Role of communication source in a narrative intervention promoting HPV vaccination among college women

This longitudinal study reports on the development and evaluation of a theoretically based, narrative HPV vaccine intervention aimed at increasing vaccination among college women. The prevention of HPV is a public health priority due to its pervasiveness and relationship to cervical cancer, one of the leading causes of cancer deaths among women worldwide. Pilot work utilizing culture-centric narrative theory guided development of the intervention content from college women's HPV vaccine decision narratives. Exemplification theory led to hypotheses comparing communication sources for these narrative messages (peer only, medical expert only, or a combination of the two source types) in a four-arm randomized controlled trial (N=404; 18-26 year olds). Structural equation modeling and logistic regression were used to test the hypotheses. The combined peer-expert intervention nearly doubled vaccination compared to controls (22% vs. 12%). The pragmatic goal of increasing vaccination and the theoretical predictions about message source were supported. As predicted, the inclusion of peer and medical expert sources plays a critical role in promoting HPV vaccination among college women. Furthermore, the intervention increased vaccination by increasing vaccine self-efficacy and intent. However, contrary to predictions, HPV susceptibility and vaccine response-efficacy play less critical roles in motivating vaccine adoption among college women. Theoretical and practical implications for designing effective HPV vaccine messages are discussed.