Abstract
-
Purpose
This descriptive study identified factors influencing high school students’ intentions to receive human papillomavirus (HPV) vaccination using Ajzen’s theory of planned behavior as the guiding framework.
-
Methods
Participants were 192 male and female high school seniors aged 18 years or older who could express their opinions independently. In April 2023, participants completed structured, self-administered questionnaires assessing HPV vaccination intention, HPV knowledge, attitudes toward HPV vaccination, subjective norms, and perceived behavioral control. Data were analyzed using independent t-tests, one-way analysis of variance with the Scheffé post hoc test, Pearson correlation coefficients, and hierarchical multiple regression.
-
Results
Intention to receive HPV vaccination was significantly predicted by subjective norms (β=.31, p<.001), perceived behavioral control (β=.31, p<.001), attitudes (β=.22, p<.001), and school gender composition (β=.19, p=.005). Subjective norms and perceived behavioral control exerted the greatest influence and together explained 54% of the variance in intention (adjusted R2=.54).
-
Conclusion
These findings provide fundamental evidence for developing effective interventions to enhance high school students’ intentions to receive HPV vaccination. Efforts should focus on fostering positive perceptions of HPV vaccination by providing accurate information about its benefits and potential adverse effects, supported by credible public messaging.
-
Key words: Attitudes; Intentions; Knowledge; Norms; Students
INTRODUCTION
1. Background
Human papillomavirus (HPV) is a prevalent sexually transmitted infection. Although most HPV infections resolve spontaneously, persistent infection with high-risk types 16 and 18 markedly increases the likelihood of progression to cervical cancer [
1]. HPV is also implicated in vulvar, penile, anal, oropharyngeal, and head-and-neck cancers, as well as genital warts [
1].
Globally, HPV accounted for approximately 7.5% of all cancer cases in 2022, with about 1,505,394 HPV-associated cancer cases newly diagnosed worldwide [
2]. In South Korea, 16.7% of women were infected with HPV in 2021 [
3]. Additionally, surveillance data identified HPV infection in 107 men and 12,862 women in 2022; in 2025, a total of 13,193 HPV cases were reported through the sentinel surveillance system [
4]. These findings underscore HPV’s detrimental impact on quality of life for both men and women and highlight HPV as a pervasive health threat.
In particular, HPV infection in men is frequently asymptomatic, increasing the risk of inadvertent transmission [
1]. The most common route of HPV infection is direct contact during sexual intercourse, with incidence peaking immediately after sexual debut [
1]. In South Korea, 7.6% of male and 4.7% of female middle and high school students report having had sexual experience, and this proportion rises sharply to 53.8% among individuals in their 20s [
5,
6].
To prevent HPV infection, the US Food and Drug Administration approved the first HPV vaccine in 2006 to curb HPV-related diseases associated with increasing sexual activity [
7]. The vaccine is now also recommended for preventing penile, oropharyngeal, and anal cancers [
8]. Currently, the National Immunization Program provides free HPV vaccination to females aged 12–26 for the prevention of cervical and oropharyngeal cancers. For the first time, the program is being extended to include 12-year-old boys [
9]. Administering the vaccine before the rapid rise in sexual activity maximizes coverage and cost-effectiveness. Moreover, the overall incidence of HPV-related diseases decreases when men are vaccinated compared with vaccinating only women [
10].
However, HPV vaccination rates among adolescent girls remain suboptimal, and rates among adolescent boys are extremely low (approximately 1% or less), which is insufficient to achieve herd immunity [
3]. Therefore, achieving herd immunity requires vaccinating students of both sexes, particularly during late adolescence—just before the sharp rise in HPV exposure associated with increased sexual experience. In addition, because HPV is increasingly recognized as a major cause of various cancers affecting both men and women—including cervical, anal, oral, and penile cancers—expanding national support for HPV vaccination to male adolescents is under active policy discussion [
11].
Ajzen [
12] identified behavioral intention as the most proximate determinant of action in the theory of planned behavior (TPB). According to the TPB, intention is shaped by attitudes toward the behavior, subjective norms, and perceived behavioral control. Furthermore, behavior manifests only when it is under voluntary control [
12]. Thus, understanding high school students’ intention to receive HPV vaccination—and the attitudes, subjective norms, and perceived behavioral control that shape it—through the TPB framework is essential.
