% CI: 0.327–0.848) reported greater acceptance of children’s vaccination. Among parents, the most frequent (40.9%) reason for vaccinating children was to prevent infection in other family members. What may underlie this result is that some parents understand that children can carry pathogens from persons in school to thoseat home. The most frequent (22.2%) reason for refusing vaccination was concerns about the side effects of the vaccine. Conclusions: Parents have differing opinions on frequencies and risks of coronavirus disease transmission and medical complications and of effectiveness and adverse effects of a vaccine. These results could be of use in designing public health information campaigns and health promotion programs based on perceived parental behavior and positive attitudes.

The current study used data surveyed with 5357 parents/guardians (parents would be used to represent both ‘parents’ and ‘guardians’ hereafter) between February and March 2022 in Vietnam to examine their willingness to vaccinate their children with current COVID-19 vaccines. It applied the multinomial logistic regression model to examine the association between the willingness of parents and selected influential factors. In addition, the reasons that made parent hesitant or unwilling to vaccinate their children were investigated. Moreover, it identified parents’ preferences for vaccine origins. Approximately, 75.4% of the parents were willing, 21.3% were hesitant and 3.3% were unwilling to vaccinate their children. The most common reasons that made the parents hesitant or unwilling to vaccinate their children were their concerns about the vaccine safety, efficacy and immunity. The most and the second most preferred vaccines were those developed/originated in the US and EU, respectively. Parents who were more likely to vaccinate their children included those whose children were insured, who regularly vaccinated their children, who belonged to the vaccine priority groups, who possessed sufficient knowledge about the ways to prevent the virus or about the herd immunity, and who perceived that their children might be infected with the virus and whose children were afraid of needles. Parents who were less likely to vaccinate their children included those who were the family main income source, who had savings, and who had tertiary education or higher.

ObjectivesTo assess attitudes and willingness of parents of children with congenital heart disease (CHD) regarding donating biospecimens for future CHD research, and to identify factors associated with biospecimen donation.DesignFace-to-face cross-sectional survey data were analysed using logistic regression.SettingCardiothoracic Surgery Inpatient Department, Shanghai Children’s Medical Centre.ParticipantsParents of children attending the cardiothoracic surgery inpatient department at Shanghai Children’s Medical Center, 1 March–31 December 2016.Primary and secondary outcome measuresWillingness and motivation regarding donating children’s biospecimens, and ethical and legal considerations concerning children’s future willingness to donate.ResultsOf 550 parents, 508 completed the questionnaire (response rate=92.4%). Overall, 69.1% (n=351) were willing to donate their children’s biospecimens for medical research. Multivariate analysis indicated higher education level (college/graduate degree: OR 2.435, 95% CI 1.221 to 4.857, p=0.012; high school: OR 1.827, 95% CI 1.190 to 2.804, p=0.006) and children’s hospitalisation history (OR 1.581; 95% CI 1.069 to 2.338, p=0.022) were positively associated with willingness to donate. The most common motivation for donation was potential benefit to other children with CHD (81.2%, n=285). The main barriers to donation were physical discomfort to their children (52.3%, n=54) and concerns about personal privacy (47.1%, n=48). Most parents (86.0%, n=302) wanted to be informed of research results using their children’s donated biospecimens, and 34.8% (n=177) believed that children aged 10–18 years had the right to consent independently to research participation.ConclusionsNearly 70% of the parents in this study were willing to donate their children’s biospecimens for future CHD research. Parents’ education level and children’s hospitalisation history influenced willingness to donate. Most parents wanted to receive the research results related to their children’s biospecimens.

IntroductionHPV vaccination of adolescent girls is the primary strategy for cervical cancer prevention but in Ethiopia, it lacks emphasis. Despite different studies done and found a highly variable level of parents’ willingness to vaccinate their daughter for HPV; however, there was no summarized evidence of parents' willingness as a nation. Thus this systematic review and meta-analysis aimed to assess the pooled prevalence of parents' willingness to HPV vaccination of their daughters and associated factors in Ethiopia.MethodsA systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in international databases. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q test and I2 statistics were computed to assess heterogeneity. Funnel plot and Eggers test were done to assess publication bias. Review manager software was used to identify determinants of parents’ willingness.ResultsOverall, 172 articles were retrieved and finally 7 articles were included in this review. The pooled prevalence of parents' willingness to HPV vaccination of their daughters was 71.82% (95% CI 57.73–85.91%). Knowledge about HPV vaccination (AOR = 2.80, 95% CI (2.10–3.73)), attitude (AOR = 4.93, 95% CI (3.48–6.99)), educational status (AOR = 2.19, 95% CI 1.54–3.10) and income (AOR = 3.13, 95% CI 1.96–5.02)) were significantly associated with parents' willingness.ConclusionsParents' willingness to HPV vaccination of their daughters in Ethiopia was low. Knowledge, attitude, educational status, and income were positively associated with parents' willingness. Therefore, policymakers and program planners should target those important stakeholders (parents) in increasing their awareness and changing their attitude to enhance their vaccine acceptance specifically focusing on those who are lower in economic and educational status so as to prevent the lethal cervical cancer.

