How to Inform: Comparing Written and Video Education Interventions to Increase Human Papillomavirus Knowledge and Vaccination Intentions in Young Adults

Abstract

Objective: To compare the efficacy of 2 human papillomavirus (HPV) educational interventions on increasing HPV knowledge and vaccination intentions in college students. Participants: Male (n = 60) and female (n = 140) undergraduates (M _age = 20.4, SD = 2.3) recruited from a university in Montreal, Quebec, Canada, from October 2009 to March 2010. Methods: Using theory-based interventions, participants were randomly assigned to either a written HPV pamphlet, an HPV video, or a control. HPV knowledge and vaccination intentions were assessed pre and postintervention. Results: Low baseline knowledge and intentions were found across groups. Postintervention, participants in the written and video interventions had significantly higher knowledge and intentions than the control. No differences were found between written and video interventions on knowledge or intentions. Conclusion: This study, a first in comparing HPV educational formats, suggests that both written and video interventions are equally effective in educating about HPV and increasing young adults’ vaccination intentions.     

Knowledge,Beliefs, and Behaviors: Examining Human Papillomavirus–Related Gender Differences Among African American College Students

Abstract

Objective: Given recent approval for administration of a human papillomavirus (HPV) vaccine to men, it is important to assess the HPV-related perspectives of men and women. The purpose of this study was to examine gender differences in HPV knowledge, beliefs, and vaccine acceptance among college students attending 3 historically black colleges/universities in the Southeast. Participants and Methods: A nonprobability sample of 575 students completed a self-report questionnaire. Results: Males were significantly less likely to have heard of HPV, scored lower in HPV knowledge, were less likely to perceive HPV health outcomes as severe and that there was a benefit to vaccinate, reported fewer cues for vaccine acceptance, and perceived more barriers to vaccination compared to females (all p < .05). Conclusions: The gender disparities demonstrated in this study highlight the need to increase HPV-related communication/education to include men and to extend HPV research to a broader segment of the college population.     

The Effects of a Web-Based Intervention on College Students' Knowledge of Human Papillomavirus and Attitudes toward Vaccination

ABSTRACT

Research suggests that college students know relatively little about human papillomavirus (HPV), and that educational interventions increase knowledge of HPV. However, to date, there are no published studies testing the effects of computer-based education on attitudes toward being vaccinated in this population. The present study of 119 college students explored the effect of a web-based intervention on participants' knowledge of HPV and attitudes toward HPV vaccination. Participants were randomized to a web-based, self-administered HPV educational intervention or to a control group. Knowledge and attitudes were assessed at baseline, after the completion of the intervention, and at one-month follow-up. At baseline, women knew more than men about risks and symptoms of HPV. At immediate and long-term follow-up, the intervention group had better knowledge of HPV and more positive attitudes toward HPV vaccination than the control group. There were some gender differences in response to the intervention; increases in knowledge of HPV were greater in men, while changes in attitudes toward vaccination were larger in women.     

Knowledge and perception of female nursing students about human papillomavirus (HPV), cervical cancer,and attitudes toward HPV vaccination

Objective: The researchers aimed to evaluate the knowledge and perceptions of first-year female nursing students about human papillomavirus (HPV), cervical cancer (CC), and HPV vaccination. Participants: The sample included 690 female nursing students from sampled universities between April and June 2015. Methods: Students were surveyed by using a pretested HPV and CC awareness questionnaire. Results: More than half of the students (65.1%) answered questions incorrectly with a mean HPV knowledge score of 6.085?±?3.38. The majority of students (82.6%) did not hear HPV vaccine. Only, 2.8% of the students had been vaccinated. A statistically significant relationship was found between HPV knowledge score and hearing about HPV vaccine (U?=?28280.500, p?=?.015), and believing HPV vaccine protectiveness (χ²?=?14.153, p?=?.001). Conclusions: This study highlights the lack of knowledge and low level of awareness about HPV, CC, and HPV vaccination among first-year nursing college students.     

