HPV vaccination and the effect of information framing on intentions and behaviour: an application of the theory of planned behaviour and moral norm

Abstract

Background: Human papillomavirus (HPV) is a common sexually transmitted infection (STI) known to cause cervical cancer and genital warts. However, making the genital warts aspect explicit may reduce HPV vaccination intention and behaviour due to perceived stigma associated with STIs.

Purpose: This study investigated the effect of differential information framing on intention to receive the HPV vaccine using the Theory of Planned Behaviour (TPB) and moral norm construct.

Method: Female university students were randomised to receive a fact sheet describing the HPV vaccine as: (1) preventing cervical cancer only (n = 81); or (2) preventing both cervical cancer and genital warts (n = 78). A 2-month follow-up investigated relationships between vaccination intention and actual behaviour.

Results: No effect of information framing was detected on intention to receive the HPV vaccine, or vaccine uptake behaviour at 2-month follow-up. The traditional TPB components predicted 54% of the variance in vaccination intention (F (3,155) = 61.580, p < 0.001), and moral norm explained an additional 6.2%. Intention predicted a significant but relatively small proportion of variation (9.6%) in behaviour.

Conclusion: The HPV vaccine does not seem to be associated with perceptions of stigma related to genital warts, and has broad acceptance among a female university population. This study demonstrates that TPB is suited to investigate HPV vaccination, and has helped clarify the role of moral norm within the TPB.