Knowledge,Attitudes, and Informational Behaviors of College Students in Regard to the Human Papillomavirus

Abstract

Objective: To assess students’ human papillomavirus (HPV) knowledge, attitudes, and behaviors. Participants/ Methods: Students (N = 1,282) at a large, public university in the Northeast United States completed a questionnaire during February 2008 assessing HPV knowledge, prevalence, transmission, cervical cancer risk and stigma; sexual behavior, vaccination status, as well as past and preferred sources of information about HPV and sexual health. Results: A majority of respondents know of HPV. However, understanding was insufficient in several important areas. Overwhelmingly, respondents heard about HPV via television commercials yet preferred to obtain sexual health information from physicians. Hearing about HPV on a TV commercial was associated with increased knowledge. More knowledge of HPV was associated with less stigma. Men exhibit a higher level of stigma and less knowledge than women. Conclusions: Publicly funded health campaigns aimed at increasing knowledge about HPV are overdue and necessary. This is especially true for efforts targeting young adults about this extremely common sexually transmitted infection (STI).     

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.     

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.     

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.     

Predicting Human Papillomavirus Vaccine Intentions of College-Aged Males: An Examination of Parents’ and Son's Perceptions

Abstract

Objective: To examine male students’ and their parents’ human papillomavirus (HPV) vaccine communication in relation to males’ willingness to discuss the vaccine with their health care provider and the likelihood of being vaccinated. Participants: Dyads (n = 111) of students and parents. Methods: Participants completed a HPV vaccine survey based on the risk perception attitude framework in 2009. Results: Male students’ perceived susceptibility for HPV and self-efficacy to talk to their provider were directly related to their intention to discuss the HPV vaccine, and their intention was directly related to their likelihood of being vaccinated. Parents’ perceived self-efficacy to talk to their son and response efficacy of the vaccine were directly related to their intention to talk to their son; however, parents’ intention was not related to the likelihood of their son being vaccinated. Conclusions: College males may benefit from HPV vaccine educational programs that include communication skills training to discuss the HPV vaccine with their parents.     

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.     

Evaluation of targeted human papillomavirus vaccination education among undergraduate college students

Abstract

Objective: To design and evaluate pharmacy student-led educational sessions to improve health beliefs about the HPV vaccine in college-aged students. Participants: Students aged 18–26 attending a large, urban university, including 545 respondents to a December 2014 needs assessment survey about HPV-related health beliefs, 131 students participating in educational sessions during 2015–2016 (intervention group), and 369 undergraduate respondents completing the needs assessment survey (control group). Methods: A needs assessment survey was conducted to inform design and implementation of pharmacy student-led educational sessions. A similar survey was administered to students after attending educational sessions. Health beliefs were compared for the intervention versus control group. Results: The intervention group was less likely to report high perceived barriers to HPV vaccination and more likely to report high perceived benefits and intention to vaccinate (if previously unvaccinated). Conclusions: Pharmacy student-led, health belief-based educational sessions were associated with improved health beliefs about HPV vaccination.     

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.     

Using the Theory of Planned Behavior to predict HPV vaccination intentions of college men

Objective: The purpose of this study was to test Theory of Planned Behavior (TPB) constructs in predicting human papillomavirus (HPV) vaccination behavioral intentions of vaccine-eligible college men. Participants: Participants were unvaccinated college men aged 18–26 years attending a large public university in the southeastern United States during Spring 2015. Methods: A nonexperimental, cross-sectional study design was employed. Instrumentation comprised a qualitative elicitation study, expert panel review, pilot test, test-retest, and internal consistency, construct validity, and predictive validity assessments using data collected from an online self-report questionnaire. Results: The sample consisted of 256 college men, and the final structural model exhibited acceptable fit of the data. Attitude toward the behavior (β = .169) and subjective norm (β = 0.667) were significant predictors of behavioral intention, accounting for 58% of its variance. Conclusions: Practitioners may utilize this instrument for the development and evaluation of TPB-based interventions to increase HPV vaccination intentions of undergraduate college men.     

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 Special Historical Section of the Journal of American College Health

Abstract

Objective: To identify human papillomavirus (HPV) infection and HPV vaccine–related attitudes among college-aged women and the relationship between HPV vaccine uptake and subsequent sexual behaviors. Methods: PubMed, MEDLINE, CINAHL, and Google Scholar searches were performed from 2006, the date after the first HPV vaccine became available, to present. Results: Of the 13 studies identified, most were cross-sectional. College-aged women saw HPV infection as serious and had positive attitudes toward the HPV vaccine. Barriers (ie, cost, lack of insurance coverage) existed that prevented women from obtaining the vaccine and many women did not see themselves at risk for HPV. The vaccine uptake rate, although increasing, has been slow. Conclusion: College-aged women in the United States may need unbiased information about HPV and HPV vaccine. Studies that focus on risk perception and the relationship between knowledge, attitudes, vaccine uptake, and sexual behaviors are needed to inform interventions and public health programs.     

HPV vaccine acceptance among a sample of Southern men who have sex with men: A comparison of younger and older men

Objectives: Do short, online educational messages about the human papillomavirus (HPV) influence younger and older men who have sex with men (MSM) differently? Second, what are the HPV knowledge levels and risk perceptions of Southern MSM living outside of major metropolitan areas? Methods: This study draws on participants who completed an anonymous online survey asking about their knowledge, risk assessment, and vaccine acceptance regarding HPV. Results: Knowledge about HPV was low among the MSM in this study. After reading a one-page information intervention, vaccine acceptability increased by a statistically significant amount among both a Younger and Older cohort but risk perception only increased among the younger respondents. Single men regardless of age cohort reported sharper increases in perceived risk after the intervention, but relationship status did not produce significant differences in vaccine acceptability. Conclusion: Online, brief interventions may be effective means of increasing motivation to vaccinate among Southern MSM.     

