Numerous studies examined HPV vaccination promotional strategies. However, an overview of theory use, a synthesis of strategies’ effectiveness and an examination of the moderating influence of theory are absent.
Data Source:
We retrieved studies from Academic Search Complete, Business Source Complete, PubMed, PsycINFO, Web of Science, CMMC, CINAHL, and MEDLINE.
Study Inclusion and Exclusion Criteria:
1) peer-reviewed articles written in English, 2) experimental or quasi-experimental, 3) measure HPV vaccination-related outcomes, 4) had to contain a control condition and report statistics necessary for conversion (for meta-analysis only).
Data Extraction:
70 and 30 studies were included for the systematic review and meta-analysis respectively.
Data Synthesis:
Four major categories were coded: study information, theory use, type of theory, and outcomes. Two independent coders coded the sample (Cohen’s Kappa ranged from .8 to 1).
Results:
Most of the studies were based in the U.S. (77%, k = 54) with convenient samples (80%, k = 56), targeted toward females (46%, k = 32), and around a quarter did not employ any theories (47%, k = 33). Among theory-driven studies, the most commonly used were Framing (22%, k = 19), Health Belief Model (HBM; 13%, k = 12), and Narrative (7%, k = 6). Among controlled studies, promotional strategies were significantly more effective compared to the control (r+ = .25, p < .001). Strategies guided by the information, motivation, behavioral skills model (IMB) were more effective (r+ = .75, p < .001) than studies guided by framing theory (r+ = −.23, p < .001), HBM (r+ = .01, p < .001), and other theories (r+ = .11, p < .001).
Conclusion:
This review contributes to HPV vaccination promotion literature by offering a comprehensive overview of promotional strategies and practical suggestions for future research and practices.
BennettATPatelDACarlosRC, et al.Human papillomavirus vaccine uptake after a tailored, online educational intervention for female university students: a randomized controlled trial. J Womens Health (Larchmt). 2015;24(11):950–957. doi:10.1089/jwh.2015.5251
3.
President’s Cancer Panel. HPV vaccination for cancer prevention: progress, opportunities, and a renewed call to action. Published November, 2018. Accessed April 15, 2021. https://prescancerpanel.cancer.gov/report/hpvupdate
4.
BednarczykRAEllingsonMKOmerSB. Human papillomavirus vaccination before 13 and 15 years of age: analysis of national immunization survey teen data. J Infect Dis. 2019;220(5):730–734. doi:10.1093/infdis/jiy682
5.
BellRAMcGloneMSDragojevicM. Vicious viruses and vigilant vaccines: effects of linguistic agency assignment in health policy advocacy. J Health Commun. 2013;19(10):1178–1195. doi:10.1080/10810730.2013.811330
6.
CarcioppoloNLiCChudnovskayaEVKharsaRStephanTNickelK. The comparative efficacy of a hybrid guilt-fear appeal and a traditional fear appeal to influence HPV vaccination intentions. Commun Res. 2016;44(3):437–458. doi:10.1177/0093650215616457
7.
KimJ. The impact of narrative strategy on promoting HPV vaccination among college students in Korea: the role of anticipated regret. Vaccines. 2020;8(2):176. doi:10.3390/vaccines8020176
8.
KimJNanX. Temporal framing effects differ for narrative versus non-narrative messages: the case of promoting HPV vaccination. Commun Res. 2016;46(3):401–417. doi:10.1177/0093650215626980
9.
LeeMJChoJ. Promoting HPV vaccination online: message design and media choice. Health Promot Pract. 2017;18(5):645–653. doi:10.1177/1524839916688229
10.
LeeHYKoopmeinersJSMcHughJRaveisVHAhluwaliaJS. mHealth pilot study: text messaging intervention to promote HPV vaccination. Am J Health Behav. 2016;40(1):67–76. doi:10.5993/ajhb.40.1.8
11.
NanX. Relative persuasiveness of gain- versus loss-framed human papillomavirus vaccination messages for the present- and future-minded. Hum Commun Res. 2011;38(1):72–94. doi:10.1111/j.1468-2958.2011.01419.x
12.
VanderpoolRCCohenELCrosbyRA, et al. “1-2-3 Pap” Intervention improves HPV vaccine series completion among Appalachian women. J Commun. 2013;63(1):95–115. doi:10.1111/jcom.12001
13.
XiaoXBorahP. Do norms matter? Examining norm-based messages in HPV vaccination promotion. Health Commun. 2020:1–9. doi:10.1080/10410236.2020.1770506
14.
BrewerNTFazekasKI. Predictors of HPV vaccine acceptability: a theory-informed, systematic review. Prev Med. 2007;45(2-3):107–114. doi:10.1016/j.ypmed.2007.05.013
15.