Ajzen [
12] also noted that researchers may modify the model or introduce additional variables to better predict behavioral intentions or behaviors. HPV knowledge is an important predictor of HPV vaccination intentions; greater knowledge is associated with a higher likelihood of vaccination [
13]. Previous studies have demonstrated that greater HPV knowledge is associated with more favorable attitudes toward HPV vaccination and stronger intentions to vaccinate, thereby influencing behavioral intention. Notably, research involving parents of adolescent girls has reported that higher levels of HPV-related knowledge significantly increase the likelihood of HPV vaccine acceptance and uptake [
13]. Thus, this study conceptualized HPV-related knowledge not as a core extension of the TPB, but as a supplementary contextual variable that may influence vaccination intention through its association with TPB constructs.
Previous research on HPV vaccination intention has focused mainly on female populations, including female students and mothers [
14,
15]. Because HPV also poses serious risks to men, vaccinating both sexes can further reduce infection rates and related diseases [
10]. Therefore, enhancing HPV vaccination intention among high school students—who can make independent health decisions and are on the brink of increased sexual activity—is critical to safeguarding late-adolescent health.
High school students are in a developmental period during which sexual activity and the risk of HPV exposure increase rapidly, making this a critical window for prevention. Building on prior research, this study integrated HPV knowledge into a TPB-based framework and examined its influence on HPV vaccination intention among high school students. These findings may inform policy in South Korea, where legislators are actively discussing expanding free HPV vaccination to male adolescents under the National Immunization Program. Accordingly, this study investigated how HPV-related knowledge, attitudes toward HPV vaccination, subjective norms, and perceived behavioral control influenced high school students’ intention to receive HPV vaccination (
Figure 1).
This study examined relationships between high school students’ HPV vaccination intention and HPV knowledge, attitudes toward HPV vaccination, subjective norms, and perceived behavioral control. It also determined how these TPB constructs influenced vaccination intention.
METHODS
Ethical statements: This study was approved by the Institutional Review Board (IRB) of Chonnam National University in South Korea (IRB No. 1040198-221116-HR-136-02). Informed consent was obtained from all participants.
1. Study Design
This cross-sectional study aimed to identify factors influencing high school students’ intention to receive HPV vaccination. Reporting followed the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines [
16].
Students from two general high schools in residential areas of Kwang ju Metropolitan City—one boys’ school and one girls’ school—participated in this study. Eligible participants were at least 18 years old and able to provide informed consent independently. Using multivariate power analysis (α=.05, power=.80, medium effect size=.15) and accounting for the required number of predictor variables, the minimum sample size was calculated as 163. To account for a potential dropout rate of approximately 20%, a total of 210 participants were recruited. Ultimately, after excluding incomplete responses, 192 datasets were included in the analysis, exceeding the minimum sample size by approximately 20%.
3. Measurement
1) Demographic characteristics and HPV-related variables
Variables included age, school gender composition, religious affiliation, smoking history, drinking history, contraceptive experience, awareness of cervical cancer, family history of cervical cancer, awareness of HPV, awareness of HPV vaccination, awareness of the expanded national support for HPV vaccination, vaccination status, and reasons for non-vaccination.
2) HPV-related knowledge
HPV knowledge was measured using a 20-item instrument developed by Kim and Ahn [
17] for female college students. The scale covers HPV types, related diseases, symptoms, incubation period, prognosis, immunity, transmission routes, testing and diagnosis, prevention and treatment, fetal infection, and the age of peak prevalence. Each item is answered with “yes,” “no,” or “I don’t know,” yielding a total score of 0–20. Correct responses are scored as 1, whereas incorrect or “I don’t know” responses are scored as 0; higher scores indicate greater knowledge. The KR-20 (Kuder–Richardson 20) reliability coefficient in this study was .62.
3) Attitude toward HPV vaccination
Attitude was measured using an instrument developed by Ajzen [
18] and subsequently modified by Lee [
19] based on a scale developed by Lee [
20]. The final instrument comprises eight pairs of bipolar adjectives on a semantic differential scale, scored from +3 to −3 (total possible range, −24 to +24), with higher scores reflecting a more favorable attitude toward vaccination. Cronbach’s α was .96.
