Eliciting college females' salient beliefs about HPV vaccination

Background: Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the United States. While college females are at high risk for HPV infection, HPV vaccine initiation and series completion rates are relatively low among this population. The theory of planned behavior (TPB) proposes that behavioral, normative, and control beliefs impact behavioral intention, and subsequently, behavior. The purpose of this study was to elicit college females’ salient behavioral, normative, and control beliefs about getting the HPV vaccine series. Methods: Vaccine-eligible, undergraduate college females between 18 and 26 years of age who were enrolled in personal health courses during fall 2014 completed an open-ended, TPB-based, salient belief elicitation questionnaire. Respondents listed salient advantages/disadvantages, salient referents, and salient factors/circumstances for getting the HPV vaccine series in the next 12 months. Three respondents participated in a pilot test of the questionnaire. Two researchers independently performed the content analysis. The investigators reached 100% consensus on the extracted themes through discussion. Results: A total of 24 unvaccinated undergraduate females participated. Content analysis identified six salient advantages/disadvantages, including protection against HPV, good idea, adverse side effects, ineffective, negative health effects, and discomfort with needles. Doctors, mothers, friends, parent(s), and family members were the most salient referents. Vaccine cost, clinic location, and time were the most salient factors/circumstances. Participants held several misconceptions about the HPV vaccine. Conclusion: Findings from this study suggest college females may benefit from programs that provide medically accurate information about the HPV vaccine, and address corresponding behavioral, normative, and control beliefs.