Predicting Human Papillomavirus Vaccine Uptake in Young Adult Women: Comparing the Health Belief Model and Theory of Planned Behavior

Department of Medical Humanities and Social Sciences, College of Medicine, Florida State University, 1115 West Call Street, Tallahassee, FL, 32306-4300, USA, .
Annals of Behavioral Medicine (Impact Factor: 4.2). 05/2012; 44(2):171-80. DOI: 10.1007/s12160-012-9366-5
Source: PubMed


Although theories of health behavior have guided thousands of studies, relatively few studies have compared these theories against one another.
The purpose of the current study was to compare two classic theories of health behavior-the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB)-in their prediction of human papillomavirus (HPV) vaccination.
After watching a gain-framed, loss-framed, or control video, women (N = 739) ages 18-26 completed a survey assessing HBM and TPB constructs. HPV vaccine uptake was assessed 10 months later.
Although the message framing intervention had no effect on vaccine uptake, support was observed for both the TPB and HBM. Nevertheless, the TPB consistently outperformed the HBM. Key predictors of uptake included subjective norms, self-efficacy, and vaccine cost.
Despite the observed advantage of the TPB, findings revealed considerable overlap between the two theories and highlighted the importance of proximal versus distal predictors of health behavior.

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    • "In the context of HPV vaccination, research has revealed that loss-framed messages tend to lead to greater intentions to get vaccinated, but results also indicate that the persuasive advantage of loss-framed messages holds only under certain conditions (Gerend et al., 2008; Nan, 2012). For example, when people were told that the vaccine involves a single dose, loss frames were more persuasive, but gain-and lossframed messages were equally influential when people believed that multiple doses are required (Gerend et al., 2008). "
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    ABSTRACT: This research examines the interaction effect of message framing (gain vs. loss) and perceived susceptibility (i.e., perceived likelihood that one's child is at risk of contracting HPV) on African American parents' intentions to vaccinate their children against HPV. Results of an experiment (N = 193) in which parents were exposed to either a gain-framed or loss-framed message about HPV vaccination revealed a significant interaction between message framing and perceived susceptibility when parents were required to pay for the vaccine. The specific pattern of interaction suggested that parents who perceived their children to be at high risk of contracting HPV were more persuaded by the gain-framed message, whereas those who believed their children to be at low risk of contracting HPV were more persuaded by the loss-framed message. Implications of the findings for HPV vaccination messaging are discussed.
    No preview · Article · Dec 2015 · Health Communication
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    • "This study adopted the theory of planned behavior (TPB) (Ajzen 1991) (Fig. 1) in modeling the cognitive factors influencing the behaviors of scaffolders. The TPB had been widely applied in many areas such as traffic safety, health interventions, adolescent behavior, food safety, and information security [e.g., Gerend and Shepherd (2012), Heirman and Walrave (2012), Ifinedo (2012), Milton and Mullan (2012), and Parker et al. (1992)]. The TPB postulates that planned behaviors are significantly influenced by intention, subjective norm (SN), attitude, and perceived behavioral control (PBC). "
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    ABSTRACT: Despite efforts in recent years, the construction industry remains one of the top contributors for workplace fatalities in many countries. One of the key concerns in the industry is the management of workers' safety behavior. This paper aims to explore the cognitive factors influencing the unsafe behavior of not anchoring a safety harness when working at height. In addition, multiple stepwise linear regression, artificial neural network, and decision tree techniques were applied in the study to assess their usefulness in evaluating survey data of safety cognitive factors. The theory of planned behavior (TPB) was adopted to model the cognitive factors influencing the unsafe behavior of scaffolders. The TPB postulates that attitude, perceived behavioral control, and subjective norms affect the intention of workers, which ultimately affects intentional behavior. The unsafe act of not anchoring harnesses while working on a scaffold was selected as the focal behavior based on observations and interviews with safety supervisors. Supervisors also provided their opinions on the underlying reasons for the unsafe act. A questionnaire was then developed based on the site observations, interviews, and literature review. Subsequently, 40 migrant workers from Bangladesh, India, and China were surveyed. Stepwise multiple linear regression, neural network, and decision tree analyses were implemented. The analyses revealed that subjective norm was the key variable influencing a worker's decision to anchor the safety harness. The significance of subjective norm was probably affected by the national culture of the migrant workers. In addition, the analyses showed that the relationships between the variables were probably nonlinear, thus neural network and decision tree are suitable techniques. The exploratory study provides the basis for design of an in-depth study on the cognitive factors influencing safety behavior and it expands the choice of analyses techniques.
    Full-text · Article · Jun 2015 · Journal of Construction Engineering and Management
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    • "A previous study used the health belief model to predict vaccine intentions among college-age women and also found that women's self-efficacy was one of the major predictors for HPV vaccine intent and behavior [24]. Using the theory of planned behavior, Gerend and Shepherd [25] also found that key predictors for receiving HPV vaccination by young adult women included subjective norms, self-efficacy, and vaccine cost. "
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    ABSTRACT: Objective To investigate factors influencing commitment to human papilloma virus (HPV) vaccination and prior vaccination among female college students in northern Taiwan. Methods A quota sample of 400 female college students was recruited from nine colleges in northern Taiwan during March 2013. Of these, 398 completed the self administered questionnaire which was designed based on the health promotion model. Results The results showed that factors associated with prior vaccination behavior were family history of gynecologic malignancy, ever being advised to get HPV vaccination, perceived barriers of action and perceived self-efficacy. Predictors for commitment to HPV vaccination in the next 6 months were the cost of vaccination, ever being advised to get HPV vaccination, perceived self-efficacy and situational influences. Perceived self-efficacy was significantly influenced by relationship status, past receipt of a recommendation for HPV vaccination and level of knowledge about HPV. Conclusion When formulating vaccination policies, governmental or medical institutions should include these factors to promote vaccination.
    Full-text · Article · Jul 2014 · Journal of Gynecologic Oncology
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