4) Subjective norms for HPV vaccination
Subjective norms were assessed using an instrument developed by Ajzen [
18] and modified by Lee [
19] based on the scale developed by Lee [
20]. The instrument comprises three items rated on a 7-point Likert scale (1=not at all, 7=very much), yielding total scores ranging from 3 to 21. Higher scores indicate stronger perceived social pressure to be vaccinated. Cronbach’s α was .68.
5) Perceived behavioral control regarding HPV vaccination
Perceived behavioral control was measured with a four-item instrument adapted by Lee [
19] from Ajzen [
18], based on the scale developed by Lee [
20]. Items were rated on the same 7-point Likert scale (1=not at all, 7=very much), yielding scores ranging from 4 to 28. Negatively worded items were reverse-coded; higher scores represent greater perceived ease of receiving the vaccine. Cronbach’s α was .68.
6) Intention to receive HPV vaccination
Intention was evaluated using an instrument originally developed by Ajzen [
18] and, with permission, adapted by Lee [
19] from Lee [
20]. The instrument comprises three items rated on a 7-point Likert scale, yielding a total score ranging from 3 to 21; higher scores denote stronger vaccination intention. Cronbach’s α was .94.
Data were collected in April 2023 after approval from the university IRB and permission from the principals of two high schools in Gwangju City, South Korea. The study purpose and procedures were explained to students who volunteered to participate. Participants then received anonymous questionnaires and consent forms describing the study aims, their participation rights (including the freedom to withdraw at any time), the estimated time required, and data management procedures. Participation offered no benefits and posed no harm to school life, and personal identification was not possible. Participants were instructed to respond honestly. Data were coded with identification numbers to support anonymity. Of the 210 questionnaires collected, 18 were excluded because of incomplete responses or substantial missing data. The final analysis included 192 complete cases.
5. Data Analysis
Data were analyzed using IBM SPSS Statistics for Windows ver. 27.0 (IBM Corp.). Means and standard deviations were calculated for all general and HPV-related characteristics. Relationships among variables were examined using t-tests and Pearson correlation coefficients. Hierarchical regression analysis was conducted to identify factors associated with high school students’ intention to receive HPV vaccination. Before hierarchical regression analysis, assumptions of normality, linearity, homoscedasticity, and multicollinearity were examined. Missing data were handled using a complete-case approach, as the proportion of excluded cases was small and did not materially affect the overall sample size.
6. Research Ethics
All procedures involving human participants followed ethical standards established by the institutional and/or national research committee in accordance with the 1964 Helsinki Declaration and its amendments. Participants received a brochure detailing the study’s objectives, methods, confidentiality, voluntary participation, and risks and benefits. Informed consent was obtained from all participants, who completed a 15-minute self-report questionnaire only after voluntarily signing the consent form.
RESULTS
1. HPV Vaccination Intention by Demographic and HPV-Related Characteristics
A total of 210 high school students were initially recruited. Eighteen questionnaires were excluded because of incomplete or missing responses; therefore, 192 participants were included in the final statistical analysis.
The participants’ mean age was 18.04±0.19 years; 185 participants (96.4%) were 18 years old, and 7 (3.6%) were 19 years old. Regarding health-related behaviors, 30 participants (15.6%) reported smoking, 99 (51.6%) reported drinking alcohol, and 19 (9.9%) reported contraceptive use. Cervical cancer awareness was reported by 155 participants (80.7%). With multiple responses permitted, the main sources of information were school (n=77; 49.7%), television, the Internet, or radio (n=52; 33.5%), medical institutions (n=40; 25.8%), and family (n=39; 25.2%). Most participants (n=184; 95.8%) reported no family history of cervical cancer.
Overall, 136 participants (70.8%) were unaware of HPV. Among those who knew about HPV, the most common sources of information were television, the Internet, and radio (n=25; 44.6%), followed by school (n=24; 42.9%) and medical institutions (n=11; 19.6%). Similarly, 128 participants (66.7%) were unaware of the HPV vaccine. Among those who were aware, the main sources were school (n=30; 46.9%) and television, the Internet, and radio (n=23; 35.9%). Most participants (n=154; 80.2%) were unaware of the expanded national support for HPV vaccination. Forty-one participants (21.3%) had received at least one HPV vaccine dose, whereas 151 (78.6%) had not been vaccinated.