Vaccinating children against COVID-19 is an essential public health strategy in order to reach herd immunity and prevent illness among children and adults. Parents are facing tremendous stress in relation to the COVID-19 pandemic and the effectiveness of the COVID-19 vaccination program for children. In this study, we aimed to investigate parents’ perceptions and acceptance of the COVID-19 vaccine for their children in Saudi Arabia. A well-designed, pre-validated, Google questionnaire was distributed to parents through social media websites. The selection of the participants was based on the simple random sample technique. The study sample size was 1304 participants, with 342 males (26.2%), and 962 females (73.8%). The personal information, perception about COVID-19, and their children’s vaccination status were obtained. Among the participants, 602 (46.1%) were willing to get the COVID-19 vaccination for their children, whereas 382 (29.3%) were hesitant to inoculate their children for COVID-19 and 320 (24.4%) were unsure. Age (p = 0.004), gender (p = 0.001), occupation (0.004), income (p = 0.030), and vaccination status (p = 0.001) had an influence on the parents’ acceptance of COVID-19 vaccination of their children. On the other hand, education level, number of children, and having been previously infected with COVID-19 had no statistically significant effect on the parent acceptance. The correlation of parents’ knowledge about COVID-19 and their agreement to the vaccination of their children was statistically significant, along with gender (males were more knowledgeable, with p < 0.001), occupation, income (higher income showed a statistical difference, with p < 0.001), and vaccination status (p < 0.001). There was a decrease in parents’ acceptance toward the COVID-19 children vaccine in Saudi Arabia, which requires more attention and focus from health providers to eliminate fear and anxiety among the parents through additional educational programs and events to decrease the resistance toward the vaccination of children. More emphasis is required to increase the awareness of parents and convey the importance of the vaccine for children. In addition, more studies are needed to ensure the vaccine’s safety.

Purpose This study aims to understand the extent to which packaging influences Brazilian parents' purchasing willingness based on children's food preferences for unhealthy food products. Design/methodology/approach Parents, with children up to 12 years old, answered questions about the positive influence of the packaging on the children, the preferences of the children in their willingness to buy and the propensity to give in to the desires of the children. Data analysis was performed with the statistical software SPSS and Stata used for structural equations modeling. Findings The results back the outlined hypotheses and point out that the characteristics of the packaging positively influence children's preferences as well as parents’ who are prone to give in to such influences. In some relationships, there was a minute moderating effect of social desirability and social class. Research limitations/implications The research presents as a limitation the nature of the sample, parents, to the extent that the influences of the packages on the children were analyzed from their perspectives. Practical implications Findings from the research can be used to think about preventive public policies to protect children as highly vulnerable subjects. Another practical implication is that the same marketing strategies that are used for unhealthy foods can also be used for healthy foods, improving their linkage to the children once there are evidences that packaging can positively influence their preferences. Originality/value The originality of this study is to focus on children's food preferences for unhealthy products and in parents with children up to 12 years old, which is not often investigated by researchers.

This article reviews the economics literature dealing with valuation of reduced environmental risks to children's health. We describe conceptual models together with results from a number of empirical studies. The conceptual models analyze valuation issues from the perspective of parents; treat health risk as endogenously determined; and demonstrate that in equilibrium, marginal willingness to pay to reduce risk for the child relative to marginal willingness to pay to reduce risk for the parent should equal the ratio of marginal risk reduction costs. Empirical studies treat both mortality and morbidity associated with exposure to environmental health risks. These studies generally find that parents are willing to pay more for absolute risk reductions for their children than they are willing to pay for corresponding risk reductions for themselves. Possible reasons for this outcome along with suggestions for further research are discussed.

Recent theories endogenize the attitude endowments of individuals, assuming that they are shaped by the attitudes of parents and other role models. This paper tests empirically for the relevance of three aspects of the attitude transmission process highlighted in this theoretical literature: (1) transmission of attitudes from parents to children; (2) an impact of prevailing attitudes in the local environment on child attitudes; and (3) positive assortative mating of parents, which enhances the ability of a parent to pass on his or her attitudes to the child. We focus on two fundamentally important attitudes, willingness to take risks and willingness to trust others. We find empirical support for all three aspects, providing an empirical underpinning for the literature. An investigation of underlying mechanisms shows that socialization is important in the transmission process. Various parental characteristics and aspects of family structure are found to strengthen the socialization process, with implications for modeling the socialization production function and for policies focused on affecting children's non-cognitive skills. The paper also provides evidence that the transmission of risk and trust attitudes affects a wide variety of child outcomes, implying a potentially large total effect on children's economic situation.