HollowayGL. Effective HPV vaccination strategies: what does the evidence say? An integrated literature review. J Pediatr Nurs. 2019;44:31–41. doi:10.1016/j.pedn.2018.10.006
16.
LokeAYKwanMLWongY-TWongAK. The uptake of human papillomavirus vaccination and its associated factors among adolescents: a systematic review. J Prim Care Commun Health. 2017;8(4):349–362. doi:10.1177/2150131917742299
17.
NewmanPALogieCHDoukasNAsakuraK. HPV vaccine acceptability among men: a systematic review and meta-analysis. Sex Transm Infect. 2013;89(7):568–574. doi:10.1136/sextrans-2012-050980
18.
WallingEBBenzoniNDornfeldJ, et al.Interventions to improve HPV vaccine uptake: a systematic review. Pediatrics. 2016;138(1):e20153863. doi:10.1542/peds.2015-3863
19.
FuLYBonhommeL-ACooperSCJosephJGZimetGD. Educational interventions to increase HPV vaccination acceptance: a systematic review. Vaccine. 2014;32(17):1901–1920. doi:10.1016/j.vaccine.2014.01.091
20.
NiccolaiLMHansenCE. Practice- and community-based interventions to increase human papillomavirus vaccine coverage. JAMA Pediatr. 2015;169(7):686. doi:10.1001/jamapediatrics.2015.0310
21.
SmulianEAMitchellKRStokleyS. Interventions to increase HPV vaccination coverage: a systematic review. Human Vaccines Immunother. 2016;12(6):1566–1588. doi:10.1080/21645515.2015.1125055
22.
FrancisDBCatesJRWagnerKPZolaTFitterJECoyne-BeasleyT. Communication technologies to improve HPV vaccination initiation and completion: a systematic review. Patient Educ Couns. 2017;100(7):1280–1286. doi:10.1016/j.pec.2017.02.004
23.
JuraskovaIBariRAO’BrienMTMcCafferyKJ. HPV Vaccine promotion: does referring to both cervical cancer and genital warts affect intended and actual vaccination behavior?Womens Health Issues. 2011;21(1):71–79. doi:10.1016/j.whi.2010.08.004
24.
GerendMAShepherdJE. Predicting human papillomavirus vaccine uptake in young adult women: comparing the health belief model and theory of planned behavior. Ann Behav Med. 2012;44(2):171–180. doi:10.1007/s12160-012-9366-5
25.
DiClementeRJMurrayCCGrahamTStillJ. Overcoming barriers to HPV vaccination: a randomized clinical trial of a culturally-tailored, media intervention among African American girls. Hum Vaccin Immunother. 2015;11(12):2883–2894. doi:10.1080/21645515.2015.1070996
26.
PerezGCruessDGStraussN. A brief information–motivation–behavioral skills intervention to promote human papillomavirus vaccination among college-aged women. Psychol Res Behav Manag. 2016;9:285–296. doi:10.2147/prbm.s112504
27.
BigmanCACappellaJNHornikRC. Effective or ineffective: attribute framing and the human papillomavirus (HPV) vaccine. Patient Educ Couns. 2010;81:S70–S76. doi:10.1016/j.pec.2010.08.014
28.
GainforthHLCaoWLatimer-CheungAE. Message framing and parents’ intentions to have their children vaccinated against HPV. Public Health Nursing. 2012;29(6):542–552. doi:10.1111/j.1525-1446.2012.01038.x
29.
ParkS-Y. The effects of message framing and risk perceptions for HPV vaccine campaigns: focus on the role of regulatory fit. Health Mark Q. 2012;29(4):283–302. doi:10.1080/07359683.2012.732847
30.
WenNShenF. Communicating to young Chinese about human papillomavirus vaccination: examining the impact of message framing and temporal distance. Asian J Commun. 2016;26(4):387–404. doi:10.1080/01292986.2016.1162821
31.
GerendMASiasT. Message framing and color priming: how subtle threat cues affect persuasion. J Exp Soc Psychol. 2009;45(4):999–1002. doi:10.1016/j.jesp.2009.04.002
32.
GerendMAShepherdJE. Using message framing to promote acceptance of the human papillomavirus vaccine. Health Psychol. 2007;26(6):745–752. doi:10.1037/0278-6133.26.6.745
33.
GainforthHLLatimerAE. Risky business: risk information and the moderating effect of message frame and past behaviour on women’s perceptions of the human papillomavirus vaccine. J Health Psychol. 2011;17(6):896–906. doi:10.1177/1359105311431173
34.
BrewerNTChapmanGBGibbonsFXGerrardMMcCaulKDWeinsteinND. Meta-analysis of the relationship between risk perception and health behavior: the example of vaccination. Health Psychol. 2007;26(2):136–145. doi:10.1037/0278-6133.26.2.136
35.