For vaccinated students, the most frequent sources of recommendation were family members (n=22; 53.7%), followed by teachers (n=16; 39.0%). The primary reasons for not receiving the HPV vaccine were lack of awareness of the vaccine (n=97; 64.2%) and perceived low risk of infection (n=36; 23.8%).
HPV vaccination intention differed significantly according to school gender composition (t=6.69,
p<.001), awareness of cervical cancer (t=3.91,
p<.001), awareness of HPV infection (t=2.80,
p=.006), awareness of HPV vaccination (t=3.34,
p=.001), awareness of the expansion of national support for HPV vaccination (t=2.91,
p=.004), and HPV vaccination status (F=5.82,
p=.004). Participants reported higher vaccination intention if they were female; if they were aware of cervical cancer, HPV, or HPV vaccination; or if they were aware of the expanded national support for the vaccine. Post hoc analyses indicated that intention was highest among individuals who had received a second or subsequent HPV vaccine dose (4.96±1.63) (
Table 1).
Item-level correct-answer rates for HPV knowledge are presented in
Supplement 1. The statement “HPV vaccination can prevent HPV infection” had the highest correct response rate (75.5%), followed by “HPV is a sexually transmitted infection” (67.7%), “HPV is a common infection transmitted through sexual contact” (59.9%), and “HPV is associated with the development of cervical cancer” (57.3%). In contrast, the lowest correct response rate (3.6%) was observed for the following statements: “low-risk viruses do not cause cervical cancer,” “high-risk viruses cause warts around the genitals,” and “sexually active women should undergo an annual HPV test” (
Supplement 1).
The mean HPV knowledge score was 5.06±2.53 out of a possible 20 points. The mean attitude score toward vaccination was 1.78±1.10 on a −3 to +3 scale. Mean subjective norm and perceived behavioral control scores were 4.31±1.24 and 4.82±1.06, respectively, on a 7-point scale. The mean intention to receive HPV vaccination was 4.07±1.55 on the same 7-point scale (
Table 2).
Intention to receive HPV vaccination was positively correlated with attitude toward vaccination (r=.51,
p<.001), subjective norm (r=.59,
p<.001), and perceived behavioral control (r=.61,
p<.001). In contrast, HPV knowledge was not significantly associated with vaccination intention (r=−.04,
p=.551) (
Table 3).
Diagnostic statistics indicated no multicollinearity (variance inflation factors ranged from 1.34 to 2.09) and no autocorrelation (Durbin–Watson statistic=1.92). Tolerance values were ≥0.1, and variance inflation factors were <10 in both models. Examination of residual distributions indicated that the assumptions of normality and homoscedasticity were satisfied.
A two-stage hierarchical multiple regression analysis was conducted to identify factors associated with intention to receive HPV vaccination. In Model 1, which included only general and HPV-related characteristics, sex was a significant predictor (β=.42, p<.001) and explained 22% of the variance (adjusted R2). The overall model fit was significant (F=10.09, p<.001).
In Model 2, after the psychosocial variables were added, subjective norm (β=.31,
p<.001), perceived behavioral control (β=.31,
p<.001), attitude toward vaccination (β=.22,
p<.001), and school gender composition (β=.19,
p=.005) remained significant predictors. This model accounted for 54% of the variance (adjusted R
2) and showed good overall fit (F=26.15,
p<.001) (
Table 4).
DISCUSSION
This study examined factors influencing high school students’ intention to receive the HPV vaccine by adding HPV knowledge variables to the TPB. Participants’ HPV knowledge was very low, averaging 5.06 out of 20 points. This average is comparable to previously reported scores for female college students (5.49 points) [
21] and health and non-health-related male undergraduate students (5.16 and 4.71 points, respectively) [
22].
HPV knowledge was relatively high for items on vaccine preventability, its classification as a sexually transmitted disease, transmission routes, and its link to cervical cancer. In contrast, knowledge of HPV genotypes, related diseases, testing methods and intervals, and treatment options was low. Accordingly, topics with low correct-response rates should be reinforced through mass media, school curricula, or extracurricular sessions using proven educational tools, such as PowerPoint lectures, talk concerts, videos, webtoons, and booklets to enhance HPV knowledge [
23,
24]. Schools can also support learning by providing educational materials, inviting expert instructors, and strengthening teachers’ expertise through targeted training for health educators.