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.     

The Lifestyling Program

Abstract

Objective: To assess knowledge of human papillomavirus (HPV) and perceived barriers to being vaccinated against the virus. Participants: Three hundred ninety-six undergraduate women enrolled at Penn State University in Fall 2008. Methods: A random sample of students were invited to participate in a Web-based survey. Results: Awareness of HPV and the vaccine was high, but knowledge of HPV-related facts averaged only 65% overall. Knowledge was significantly predicted by frequency of media exposure and physician encouragement to be vaccinated, but not by the number of sex partners nor the frequency of condom/dental dam use. On average, women indicated that 2 of the 10 barriers listed applied to them. Physician encouragement negatively predicted barriers at p = .066. No other predictors approached significance. Conclusions: Serious misconceptions remain about specific aspects of the diseases and how they are acquired. Health education efforts are needed to improve knowledge in college populations and counteract perceived barriers.     

Human papillomavirus vaccine and Pap tests on college campuses: How do historically black colleges and universities (HBCUs) measure up?

ABSTRACT

Objective: The availability of cervical cancer prevention services at college health centers was compared between historically black colleges and universities (HBCUs) and non-HBCUs.

Methods: Four-year, non–primarily distant learning colleges, matching HBCUs with randomly selected non-HBCUs within the same states (N = 136) were examined. Data were collected (2014–2015 academic year) on the availability of human papillomavirus (HPV) vaccine and Pap tests at college health centers. HBCUs were compared with non-HBCUs using conditional logistic regression, and correlates of offering these services were identified. Results: Many institutions did not offer HPV vaccine or Pap tests. Fewer HBCUs offered HPV vaccine (18% vs 53%) and Pap tests (50% vs 76%) compared with non-HBCUs. In multivariable analyses, HBCUs remained less likely than non-HBCUs to offer HPV vaccine (odds ratio [OR] = 0.07, 95% confidence interval [CI]: 0.02–0.26) and Pap tests (OR = 0.19, 95% CI: 0.06–0.61). Conclusions: Greater effort is needed to make cervical cancer prevention services available at colleges, especially at HBCUs.     

Stage-Based Computer-Delivered Interventions to Increase Condom Use in Young Men

ABSTRACT

Objectives: The aim is to examine whether adopting or increasing condom use can be influenced by psychological treatment targeting both motivational and volitional aspects, when these components are matched to the characteristics of the recipients. Method: In a randomized controlled trial, 159 heterosexual young men (intervention groups, n = 113; control condition, n = 46) were exposed to 2 computer-delivered intervention arms, 1 targeting nonintenders (n = 36; motivational intervention arm) and the other targeting intenders (n = 77; volitional intervention arm). Intention and condom use were assessed through self-report questions at 3 points in time, each 2 weeks apart. Motivational intervention involved screen content requesting decisional balance for condom use and focus on past success to trigger self-efficacy. Volitional intervention encouraged the formation of specific if-then plans, where participants were required to choose and write about the most favourable situations by means of reflection on when, where, and how to carry them out, and of thinking about strategies for obstacles that might hinder condom use. Results: Experimental nonintenders obtained higher levels of condom use intention two weeks and one month later and of reported condom use one month later than control nonintenders. Experimental intenders reported an increase in condom use in comparison with control intenders one month later. Conclusions: At a 30-day follow-up, treatment was shown to have helped nonintenders to first increase their condom use intentions and later condom use, and intenders to improve condom use behavior. A stage-based computer-delivered intervention design including motivational and volitional treatment appears to be suitable for improving condom use motivation as well as behavior after a 1-month period.     

Mental health literacy,stigma, and help-seeking behaviors among male college students

Objective: Mental health literacy (MHL) is low in college-aged men potentially resulting in impaired mental wellbeing. This study assessed MHL, psychosocial determinants, and help-seeking behaviors among male university students. Participants: Male undergraduate and graduate students were surveyed in Spring 2017 (n = 1,242) at a large southeastern university in the United States. Methods: Preexisting validated scales for MHL, psychosocial determinants, and help-seeking intention were used in measurement and demographic variables were collected. T-tests and one-way ANOVA were performed to measure differences between groups. Results: Participants showed low scores for all constructs with statistically significant differences between undergraduate and graduate students, as well as between races and major classifications. Undergraduate men had moderate MHL and low intentions to seek professional care. Conclusions: Interventions focusing on increasing mental health knowledge and improving beliefs can improve MHL among male college students. Further, interventions should be tailored for racial groups and major classifications.     

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 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.     

Safer sex in a digital world: A Web-based motivational enhancement intervention to increase condom use among college women

ABSTRACT

Objective: This study is a randomized trial of a Web-based intervention to increase condom use among college women. Participants: From October 2012 to March 2013, N = 422 completed baseline questionnaires and intervention procedures. n = 216 completed 3-month follow-up. Methods: Participants completed a decisional balance exercise examining their sex acts over the past 3 months and wrote an essay encouraging young girls to use condoms. All procedures were conducted online. Results: The intervention improved intentions to use and attitudes towards condoms for 3 subscales of condom attitudes. Attitudes following the intervention significantly predicted condom use at 3-month follow-up, and this relationship was mediated by condom intentions immediately post intervention. The relationship between intentions and condom use was moderated by group. Conclusions: The intervention improved condom attitudes and intentions immediately post intervention, and immediately post intervention intentions had a greater impact on condom use at 3-month follow-up among those in the condom intervention compared with those in the control group.