Predicting intention to get the HPV vaccine using the underlying behavioral, normative, and control belief constructs of the Theory of Planned Behavior

Background: HPV is associated with cervical, esophageal, and vaginal cancers. It is important to examine vaccination behaviors among college women as less than half reported receiving all three shots of the HPV vaccine. The purpose of this study was to identify the underlying behavioral, normative and control beliefs that can predict individuals’ intention to get the HPV vaccine using the Theory of Planned Behavior (TPB).   

Methods: A questionnaire consisting of 45 items, including demographic variables and items assessing TPB underlying cognitive constructs, was administered to a sample of female college students (n = 608). Discriminant function analysis was conducted using behavioral, normative, and control beliefs as predictors of getting the HPV vaccine.

Results: The discriminant functions were calculated; after removal of the first function, a strong association between groups (individuals who received the vaccine vs. individuals who never received the vaccine) and predictors remained. The two discriminant functions remaining accounted for 53% and 21% of the between group variability respectively. The structure loading matrix between predictors and discriminant functions suggest that the best predictors for distinguishing between groups are cost, side effects, protection against cervical cancer, support of mothers and healthcare providers, having health insurance, and time.

Implications: Results from the current study suggest that changing barriers such as cost and having health insurance as well as increasing knowledge about side effects and advantages of getting the vaccine can be effective strategies in intervention design. Findings also suggest that the TPB is a useful conceptual framework for studying vaccination behavior.