The mean intention-to-vaccinate score was 4.07 on a 7-point scale, exceeding the score reported for female college students (3.88 on a 7-point scale) [
19] but lower than that reported for college students overall (5.20 on a 7-point scale) [
25]. Significant differences in vaccination intention were associated with gender, cervical cancer awareness, HPV awareness, HPV vaccination awareness, awareness of the expansion of national HPV vaccination support, and prior HPV vaccination status. These results partially align with prior findings showing higher intention among female and older college students [
25] and among adult males with sexual experience and vaccine awareness [
26].
In a previous study, mothers of upper-grade elementary school boys exhibited high intention to have their sons vaccinated against HPV when health insurance coverage was available [
27]. Parents of female adolescents also argued that boys should be included in the national free vaccination program [
15]. Together, these findings underscore the need to extend government support for HPV vaccination to males. Furthermore, systematic health education focusing on HPV-related cancers, routes and rates of infection, symptoms, and preventive measures is essential because intention to receive the vaccine varied by awareness of cervical cancer, HPV, and HPV vaccination. More active promotion of the current national HPV vaccination program is likewise warranted.
Subjective norms, perceived behavioral control, attitude, and school gender composition significantly influenced intention to receive the HPV vaccine and explained 54% of the variance. Among these variables, subjective norms and perceived behavioral control were the strongest predictors. These results concur with findings for female college students [
19], in which subjective norms were the most influential, as well as studies of female high school students [
28] and parents of female adolescents [
15], in which perceived behavioral control was paramount.
When making health-related decisions, individuals often rely heavily on advice from family members, peers, or healthcare providers [
29]. Accordingly, interventions should elicit support and encouragement from family members and teachers, who were the primary recommenders of HPV vaccination in this study. Barriers such as the vaccine’s cost and lack of time, both cited as reasons for non-vaccination, must be addressed to enhance perceived behavioral control. Additional research to identify obstacles preventing high school students from receiving the vaccine, as well as factors facilitating vaccination, will likely further strengthen their intention to be vaccinated.
Attitude toward HPV vaccination also influenced vaccination intention, consistent with findings among high school girls [
28] and parents of upper-grade elementary school students [
30]. In previous studies, male students had a low awareness of the need for HPV vaccination, while female students showed a low awareness of safety factors, Thus, active promotion and education will be necessary to alleviate concerns related to HPV vaccine side effects [
31]. Because the Korea Disease Control and Prevention Agency [
32] has confirmed the vaccine’s safety, accurate information about both safety and the importance of HPV vaccination should be disseminated.
School gender composition was also identified as a factor affecting the intention to receive HPV vaccination. Extending free HPV vaccination to boys would increase male students’ willingness to be vaccinated. Hence, these findings underscore the need for national support for HPV vaccination regardless of sex. Education explaining HPV transmission routes and HPV-related diseases in males is also required to increase vaccination intention among male students.
However, HPV knowledge did not significantly influence vaccination intention. This finding is consistent with prior research indicating that parents of elementary school boys’ HPV knowledge does not predict their intention to receive the HPV vaccine [
30]. Although moderate correct-response rates were observed for basic HPV-related questions, overall knowledge was low; several questions had extremely low correct-response rates, suggesting limited response variability and possible floor effects. Together, these findings indicate that factual knowledge alone cannot sufficiently explain adolescents’ intentions to receive HPV vaccination and may be unevenly distributed across adolescents, limiting its utility as a direct predictor of intention.
In addition, among adolescents, behavioral intention may be shaped more directly by attitude, perceived social norms, and perceived behavioral control than by knowledge. Social influence and perceptions of vaccination accessibility are therefore expected to function as stronger determinants. Future research should systematically examine how HPV knowledge influences vaccination intentions through educational delivery methods that are understandable and accessible and that account for high school students’ cognitive levels.
This study employed a convenience sample from two high schools in a single metropolitan area in South Korea, which limits the generalizability of its findings and may have introduced selection bias. In addition, this study focused on personal factors; variables related to parental support, parental attitudes, or parental recommendations regarding HPV vaccination were not included. Future studies should incorporate these familial determinants to provide a more comprehensive understanding of HPV vaccination intention.
