Individual adolescent factors

Facilitative

Obstructive

Have knowledge about CC and HPV vaccine

Have less knowledge about CC and HPV vaccine

Try to get more information

Have future self-image and visions

Express fear and desire to escape from CC

Do not get a concrete picture of what CC really

Recognize the value of the HPV vaccine

Distrust the HPV vaccine

Have anxiety regarding IM injection

Already have boyfriends

Do not have a boyfriend or have no plan to get a boyfriend

Be aware of slow sexual growth

Discuss CC and HPV vaccine with their caregivers

Do not seriously discuss HPV vaccination with caregivers

Express willingness to accept HPV vaccination to their caregivers

Prioritize the caregiver’s thinking on HPV vaccination

Have psychological anguish

Regularly visit the clinic

Caregiver factors

Facilitative

Obstructive

Have basic understanding about the effectiveness of HPV vaccination against CC

Be aware of the increasing prevalence of CC in the Japanese younger generations

Be deprived of the future childbearing opportunities due to CC

Know that HPV vaccination was recommended before the start of sexual intercourse

Have expectation for the effects of vaccination

Distrust the HPV vaccine

Have fears against cancer

Adolescents have boyfriends

Adolescent girls did not have any boyfriends

Believe the adolescents had not yet had any sexual relationships

Unilateral decision on the adolescents’ HPV vaccination

Respect the adolescents’ opinions

Feel difficult to explain HPV vaccine to the adolescents

Feel embarrassed explaining the detail of sexual intercourse

Adolescents have regularly visited the clinic

Be trust in doctors’ recommendations for HPV vaccination

Doctors’ responses to caregivers’ questions about HPV vaccination

Easy to locate the hospital