Systematic review of primary prevention human papillomavirus interventions targeting college students

ABSTRACT. Objectives: The purpose of this research was to systematically analyze human papillomavirus (HPV) interventions targeting college students. Methods: Completed interventions targeting general HPV prevention, HPV vaccine uptake, or antecedents of HPV vaccination uptake that used any quantitative design, published from January 2000 to January 2014 in the English language, were reviewed. Results: Twelve interventions met the criteria. Ten interventions produced 1 or more significant outcomes on primary or secondary variables of interest. Conclusions: Efficacy of interventions can be enhanced through tailoring materials and pretesting by sex, operationalizing theories, incorporating process evaluations, employing HPV vaccine uptake outcome measures, and utilizing Web-based delivery of programs.     

Disparities in Human Papillomavirus Vaccine Literacy and Vaccine Completion Among Asian American Pacific Islander Undergraduates: Implications for Cancer Health Equity

Abstract

Purpose: Low rates of human papillomavirus (HPV) vaccination among young Asian American and Pacific Islander (AAPI) women need to be addressed, particularly given the high incidence of cervical cancer in this population. The current study aims to investigate predictors of HPV vaccination in young AAPI and non-Latina white (NLW) women. Methods: A secondary data analysis was conducted of a health survey administered to college-aged women (N = 2,270) at a large public university in the Midwest. Andersen's behavioral model of health services utilization guided the study theoretically, and hierarchical logistic regression analysis was conducted to investigate research aim. Results: NLW women had a significantly higher rate of vaccine completion than AAPI women (NLW = 60.7%; AAPI = 38.6%). NLW women also scored higher on all 5 measures of HPV vaccine literacy than AAPI women. Both groups of undergraduate women reported that increasing age, knowledge about HPV, greater use of gynecological services, and knowing someone who had cancer were significant factors related to HPV vaccination completion. In the NLW group, father's income was also found to be a predictor of HPV vaccination completion. Conclusions: Rate and predictors of HPV vaccination completion vary between NLW and AAPI women. Greater promotion of HPV literacy and gynecological service use should be made to young AAPI women to increase their HPV uptake. Further research should examine sociocultural factors that could hinder or promote HPV vaccination in young AAPI women.     

Human Papillomavirus Vaccine Intention Among College Men: What's Oral Sex Got to Do With It?

Abstract

Objective: To identify associations between engaging in oral sex and perceived risk of oral cancer among college men. Also, to identify associations, and their moderating factors, between oral sex and human papillomavirus (HPV) vaccine acceptance. Methods: Young men were recruited from 2 university campuses in the South (N = 150). Men completed an audio computer-assisted self-administered interview. Results: With the exception of receiving fellatio, each measure of oral sex behavior was significantly associated with greater perceived risk of oral cancer. Four oral sex behaviors evidenced significant associations with vaccine acceptance. Men engaging in recent oral sex or reporting oral sex behaviors with more than 2 partners were more likely to indicate vaccine intent. African American/black race, communication with parents about sex-related topics, and HPV-related stigma/shame were identified as moderating factors. Conclusion: Young college men giving or receiving oral sex with multiple partners may be predisposed to HPV vaccination.     

Examining interactions within the theory of planned behavior in the prediction of intentions to engage in cannabis-related driving behaviors

Abstract

Objective: As marijuana use becomes more available to college students through increasing legal reform, this paper seeks to examine intentions for driving under the influence of cannabis (DUIC) and riding with a high driver (RWHD) through the lens of the theory of planned behavior (TPB) and assess potential interactions between personal attitudes, subjective norms, perceived behavioral control (PBC), and sex. Participants: Undergraduate college students (N?=?311) completed online surveys in September, 2013. Method: Participants self-reported their attitudes toward DUIC, subjective norms, PBC, past DUIC and RWHD, and intentions to DUIC and RWHD. Results: Participants’ attitudes toward DUIC, subjective norms, and PBC were strongly associated with intentions to DUIC and RWHD bivariately. In regression models, attitudes and PBC were both positively and significantly related to intentions to DUIC and RWHD. Conclusions: DUIC and RWHD are concerns for college populations. Targeting personal attitudes and perceived behavioral control via interventions may reduce these behaviors.     

