Health beliefs and parental responses to human papillomavirus vaccination in the Middle East: a theory-informed narrative synthesis guided by the health belief model
- 1Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
- 2Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
Abstract
BackgroundHuman papillomavirus (HPV) is the most common sexually transmitted infection in women and the primary cause of cervical cancer (CC). HPV vaccination and screening programs have significantly reduced CC incidence and mortality worldwide, preventing up to 70% of HPV-related CC and 90% of genital warts. Developing effective vaccination strategies is therefore essential.ObjectivesThis study systematically synthesizes the attitudes and health beliefs of Middle Eastern (ME) parents regarding HPV vaccination, examines parental vaccine uptake, and assesses uptake among their children.MethodsThis systematic review followed PRISMA guidelines. PubMed/MEDLINE, Web of Science, CINAHL, and Google Scholar were searched for studies published between January 2006 and May 2025. Thirty-three studies were included. A theory-informed narrative synthesis of predominantly quantitative evidence was conducted, with deductive mapping of findings to the health belief model (HBM) constructs. The review protocol was registered in PROSPERO (CRD42025645551).ResultsThe review included 32 quantitative cross-sectional studies and one qualitative study, involving 18,170 participants. Findings were organized according to HBM constructs, including perceived susceptibility, severity, barriers, benefits, self-efficacy, and cues to action. Parents generally demonstrated limited knowledge of HPV and vaccination. Major barriers included safety concerns, cost, limited access, lack of healthcare provider recommendations, and insufficient information. Cultural and systemic factors were also associated with vaccine uptake.ConclusionHPV-related knowledge in ME countries remains insufficient and is frequently associated with vaccination attitudes and acceptance across the included studies. Improving uptake requires targeted educational interventions, healthcare provider engagement, public health campaigns, financial support, and policy-level initiatives. Strengthening awareness and addressing structural barriers are critical for enhancing vaccination acceptance. Self-efficacy, where directly reported, appeared to be associated with more favorable vaccine attitudes; however, direct evidence for parental self-efficacy as a distinct HBM construct was limited across the included studies and should not be overstated.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/myprospero/CRD42025645551.
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BibTeX
@article{abuzoor2026health,
title = {{Health beliefs and parental responses to human papillomavirus vaccination in the Middle East: a theory-informed narrative synthesis guided by the health belief model}},
author = {Ahmad Abuzoor and Md. Shafiqur Rahman Jabin and Md. Shafiqur Rahman Jabin and Cor Jonker},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1853938},
url = {https://doi.org/10.3389/fpubh.2026.1853938},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Health beliefs and parental responses to human papillomavirus vaccination in the Middle East: a theory-informed narrative synthesis guided by the health belief model
AU - Ahmad Abuzoor
AU - Md. Shafiqur Rahman Jabin
AU - Md. Shafiqur Rahman Jabin
AU - Cor Jonker
PY - 2026
DA - 2026/10/23
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1853938
UR - https://doi.org/10.3389/fpubh.2026.1853938
AB - BackgroundHuman papillomavirus (HPV) is the most common sexually transmitted infection in women and the primary cause of cervical cancer (CC). HPV vaccination and screening programs have significantly reduced CC incidence and mortality worldwide, preventing up to 70% of HPV-related CC and 90% of genital warts. Developing effective vaccination strategies is therefore essential.ObjectivesThis study systematically synthesizes the attitudes and health beliefs of Middle Eastern (ME) parents regarding HPV vaccination, examines parental vaccine uptake, and assesses uptake among their children.MethodsThis systematic review followed PRISMA guidelines. PubMed/MEDLINE, Web of Science, CINAHL, and Google Scholar were searched for studies published between January 2006 and May 2025. Thirty-three studies were included. A theory-informed narrative synthesis of predominantly quantitative evidence was conducted, with deductive mapping of findings to the health belief model (HBM) constructs. The review protocol was registered in PROSPERO (CRD42025645551).ResultsThe review included 32 quantitative cross-sectional studies and one qualitative study, involving 18,170 participants. Findings were organized according to HBM constructs, including perceived susceptibility, severity, barriers, benefits, self-efficacy, and cues to action. Parents generally demonstrated limited knowledge of HPV and vaccination. Major barriers included safety concerns, cost, limited access, lack of healthcare provider recommendations, and insufficient information. Cultural and systemic factors were also associated with vaccine uptake.ConclusionHPV-related knowledge in ME countries remains insufficient and is frequently associated with vaccination attitudes and acceptance across the included studies. Improving uptake requires targeted educational interventions, healthcare provider engagement, public health campaigns, financial support, and policy-level initiatives. Strengthening awareness and addressing structural barriers are critical for enhancing vaccination acceptance. Self-efficacy, where directly reported, appeared to be associated with more favorable vaccine attitudes; however, direct evidence for parental self-efficacy as a distinct HBM construct was limited across the included studies and should not be overstated.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/myprospero/CRD42025645551.
SN - 2296-2565
ER -