Background-Although theories of health behavior have guided thousands of studies, relatively few studies have compared these theories against one another.
Findings highlight characteristics of the message recipient that may affect the success of framed messages promoting vaccine acceptance. This study has practical implications for the development of health communications promoting vaccination.
This study provides an important exception to the commonly observed gain-framed advantage for preventive health behaviors. Loss-framed appeals appear to be particularly effective in promoting interest in low-frequency prevention behaviors such as HPV vaccination.
Objective
Perceived barriers are one of the strongest determinants of health behavior. The current study presents a novel conceptualization of perceived barriers by testing the following hypotheses: (a) perceived barriers are multidimensional and thus should cluster into distinct factors; (b) practical barriers should be salient for individuals intending to engage in a particular health behavior, whereas global barriers should be salient for individuals not intending to enact the behavior; and (c) whereas global barriers should be negatively associated with behavioral intentions, practical barriers should be positively related to intentions.
Methods
The context for this investigation was young adult women’s perceived barriers to human papillomavirus (HPV) vaccination. Two months after viewing an educational video about HPV vaccination, women (aged 18-26) who had not initiated the series (n = 703) reported their perceived barriers to HPV vaccination and intentions to receive the vaccine.
Results
Relative to the conventional single factor approach, a five-factor model provided better fit to the data and accounted for a larger proportion of variance in vaccination intentions. The relative salience of different perceived barriers varied as a function of women’s intentions. Participants who were not intending to get vaccinated cited global concerns about vaccine safety and low perceived need for the vaccine. In contrast, participants intending to get vaccinated cited practical concerns (cost, logistical barriers) related to carrying out their intentions. Moreover, whereas global perceived barriers were associated with lower intentions, practical barriers were associated with higher intentions.
Conclusions
Perceived barriers are multidimensional and vary systematically as a function of people’s behavioral intentions.
Until recently, awareness of the sexually transmitted infection human papillomavirus-the virus that causes cervical cancerwas relatively low. The purpose of this study was to identify factors associated with human papillomavirus knowledge now that human papillomavirus vaccines have become widely available. Young adult women (n D 739; aged 18-26 years) attending Florida State University who had not yet initiated human papillomavirus vaccination completed a survey between March-August 2009. The survey assessed human papillomavirus awareness, human papillomavirus knowledge, demographics, socio-political variables, sexual history, and health history variables. Over 97% of participants were aware of human papillomavirus prior to study enrollment; however, knowledge of human papillomavirus was only moderate. A multivariate regression analysis examining factors related to human papillomavirus knowledge revealed five independent correlates: Latina ethnicity, premarital sex values, number of lifetime sexual partners, history of cervical dysplasia, and HIV testing. These variables accounted for 14% of the variance in human papillomavirus knowledge. Less knowledge was observed for Latinas and women opposed to premarital sex. Greater knowledge was observed for women who had been tested for HIV and women with more sexual partners or a history of cervical dysplasia. These findings can inform future human papillomavirus vaccination campaigns and may be particularly useful in developing interventions for individuals with the largest deficits in human papillomavirus knowledge.
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