The role of human papillomavirus (HPV)-related stigma on HPV vaccine decision-making among college males

ABSTRACT

Objective: The goals of the present study are (1) to identify sociodemographic and psychosocial predictors of human papillomavirus (HPV)-related stigma and (2) to examine the relationship between HPV-related stigma in predicting HPV vaccine decision-making among college males. Participants: Six hundred and eighty college males aged 18–26 from 3 Canadian universities were recruited from September 2013 to April 2014. Methods: Participants completed a self-report survey assessing HPV-related stigma, psychosocial predictors of HPV-related stigma, and HPV vaccine decision-making. The results were analyzed using variance analyses and linear regressions. Results: Ethnicity, province of residence, and perceived severity of HPV were found to significantly influence HPV-related stigma. In addition, HPV-related stigma was higher in those unaware of the availability of the HPV vaccine for males. Conclusions: Promotion efforts should concentrate on Asian minorities and should avoid HPV severity messaging, as these may lead to higher HPV-related stigma, which in turn may act as a barrier to vaccination.     

Sex Differences Among College Students in Awareness of the Human Papillomavirus Vaccine and Vaccine Options

Abstract

Objectives: To explore awareness of human papillomavirus (HPV) and use of HPV vaccines (Gardasil and Cervarix) by college students. Participants: The sample was composed of 817 undergraduates at 2 northeastern US universities; they participated between February and May 2010. Methods: Students were provided with a link to an anonymous, self-administered, Web-based survey comprised of 76 questions. The survey included questions about health behaviors, awareness, and knowledge of HPV and the 2 HPV vaccines, and vaccine uptake. Results: Results indicate high levels of awareness of HPV as well as marked sex differences related to vaccine awareness and uptake. Both sexes are largely unaware of Cervarix and the differences between Cervarix and Gardasil. Conclusion: The study affirms the importance of a clinician's recommendation for HPV vaccination. Public health messaging should become more inclusive of adolescent and young adult males. College students’ awareness of HPV vaccine options mirrors Gardasil's market dominance in the United States.     

Longitudinal changes in anthropometry and body composition in university freshmen

Objective: We investigated predictors of weight gain in college freshmen. Participants: A longitudinal cohort study followed a representative sample of freshmen (N = 264) from 8/2011 to 6/2012. Methods: Repeated measurements of anthropometry, dual-energy X-ray absorptiometry (DXA), physical activity, and diet were collected. We investigated predictors of 9-month weight gain using regression models. Results: 172 participants completed follow-up: 75% gained >0.5 kg. Mean weight change was +2.3 kg (SD 3.2) and +2.0 kg (SD 3.2) and mean adiposity change was +1.3% (SD 1.6) and +0.7% (SD 2.2) in men and women, respectively. In participants gaining >0.5 kg, weight increased 5.6% and body fat increased 1.6%. Anthropometric change in men occurred in the first semester, while women increased in both semesters. Leaner DXA-defined body composition at baseline was consistently associated with greater weight gain (p-values 0.029–0.049). Conclusions: Freshman weight gain is common and reflects increased adiposity. Leaner body composition at the beginning of college predicted greater weight gain in men and women during the first year of college.     

The Effects of Discriminate Message Interventions on Behavioral Intentions to Engage in Physical Activities

Objective: The authors attempt to show the usefulness of discriminate messages designed to increase college students' intentions to engage in physical activities. Participants: The authors selected a sample of undergraduate students enrolled in communication courses at a university in the southeastern United States for a baseline online survey (n = 683) and an experiment (n = 99). Methods: The authors selected discriminate beliefs with highest regression weights and sizable effect size with behavioral intention to build messages for classroom intervention. The authors used an analysis of covariance to test the intervention effect of discriminate messages on intention to do physical activities. Results: Students exposed to the discriminate messages were more likely to report positive changes in their self-efficacy and behavioral intentions related to physical activity. Conclusions: Further research on communication theories is required to help design the selected beliefs so that they will be comprehended and ultimately lead to behavioral changes.     