Nevertheless, this study meaningfully identified factors related to HPV vaccination intention among both male and female high school students before the recent rapid increase in HPV infections. At a time when the inclusion of male adolescents in HPV vaccination policies is being discussed, these results provide timely evidence for analyzing factors related to vaccination intentions across the adolescent population. Within this evolving policy context of free vaccination for male students, this study can furnish timely, policy-relevant empirical evidence to inform future decisions on program expansion. This study is particularly timely given recent epidemiological trends showing that, despite long-term use of HPV vaccines with proven safety and efficacy, vaccination rates among adolescents—especially male students—remain low. Furthermore, the significant explanatory power of key TPB components supports the applicability of the TPB framework for understanding HPV vaccination intentions among high school students. Therefore, this study has important implications because it can contribute to future evidence-based vaccination programs by systematically analyzing adolescents’ behavioral factors related to HPV vaccination. The results could serve as a basis for developing effective intervention strategies to enhance HPV vaccination intention in this population.
CONCLUSION
Grounded in the TPB, this study examined associations among HPV vaccination intention, HPV knowledge, attitude toward HPV vaccination, subjective norm, and perceived behavioral control. The main predictors of intention were subjective norm, perceived behavioral control, attitude toward HPV vaccination, and sex; subjective norm and perceived behavioral control showed the strongest effects. These findings provide a foundation for developing and implementing interventions to increase HPV vaccination intention among high school students. To strengthen high school students’ intention to receive HPV vaccination, trusted public information campaigns should disseminate accurate information about benefits and potential adverse effects. Ongoing, targeted HPV-related health education from families, teachers, and the mass media—key influences on adolescents—should also be expanded. Policy measures should support gender-appropriate interventions, expand health insurance coverage, provide free vaccination, and improve access to vaccination services. At the family level, public health authorities should equip parents and caregivers with accessible educational materials and guidance so they can hold informed discussions about HPV vaccination with adolescents.
ARTICLE INFORMATION
Supplementary material
Figure 1.Conceptual framework of the study. HPV, human papillomavirus.
Table 1.Demographic characteristics and HPV-related variables (N=192)
|
Characteristic |
No. (%) |
Mean±SD |
t/F (p) |
|
Scheffé post hoc test |
|
Mean age (yr) |
|
18.04±0.19 |
|
|
Age (yr) |
|
|
−0.13 (.899) |
|
18 |
185 (96.4) |
4.07±1.55 |
|
|
19 |
7 (3.6) |
4.14±1.51 |
|
|
School gender composition |
|
|
6.69 (<.001) |
|
Girls’ school |
96 (50.0) |
4.74±1.37 |
|
|
Boys’ school |
96 (50.0) |
3.40±1.42 |
|
|
Religious affiliation |
|
|
1.00 (.341) |
|
Yes |
49 (25.5) |
4.25±1.47 |
|
|
No |
143 (74.5) |
4.01±1.57 |
|
|
History of smoking |
|
|
−1.82 (.070) |
|
Yes |
30 (15.6) |
3.60±1.47 |
|
|
No |
162 (84.4) |
4.16±1.55 |
