Modification and validation of the Treatment Self Regulation Questionnaire to assess parental motivation for HPV vaccination of adolescents

Abstract

Background According to Self-Determination Theory, the extent to which the motivation underlying behavior is self-determined or controlled influences its sustainability. This is particularly relevant for behaviors that must be repeated, such as completion of the human papillomavirus (HPV) vaccine series. To date, no measures of motivation for HPV vaccination have been developed. Methods As part of a larger study, parents (N=223) whose adolescents receive care at safety-net clinics completed a telephone questionnaire about HPV and the vaccine. We modified the Treatment Self-Regulation Questionnaire to assess parents’ motivation for HPV vaccination in both Spanish and English. We used confirmatory factor analysis to test a three-factor measurement model. Results The three-factor model fit the data well (RMSEA=.04, CFI=.98, TLI=.96), and the scales’ reliabilities were adequate (autonomous: α=.87; introjected: α=.72; external: α=.72). The factor loading strength for one item was stronger for Spanish- than English-speaking participants (p<.05); all others were equivalent. The intercorrelations among the scales ranged from −.17 to .32, suggesting discriminant factors. The scales displayed the expected pattern of correlations with other psychosocial determinants of behavior. Vaccination intentions showed a strong correlation with autonomous motivation (r= .52), but no correlation with external motivation (r=.02), suggesting autonomous motivation may be particularly important in vaccine decision-making. Conclusion Findings support the use of three subscales to measure motivation in HPV vaccination and suggest possible cultural differences in motivation.

Development and validation of the treatmentself-regulation questionnaire assessing healthcare professionals’ motivation for flu vaccination (TSRQ-Flu)

“…Additionally, higher autonomous feelings have been found to significantly increase the likelihood of medical students' intention to vaccinate (when instrumental attitude was positive, Lehmann et al, 2015). More recently, self-determination theory (SDT) -the only theory of human motivation placing emphasis on the conceptualisation of autonomous motivation -has been applied to understand associations with parental vaccination intentions in HPV vaccination (Denman et al, 2016) and the flu vaccination intention of university students (Chan et al, 2015;Fall et al, 2018). However, empirical measures of healthcare professionals' motivation to receive the flu vaccination are lacking, and there is a need to extend our understanding of vaccine hesitancy as a conative act.…”

“…The TSRQ has been used to assess different motivation regulations across various health behaviours, such as diabetic treatments, diet, exercise, smoking cessation, and HPV vaccination (Denman et al, 2016;Levesque et al, 2007;Williams et al, 1998Williams et al, , 2004. According to SDT, autonomy is conceptualised on a motivation continuum of six regulations: amotivation, external, introjected, identified, integrated and intrinsic.…”

Avaliação das propriedades psicométricas do Questionário de Autorregulação para o tratamento medicamentoso na doença crónica

“…Convergent validity was assessed through the correlation with two other measures of motivational variables, the perception of an autonomy-supportive therapeutic environment, and perceived competence, as well as through the association with medication adherence. Discriminant validity was assessed through intercorrelations between subscales (Denman et al, 2016).…”

“…This theory proposes a continuum of three types of motivation: autonomous motivation, behaving with a sense of volition and choice; controlled motivation, behaving in response to an external or internal pressure; amotivation, which reflects a lack of intent to act because the person does not value the behavior or does not feel competent to perform it . According to SDT, there are two forms of regulation in controlled motivation: external regulation, in which the behavior occurs in response to external pressure to get a reward or avoid negative consequences, and introjected regulation, in which the behavior results from internal pressures such as guilt, anxiety, or to receive praise Denman, Baldwin, Marks, Lee, & Tiro, 2016). When people are autonomously motivated, they commit more to behavioral changes, are more persistent and efficacious than when they are externally motivated (Deci & Ryan, 2012).…”

“…A recent perspective has considered that external regulation and introjected regulation are part of a single dimension, called controlled motivation (Marques et al, 2012). Another factor that varied across the multiple versions of the questionnaire is associated with the amotivation subscale, which was eliminated in several versions of the questionnaire (Denman et al, 2016;Marques et al, 2012). However, this subscale tends to be used when the Revista de Enfermagem Referência 2020, Série V, nº2: e19069 DOI: 10.12707/RIV19069 analyzed behaviors are associated with the initiation or maintenance of a medical treatment (Życińska, Januszek, Jurczyk & Syska-Sumińska, 2012).…”