RongenARobroekSJWvan LentheFJBurdorfA. Workplace health promotion. Am J Prev Med. 2013;44(4):406–415. doi:10.1016/j.amepre.2012.12.007
36.
XiaoXWongRM. Vaccine hesitancy and perceived behavioral control: a meta-analysis. Vaccine. 2020;38(33):5131–5138. doi:10.1016/j.vaccine.2020.04.076
37.
BorahP. Emerging communication technology research: theoretical and methodological variables in the last 16 years and future directions. New Med Soc. 2015;19(4):616–636. doi:10.1177/1461444815621512
38.
PengT-QZhangLZhongZ-JZhuJJH. Mapping the landscape of Internet studies: text mining of social science journal articles 2000–2009. New Med Soc. 2012;15(5):644–664. doi:10.1177/1461444812462846
39.
ZhangYLeungL. A review of social networking service (SNS) research in communication journals from 2006 to 2011. New Med Soc. 2014;17(7):1007–1024. doi:10.1177/1461444813520477
40.
DeSmetAShegogRVan RyckeghemDCrombezGDe BourdeaudhuijI. A systematic review and meta-analysis of interventions for sexual health promotion involving serious digital games. Games Health J. 2015;4(2):78–90. doi:10.1089/g4 h.2014.0110
41.
HeadKJNoarSMIannarinoNTGrant HarringtonN. Efficacy of text messaging-based interventions for health promotion: a meta-analysis. Social Sci Med. 2013;97:41–48. doi:10.1016/j.socscimed.2013.08.003
42.
O’KeefeDJNanX. The relative persuasiveness of gain- and loss-framed messages for promoting vaccination: a meta-analytic review. Health Commun. 2012;27(8):776–783. doi:10.1080/10410236.2011.640974
43.
PenţaMABăbanA. Message framing in vaccine communication: a systematic review of published literature. Health Commun. 2017;33(3):299–314. doi:10.1080/10410236.2016.1266574
44.
MacDonaldLCairnsGAngusKde AndradeM. Promotional communications for influenza vaccination: a systematic review. J Health Commun. 2013;18(12):1523–1549. doi:10.1080/10810730.2013.840697
45.
NewmanPALogieC. HIV vaccine acceptability: a systematic review and meta-analysis. AIDS. 2010;24(11):1749–1756. doi:10.1097/qad.0b013e32833adbe8
46.
NoarSM. A 10-year retrospective of research in health mass media campaigns: where do we go from here?J Health Commun. 2006;11(1):21–42. doi:10.1080/10810730500461059
47.
PrestwichAWebbTLConnerM. Using theory to develop and test interventions to promote changes in health behaviour: evidence, issues, and recommendations. Curr Opin Psychol. 2015;5:1–5. doi:10.1016/j.copsyc.2015.02.011
48.
ShenFSheerVCLiR. Impact of narratives on persuasion in health communication: a meta-analysis. J Advert. 2015;44(2):105–113. doi:10.1080/00913367.2015.1018467
O’KeefeDJJensenJD. The relative persuasiveness of gain-framed and loss-framed messages for encouraging disease detection behaviors: a meta-analytic review. J Commun. 2009;59(2):296–316. doi:10.1111/j.1460-2466.2009.01417.x
51.
RosenthalR. Meta-Analytic Procedures for Social Research. Sage; 1991.
52.
GallagherKMUpdegraffJA. Health message framing effects on attitudes, intentions, and behavior: a meta-analytic review. Ann Behav Med. 2011;43(1):101–116. doi:10.1007/s12160-011-9308-7
53.
BaxLYuL-MIkedaNMoonsKGM. A systematic comparison of software dedicated to meta-analysis of causal studies. BMC Med Res Methodol. 2007;7(1):40. doi:10.1186/1471-2288-7-40
CohenJ. A power primer. Psychol Bull. 1992;112(1):155–159. doi:10.1037/0033-2909.112.1.155
56.
GlanzKRimerBKViswanathK.Health Behavior and Health Education: Theory, Research, and Practice. Jossey-Bass; 2008.
57.
NanXFuterfasMMaZ. Role of narrative perspective and modality in the persuasiveness of public service advertisements promoting HPV vaccination. Health Commun. 2016;32(3):320–328. doi:10.1080/10410236.2016.1138379
58.
NanXMaddenK. HPV vaccine information in the blogosphere: how positive and negative blogs influence vaccine-related risk perceptions, attitudes, and behavioral intentions. Health Commun. 2012;27(8):829–836. doi:10.1080/10410236.2012.661348
59.
KimJNanX. Effects of consideration of future consequences and temporal framing on acceptance of the HPV vaccine among young adults. Health Commun. 2016;31(9):1089–1096. doi:10.1080/10410236.2015.1038774
60.