|
|
History of alcohol use |
|
|
1.64 (.103) |
|
Yes |
99 (51.6) |
4.25±1.54 |
|
|
No |
93 (48.4) |
3.88±1.54 |
|
|
History of contraceptive use |
|
|
0.11 (.916) |
|
Yes |
19 (9.9) |
4.11±1.84 |
|
|
No |
173 (90.1) |
4.07±1.52 |
|
|
Awareness of cervical cancer |
|
|
3.91 (<.001) |
|
Yes |
155 (80.7) |
4.28±1.53 |
|
|
No |
37 (19.3) |
3.21±1.32 |
|
|
Family history of cervical cancer |
|
|
−0.67 (.502) |
|
Yes |
8 (4.2) |
3.71±1.95 |
|
|
No |
184 (95.8) |
4.09±1.53 |
|
|
Awareness of HPV infection |
|
|
2.80 (.006) |
|
Yes |
56 (29.2) |
4.55±1.74 |
|
|
No |
136 (70.8) |
3.87±1.42 |
|
|
Awareness of HPV vaccination |
|
|
3.34 (.001) |
|
Yes |
64 (33.3) |
4.58±1.71 |
|
|
No |
128 (66.7) |
3.81±1.40 |
|
|
Awareness of expanded national HPV vaccination support |
|
|
2.91 (.004) |
|
Yes |
38 (19.8) |
4.71±1.92 |
|
|
No |
154 (80.2) |
3.91±1.40 |
|
|
HPV vaccination statusa
|
|
|
5.82 (.004) |
|
First dose onlya
|
16 (8.3) |
4.40±1.69 |
b>c |
|
Second dose or higherb
|
25 (13.1) |
4.96±1.63 |
|
|
Not vaccinatedc
|
151 (78.6) |
3.89±1.47 |
|
Table 2.Descriptive statistics for HPV knowledge, attitudes, subjective norms, perceived behavioral con-trol, and vaccination intention (N=192)
|
Variable |
Mean±SD |
Min |
Max |
Scale range |
|
HPV knowledge |
5.06±2.53 |
0 |
11 |
0 to 20 |
|
Attitude toward HPV vaccination |
1.78±1.10 |
−3 |
3 |
−3 to 3 |
|
Subjective norm toward HPV vaccination |
4.31±1.24 |
1 |
7 |
1 to 7 |
|
Perceived behavioral control toward HPV vaccination |
4.82±1.06 |
2.25 |
7 |
1 to 7 |
|
HPV vaccination intention |
4.07±1.55 |
1 |
7 |
1 to 7 |
Table 3.Correlations among HPV knowledge, theory of planned behavior variables, and HPV vaccination intention (N=192)
|
Variable |
1 |
2 |
3 |
4 |
5 |
|
1. HPV knowledge |
1 |
−.01 (.903) |
−.02 (.798) |
.01 (.936) |
−.04 (.551) |
|
2. Attitude toward HPV vaccination |
|
1 |
.35 (<.001) |
.43 (<.001) |
.51 (<.001) |
|
3. Subjective norm regarding HPV vaccination |
|
|
1 |
.48 (<.001) |
.59 (<.001) |
|
4. Perceived behavioral control over HPV vaccination |
|
|
|
1 |
.61 (<.001) |
|
5. HPV vaccination intention |
|
|
|
|
1 |
Table 4.Hierarchical regression analysis of factors predicting HPV vaccination intention
|
Variable |
Model 1 |
Model 2 |
|
B |
SE |
β |
t (p)
|
B |
SE |
β |
t (p)
|
|
Constant |
2.99 |
0.23 |
|
13.11 (<.001) |
−0.50 |
0.40 |
|
−1.26 (.209) |
|
School gender composition |
1.29 |
0.25 |
.420 |
5.22 (<.001) |
0.57 |
0.20 |
.19 |
2.84 (.005) |
|
Awareness of cervical cancer |
0.26 |
0.28 |
.067 |
0.93 (.353) |
−0.27 |
0.22 |
−.07 |
−1.19 (.234) |
|
Awareness of HPV |
0.30 |
0.29 |
.089 |
1.03 (.305) |
0.18 |
0.23 |
.05 |
0.81 (.418) |
|
Awareness of HPV vaccination |
0.37 |
0.30 |
.113 |
1.24 (.215) |
0.33 |
0.23 |
.10 |
1.41 (.160) |
|
Awareness of expanded national HPV vaccination support |
0.32 |
0.28 |
.083 |
1.15 (.251) |
−0.08 |
0.22 |
−.02 |
−0.36 (.723) |
|
Received HPV vaccination |
−0.27 |
0.30 |
−.073 |
−0.93 (.356) |
−0.19 |
0.23 |
−.05 |
−0.81 (.419) |
|
Attitude toward HPV vaccination |
|
|
|
|
0.31 |
0.08 |
.22 |
3.86 (<.001) |
|
Subjective norm toward HPV vaccination |
|
|
|
|
0.38 |
0.08 |
.31 |
5.12 (<.001) |
|
Perceived behavioral control toward HPV vaccination |
|
|
|
|
0.45 |
0.09 |
.31 |
5.12 (<.001) |
|
R2
|
.25 |
.56 |
|
Adjusted R2
|
.22 |
.54 |
|
F (p) |
10.09 (<.001) |
26.15 (<.001) |
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