HPV vaccination campaign fear visuals: An eye-tracking study exploring effects of visual attention and type on message informative value,recall, and behavioral intentions

HPV is the most common sexually transmitted disease, and there are alarming global disparities in cervical cancer and HPV vaccination uptake (CDC, 2016a). To inform HPV vaccination public health campaigns, an experiment with a psychophysiological measure (eye-tracking) explores the effects of visual attention to vaccination messages on message recall, informative value, and behavioral intentions. Results indicate 1) visual type affects recall and informative value of vaccination messages as well as intentions to vaccinate; 2) visual attention is negatively related to message recall only when a non-fear visual is used; and 3) visual attention predicts intent to vaccinate only when a fear visual is utilized. These results suggest the use of fear appeals in health, crisis, and risk public relations campaigns may promote performance of recommended safeguarding behaviors.     

Moderating Effects of Sexual Orientation and Gender Characteristic on Condom Use Intentions Among Boys’ Senior High School Students in Taiwan: An Exploration Based on the Theory of Planned Behavior

This study examined condom use intentions among adolescent boys in relation to the constructs of the Theory of Planned Behavior (TPB): attitude toward the behavior (ATB), subjective norm (SN), and perceived behavioral control (PBC). The potential moderating effects of sexual orientation and gender characteristic (masculine/feminine) were also explored. Anonymous survey data were collected from 929 students enrolled in a boys’ senior high school in Taiwan (response rate: 89.9%). Multivariate logistic regression analyses found higher condom use intentions linked to more positive ATB (adjusted odds ratio [AOR] = 8.09) and supportive SN (AOR = 2.73), as well as high PBC under facilitating conditions (AOR = 2.04). Notably, nonheterosexual boys perceiving supportive SN (AOR = 0.23) or high support for condom use from teachers and health educators (AOR = 0.10 and 0.26, respectively) had lower condom use intentions than their heterosexual peers. By contrast, relatively feminine boys perceiving supportive SN (AOR = 2.06) or high support from close friends (AOR = 2.18) had higher condom use intentions than their masculine counterparts. In conclusion, ATB and SN were strongly linked to condom use intentions; PBC was significant only under facilitating conditions. Sexual orientation and gender characteristic had important moderating effects. These empirical findings could inform tailored health education programs to increase condom use intentions in the male student population.     

Discrepant Responding across Self-Report Measures of Men's Coercive and Aggressive Sexual Strategies

Researchers have worked to refine the measurement of women's experiences with sexual victimization. Less is known about the validity and reliability of measures that assess men's use of sexual coercion and aggression. These studies explore the consistency of men's responses to two distinct, but similar, measures of sexual coercion and aggression. The two measures both assess historical use of verbal coercion, sexual assault involving drugs or alcohol, and sexual assault through threat or force. Study 1 used college men as participants (N = 398), whereas Study 2 used a mixed sample of college and community men (N = 184). In both studies, participants’ responses were largely inconsistent across the two measures. This article explores potential measurement issues that may account for the observed reporting discrepancies and offers suggestions for future research.     

A/H1N1 Vaccine Intentions in College Students: An Application of the Theory of Planned Behavior

Abstract

Objective: To test the applicability of the Theory of Planned Behavior (TPB) in college students who have not previously received the A/H1N1 vaccine. Participants: Undergraduate communication students at a metropolitan southern university. Methods: In January–March 2010, students from voluntarily participating communication classes completed a hardcopy survey assessing TPB and clinically significant constructs. Hierarchical regression equations predicted variance in vaccine intentions of students who had not received a flu shot (N = 198; 70% Caucasian). Results: The TPB model explained 51.7% (p < .001) of variance in vaccine intentions. Controlling for side effects, self-efficacy and perceived comparative susceptibility predicted intentions when entered in the first block, whereas attitudes, subjective norms, and perceived behavioral control significantly contribute when entered in the second block. Conclusions: For students who have not previously received a flu vaccine, vaccine communication should utilize self-efficacy and perceived comparative susceptibility to employ the TPB to promote vaccine intentions.     