GerendMAShepherdJEMondayKA. Behavioral frequency moderates the effects of message framing on HPV vaccine acceptability. Ann Behav Med. 2008;35(2):221–229. doi:10.1007/s12160-008-9024-0
61.
LechugaJSwainGRWeinhardtLS. Impact of framing on intentions to vaccinate daughters against HPV: a cross-cultural perspective. Ann Behav Med. 2011;42(2):221–226. doi:10.1007/s12160-011-9273-1
62.
NanX. Communicating to young adults About HPV vaccination: consideration of message framing, motivation, and gender. Health Commun. 2012;27(1):10–18. doi:10.1080/10410236.2011.567447
63.
LiuSYangJZChuH. Now or future? Analyzing the effects of message frame and format in motivating Chinese females to get HPV vaccines for their children. Patient Educ Couns. 2019;102(1):61–67. doi:10.1016/j.pec.2018.09.005
64.
NanXMaddenKRichardsAHoltCWangMQTracyK. Message framing, perceived susceptibility, and intentions to vaccinate children against HPV among African American parents. Health Commun. 2015;31(7):798–805. doi:10.1080/10410236.2015.1005280
65.
CarcioppoloNJensenJDWilsonSRCollinsWBCarrionMLinnemeierG. Examining HPV threat-to-efficacy ratios in the extended parallel process model. Health Commun. 2013;28(1):20–28. doi:10.1080/10410236.2012.719478
66.
LeaderAEWeinerJLKellyBJHornikRCCappellaJN. Effects of information framing on human papillomavirus vaccination. J Womens Health. 2009;18(2):225–233. doi:10.1089/jwh.2007.0711
67.
DiclementeRJCrosbyRASalazarLFNashRYoungeS. Is male intent to be vaccinated against HPV a function of the promotion message?Int J STD AIDS. 2011;22(6):332–334. doi:10.1258/ijsa.2011.010429
68.
McReeA-LReiterPLChantalaKBrewerNT. Does framing human papillomavirus vaccine as preventing cancer in men increase vaccine acceptability?Cancer Epidemiol Biomarkers Prev. 2010;19(8):1937–1944. doi:10.1158/1055-9965.epi-09-1287
69.
YangJZPittmanMKM. The silver lining of shame: framing HPV to influence vaccination intentions. Health Commun. 2016;32(8):987–994. doi:10.1080/10410236.2016.1196420
70.
CoxDSCoxADSturmLZimetG. Behavioral interventions to increase HPV vaccination acceptability among mothers of young girls. Health Psychol. 2010;29(1):29–39. doi:10.1037/a0016942
71.
GrandahlMRosenbladAStenhammarC, et al.School-based intervention for the prevention of HPV among adolescents: a cluster randomised controlled study. BMJ Open. 2016;6(1):e009875. doi:10.1136/bmjopen-2015-009875
BrewerNTChapmanGBRothmanAJLeaskJKempeA. Increasing vaccination: putting psychological science into action. Psychol Sci Public Interest. 2017;18(3):149–207. doi:10.1177/1529100618760521
74.
MollenSRuiterRACKokG. Current issues and new directions in psychology and health: what are the oughts? The adverse effects of using social norms in health communication. Psychol Health. 2010;25(3):265–270. doi:10.1080/08870440903262812
75.
FishbeinMYzerMC. Using theory to design effective health behavior interventions. Commun Theory. 2003;13(2):164–183. doi:10.1111/j.1468-2885.2003.tb00287.x
76.
AveryEJParkS. HPV vaccination campaign fear visuals: an eye-tracking study exploring effects of visual attention and type on message informative value, recall, and behavioral intentions. Public Relations Rev. 2018;44(3):321–330. doi:10.1016/j.pubrev.2018.02.005
StaggersSMBrannMMakiSM. Let’s talk about HPV: examining college male perceptions of the HPV vaccine. Qual Res Rep Commun. 2012;13(1):28–36. doi:10.1080/17459435.2012.719206
81.
ZhangYWangYLiuL, et al.Awareness and knowledge about human papillomavirus vaccination and its acceptance in China: a meta-analysis of 58 observational studies. BMC Public Health. 2016;16(1):216. doi:10.1186/s12889-016-2873-8
82.
Starfelt SuttonLCWhiteKM. Predicting sun-protective intentions and behaviours using the theory of planned behaviour: a systematic review and meta-analysis. Psychol Health. 2016;31(11):1272–1292. doi:10.1080/08870446.2016.1204449
83.
ArmitageCJConnerM. Efficacy of the theory of planned behaviour: a meta-analytic review. Br J Soc Psychol. 2001;40(4):471–499. doi:10.1348/014466601164939
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