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Self-efficacy and HPV Vaccine Attitudes Mediate the Relationship Between Social Norms and Intentions to Receive the HPV Vaccine Among College Students

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Abstract

Human papillomavirus (HPV) has been linked to genital warts and multiple cancers affecting both men and women. Despite college students’ high risk for HPV, their vaccination rates remain suboptimal. The current observational study examined the relationship between social norms and HPV vaccine intentions and potential mechanisms underlying this relationship among undergraduates. Participants (N = 190; 66.8% female) completed a survey assessing HPV vaccine social norms, attitudes, self-efficacy, and intentions. Three mediation analyses were conducted to examine whether self-efficacy and attitudes mediated the relationship between social norms (i.e., parents, friends, doctor) and intentions, controlling for demographic and health care covariates. Social norms were indirectly related to intentions through self-efficacy and attitudes in multiple models (ps < .05). Specifically, perceiving greater support for HPV vaccination from one’s friends, parents, and doctor was related to greater HPV vaccine self-efficacy, which, in turn, was related to increased vaccine intentions. In addition, perceiving greater parental and doctor support for HPV vaccination was related to more favorable attitudes towards the vaccine, which, in turn, were related to increased vaccine intentions. Findings suggest potential targets for future interventions to promote HPV vaccination among young adults.

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Acknowledgements

Preliminary study results were presented at the 2016 Indiana University-Purdue University Indianapolis Research Day in Indianapolis, Indiana. All authors have approved the final article.

Funding

Dr. Christy’s work was funded by the National Cancer Institute while she was a postdoctoral fellow at H. Lee Moffitt Cancer Center and Research Institute (R25CA090314; PI: T. H. Brandon). Dr. Winger’s work was funded by the American Cancer Society (130526-PF-17-054-01-PCSM; PI: J. G. Winger). Dr. Mosher’s work was funded by the National Cancer Institute (K05CA175048; PI: V. L. Champion). The funding agencies had no role in designing the study, interpreting the data, writing the manuscript, or the decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the American Cancer Society.

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Author notes

  1. Madison E. Stout and Shannon M. Christy contributed equally to this work.

Authors and Affiliations

  1. Department of Psychology, Oklahoma State University, Stillwater, OK, 74078, USA

    Madison E. Stout

  2. Department of Psychology, Purdue School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, 46202, USA

    Madison E. Stout, Shannon M. Christy & Catherine E. Mosher

  3. Department of Health Outcomes and Behavior, Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr., MFC-EDU, Tampa, FL, 33612, USA

    Shannon M. Christy & Susan T. Vadaparampil

  4. Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, 33612, USA

    Shannon M. Christy & Susan T. Vadaparampil

  5. Department of Psychiatry and Behavioral Sciences, Division of Behavioral Medicine, Duke University School of Medicine, Durham, NC, 27705, USA

    Joseph G. Winger

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  1. Madison E. Stout
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Contributions

MES had a role in data collection, analysis and interpretation of data, and drafting the article. SMC had a role in the conception and design of the study, interpretation of data, and drafting the article. JGW had a role in the conception and design of the study, acquisition of data, analysis and interpretation of data, and revising the article. STV had a role in the interpretation of data and revising the article. CEM had a role in the conception and design of the study, acquisition of data, interpretation of data, and revising the article. All authors approved the final version of the manuscript.

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Correspondence to Shannon M. Christy.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Stout, M.E., Christy, S.M., Winger, J.G. et al. Self-efficacy and HPV Vaccine Attitudes Mediate the Relationship Between Social Norms and Intentions to Receive the HPV Vaccine Among College Students. J Community Health 45, 1187–1195 (2020). https://doi.org/10.1007/s10900-020-00837-5

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