Predictors of Intrusive Sexual Behaviors in Preschool-Aged Children

Intrusive sexual behaviors (ISBs) are a specific type of problematic sexual behavior characterized by the invasive nature of the acts (e.g., touching others’ private parts, attempting intercourse; Friedrich, 1997). The limited amount of research on ISBs has focused on sexual abuse history as the primary predictor. However, Friedrich, Davies, Feher, and Wright (2003) found that ISBs in children up to age 12 were related to four broad conceptual factors: (a) exposure to sexual content, (b) exposure to violent behavior, (c) family adversity, and (d) child vulnerabilities. The current study sought to replicate Friedrich’s study using a clinical sample of 217 preschool-aged children (ages two to six). Results supported variables from within the child vulnerabilities construct (externalizing behaviors, β_EXT = 0.032, p = 0.001), post-traumatic stress disorder (PTSD) criteria met (β_PTSD = 0.177, p = 0.02), and an inverse relationship with age (β_AGE = ?0.206, p = 0.024). These results highlight the importance of considering childhood behavioral patterns and reactivity to traumatic events as correlates of ISBs in young children.     

Adaptation of the short version of the Psychological Capital Questionnaire (PCQ-12) into Spanish / Adaptación al español de la versión reducida del Cuestionario de Capital Psicológico (PCQ-12)

Psychological capital (PsyCap) has been a topic of increasing interest in the last decade. However, there is a lack of validated instruments in Spanish to map PsyCap and its consequences for individuals’ well-being. Consequently, the goal of this study is to adapt the 12-item short version of the Psychological Capital Questionnaire (PCQ-12) to the Spanish context by analysing its internal consistency and reliability, factor solution and external validity. Results indicated that the PCQ-12 exhibited good Cronbach’s alpha (.87) and omega coefficient (.93) values in a sample from a vehicle inspection company (n = 798). As expected, results also revealed that a second-order factor structure provided the best fit. Moreover, PsyCap is associated with increased job engagement (β = .579; R²_adjusted = .333), decreased job burnout (β = ?.409; R²_adjusted = .166), and lower psychological distress (β = ?.349; R²_adjusted = .121) (all p < .01), which provided additional support for using the PCQ-12 in the Spanish context. Implications for theory and practice are discussed.     

Family factors associated with emerging adults’ human papillomavirus vaccine behavior

Abstract

Objective: The current study examined the role of family influences on the vaccine behavior of emerging adults. Participants: In Spring 2017, we conducted anonymous online surveys of undergraduate students (n?=?608) at a large, public university in the mid-Atlantic. Methods: Logistic regression was used to examine associations between family factors and students’ awareness of the HPV vaccine, vaccine receipt, and vaccine intentions. Family factors included sex communication, religiosity, parental monitoring, family structure, and parents’ birthplace. Results: More comprehensive family sex communication is associated with less uncertainty regarding HPV vaccine receipt and greater likelihood of being already vaccinated. More frequent family religiosity and more parental monitoring are associated with greater likelihood of having decided against vaccination rather than already being vaccinated. Significant gender and racial disparities exist. Conclusion: Further research, policy, and programmatic intervention are needed to reduce disparities and to improve emerging adults’ compliance with HPV vaccine recommendations.     

HPV Knowledge and Behaviors of Black College Students at a Historically Black University

College students are at high risk for human papillomavirus (HPV) infection, yet their knowledge and self-protective behaviors appear inadequate. Researchers who have measured HPV-related knowledge and behaviors in evaluating college intervention efforts pay secondary attention to black college students because this group generally represents only a small subset of samples of the broader college population. Objective and Participants The authors' purpose in this study was to examine HPV-related knowledge and behaviors in 351 black undergraduates attending a historically black southeastern university in the spring of 2003. Methods Voluntary and anonymous student participation was solicited in randomly selected undergraduate classes. Results Results indicated that most students lacked HPV awareness (64%), became aware of HPV largely after infection, and gained their HPV knowledge from a health-care provider or college class. The authors performed an analysis by gender and found that women were more knowledgeable about HPV than were men. Observed HPV-related knowledge and behaviors were similar to samples of the broader US college population. Conclusions Findings suggest a greater need for HPV intervention efforts for all college students, including those at black colleges.