Predicting Human Papillomavirus Vaccine Uptake in Young Adult Women: Comparing the Health Belief Model and Theory of Planned Behavior
- 4k Downloads
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.
KeywordsTheory testing Health behavior theory Cervical cancer prevention Vaccination
We thank members of the Women’s Health research team (Khadija Andrews, Kristina Banda, Kathleen Burns, Michelle DiMarco, Sophia Harvey, Elizabeth Howe, Jessica Kraich, Lisa Langenderfer, Meghan McLeod, Mallory McRoberts, Kristina Martinez, Shella Mesa, Samantha O’Hara, Virginia Parker, Victoria Patronis, Michelle Poole, Alana Resmini, and Jennifer Rice, Stephanie Urena, and Becky Wiesenfeld) for their assistance with this project. This research was supported in part by a grant from the National Cancer Institute of the National Institutes of Health (R03-CA138069).
Conflict of Interest Statement
The authors have no conflict of interest to disclose.
- 3.Conner M, Norman P, eds. Predicting health behavior. 2nd ed. Buckinghman, UK: Open University Press; 2005.Google Scholar
- 4.Fishbein M, Ajzen I. Belief, attitude, intention, and behavior: An intro to theory and research. Reading, MA: Addison-Wesley; 1975.Google Scholar
- 6.Abraham C, Sheeran P. Health belief model. In M. Conner and P. Norman, eds. Predicting health behavior. Buckinghman, UK: Open University Press; 2005: 28–80.Google Scholar
- 7.Conner M, Sparks P. Theory of planed behaviour and health behavior. In M. Conner and P. Norman, eds. Predicting health behavior. Buckinghman, UK: Open University Press; 2005: 171–222.Google Scholar
- 8.Rosenstock IM. Historical origins of the health belief model. Health Educ Monogr. 1974; 2: 328–335.Google Scholar
- 12.Brewer NT, Rimer BK. Perspectives on health behavior theories that focus on individuals. In: Glanz K, Rimer BK, Viswanath K, eds. Health behavior and health education: Theory, research, and practice. San Francisco, CA Jossey-Bass; 2008: 149–165.Google Scholar
- 13.Champion VL, Skinner CS. The health belief model. In: Glanz K, Rimer BK, Viswanath K, eds. Health behavior and health education: Theory, research, and practice. San Francisco, CA Jossey-Bass; 2008: 45–65.Google Scholar
- 18.Markowitz LE, Dunne EF, Saraiya M, et al. Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2007; 56: 1–24.Google Scholar
- 19.Centers for Disease Control and Prevention. FDA licensure of bivalent human papillomavirus vaccine (HPV2, Cervarix) for use in females and updated HPV vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2010; 59: 626–629.Google Scholar
- 21.Paavonen J, Naud P, Salmeron J, et al. Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): Final analysis of a double-blind, randomised study in young women. Lancet. 2009; 374: 301–314.PubMedCrossRefGoogle Scholar
- 23.Zimet GD, Liddon N, Rosenthal SL, Lazcano-Ponce E, Allen B. Chapter 24: Psychosocial aspects of vaccine acceptability. Vaccine. 2006; 24 Suppl 3: S3/201–209.Google Scholar
- 32.Gerend MA, Shepherd MA, Shepherd JE. The multidimensional nature of perceived barriers: Global versus practical barriers to HPV vaccination. Health Psychol. 2011. doi: 10.1037/a0026248.
- 39.Muthén B, Muthén L. Mplus Version 3.12. 1998.Google Scholar
- 40.Newsom J. Practical approaches to dealing with nonnormal and categorical variables. Available at http://www.upa.pdx.edu/IOA/newsom/semclass/ho_estimate2.pdf. Accesibility verified March 12, 2011.