The influence of national origin cues in HPV vaccination advertising: An eye-tracking study of visual attention and vaccine perception using quantitative and qualitative analysis

Abstract

This study is among the first to investigate how national origin cues influence visual attention and perception in HPV vaccine advertisements, using eye-tracking technology to provide objective insights into consumer responses. By integrating methods from public health, psychology, and advertising research, this study explores how visual attention is shaped by national affiliation cues. In a controlled experimental setting with a sample of 40 UK university students, we investigated visual attention and effectiveness of HPV vaccination advertisements by comparing ads disclosing the national origin of the vaccine and without any origin information. We assessed total fixation duration and time to first fixation to various elements of the ad, along with intention and attitude measures. Contrary to one of our hypotheses, we did not find significant differences in intention (p = .758) and attitude (p = .620) measures. However, there was significant difference in total fixation duration toward one of the ad images between conditions (p = .043). The qualitative analysis reveals the role of country-of-origin (COO) in HPV vaccination advertising, suggesting a shift in attention from that image to the COO cue. Furthermore, eight out of the 20 participants in the treatment condition did not fixate at the COO cue. Findings provide critical insights for public health communication strategies, suggesting that the use (or omission) of national origin cues in vaccine advertisements could influence vaccine perception and hesitancy. These results highlight the need for strategic messaging approaches to enhance HPV vaccine acceptance and improve public trust in domestic and international vaccines.

Keywords: HPV prevention; HPV vaccine; Vaccine hesitancy; country-of-origin cue; country-of-origin effect; domestic vaccines; eye-tracking; national vaccines; visual attention during advertising.

Figure 1.

Advertisement in the control condition (national origin not disclosed). The advertisement includes textual content and two image components: a healthcare worker holding a vaccine and a heart logo.

Figure 2.

Advertisement in the treatment condition (national origin disclosed). The advertisement includes textual content, two image components – a healthcare worker holding a vaccine and a heart logo – and a country-of-origin cue.

Figure 3.

Heat map of total fixation duration in the control condition (warmer colors indicate longer fixations). High fixation intensity is observed on the healthcare worker’s face, the vaccine, the number 12, and the heart logo.

Figure 4.

Heat map of total fixation duration in the treatment condition (warmer colors indicate longer fixations). High fixation intensity is observed at the end of the word “always” and on the word “HPV,” with minimal fixation on the heart logo.