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Lee, Bae, Choi, Hwang, Lee, and Cho: Factors Influencing Human Papillomavirus Vaccination Adoption Stages Based on the Precaution Adoption Process Model
Original Article

Asian Oncology Nursing 2015; 15(2): 89-96.

Published online: 30 June 2015

DOI: https://doi.org/10.5388/aon.2015.15.2.89

Factors Influencing Human Papillomavirus Vaccination Adoption Stages Based on the Precaution Adoption Process Model

Eun Nam Lee1, Sun Hyoung Bae1, Eun Hui Choi2, Hyun Ju Hwang1, Young Ock Lee1, Jeong Lim Cho3

1Department of Nursing, Dong-A University, Busan, Korea.

2Department of Nursing, Masan University, Changwon, Korea.

3Department of Nursing, Kaya University, Gimhae, Korea.

Address reprint requests to: Choi, Eun Hui. Department of Nursing, Masan University, 2640 Hamma-daero, Naeseo-eup, MasanHoiwon-gu, Changwon 630-729, Korea. Tel: +82-55-230-1137, Fax: +82-55-230-1441, ceh@masan.ac.kr

Received 7 April 2015       Revised 10 June 2015       Accepted 16 June 2015

© 2015 Korean Oncology Nursing Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study aimed to identify the factors influencing human papillomavirus (HPV) vaccination adoption stages using the Precaution Adoption Process model.

Methods

A total of 173 female university students from B metropolitan city participated. Demographics, factors contributing to action, knowledge, health beliefs, and self-efficacy related to the HPV vaccination were measured. The collected data were analyzed using descriptive statistics and multiple logistic regression analysis using SPSS for Windows version 21.0.

Results

Factors that contributed to the transition from the unaware and unengaged stages to the undecided about action stage included age, economic status, experience of recommendation from doctors, perceived severity of cervical cancer, and perceived barriers. Factors that contributed to the transition from the undecided about action stage to the deciding to act stage were perceived benefit and self-efficacy of the HPV vaccination. Factors that contributed to the transition from the deciding to act stage to the acting and maintenance stages were experience of recommendation from doctors and perceived severity of cervical cancer.

Conclusion

These results suggest that aggressive HPV vaccination campaigns increase awareness. Further studies should develop tailored strategies for promoting HPV vaccination that emphasize health beliefs and self-efficacy.

Keywords: Papillomavirus Vaccines, Adoption, Students

Figures and Tables

Table 1

Demographics, Knowledge, Health Belief, and Self-efficacy Related to HPV Vaccination (N=173)

aon-15-89-i001
Characteristics Categories n (%) or M±SD Range Min-Max
Age (year) 21.7±1.39 20~25
Religion No 93 (53.8)
Yes 80 (46.2)
Economic status High level 16 (9.2)
Middle level 120 (69.4)
Low level 37 (21.4)
Experience of sexual intercourse No 122 (70.5)
Yes 51 (29.5)
Experience of recommendation about HPV vaccination No 114 (65.9)
Yes 59 (34.1)
Knowledge about HPV vaccination Health belief about HPV vaccination 8.96 ± 1.82 0~14 4~13
Perceived sensitivity 3.88 ± 1.33 2~8 2~8
Perceived seriousness 5.64 ± 1.30 2~8 2~8
Perceived benefit 6.07 ± 1.32 2~8 2~8
Perceived barrier 11.22 ± 2.19 4~16 4~16
Self-efficacy 19.52 ± 4.04 6~30 6~30

HPV=Human papillomavirus.

Table 2

Stage of HPV Vaccination (N=173)

aon-15-89-i002
Categories n (%)
Unaware 67 (38.7)
Unengaged 12 (6.9)
Undecided about acting 33 (19.1)
Decide not to act 1 (0.6)
Decide to act 18 (10.4)
Acting 36 (20.8)
Maintenance 6 (3.5)

HPV=Human papillomavirus.

Table 3

Factors Affecting Stage of HPV Vaccination (Simple Logistic Regression) (N=172)

aon-15-89-i003
Variables UA/UU DA/UA AM/DA
OR 95% CI p OR 95% CI p OR 95% CI p
Age (year) 1.69 1.23~2.32 .001 0.81 0.49~1.33 .409 1.23 0.78~1.95 .370
Religion (ref. = no) 1.07 0.47~2.41 .873 0.53 0.16~1.75 .299 2.00 0.63~6.33 .238
Economic status (ref. = Low level)
 Middle level 0.36 0.15~0.91 .031 2.49 0.66~9.43 .181 2.77 0.60~12.71 .190
 High level 0.35 0.08~1.53 .163 1.08 0.09~13.54 .950 1.00 0.13~31.98 .624
Experience of sexual intercourse (ref. = no) 1.06 0.44~2.57 .900 0.89 0.45~3.15 .850 .04 0.30~3.56 .950
Experience of recommendation about HPV vaccination (ref. = no) 25.03 5.22~120.03 < .001 0.98 0.03~3.18 .972 9.43 2.62~34.00 .001
Knowledge about HPV vaccination 1.13 0.91~1.40 .258 1.14 0.85~1.53 .394 1.10 0.73~1.66 .646
Health belief about HPV vaccination
 Perceived sensitivity 1.29 0.94~1.76 .115 1.27 0.75~2.16 .380 0.56 0.35~0.91 .019
 Perceived seriousness 1.54 1.08~2.18 .016 0.94 0.53~1.67 .838 0.76 0.46~1.27 .294
 Perceived benefit 1.04 0.75~1.43 .832 3.07 1.56~6.05 .001 0.70 0.40~1.21 .200
 Perceived barrier 1.28 1.05~1.55 .016 0.80 0.57~1.12 .192 0.96 0.68~1.37 .831
Self-efficacy 1.02 0.92~1.13 .736 1.38 1.12~1.71 .003 0.92 0.77~1.09 .330

HPV=Human papillomavirus; UA=Undecided about acting (n=33); UU=Unaware and unengaged (n=79); DA=Decide to act (n=18); AM=Acting and maintenance (n=42).

Table 4

Factors Affecting Stage of HPV Vaccination (Multiple Logistic Regression) (N=172)

aon-15-89-i004
Variables UA/UU DA/UA AM/DA
OR 95% CI p OR 95% CI p OR 95% CI p
Age (year) 1.62 1.10~2.38 .015
Religion (ref. = no)
Economic status (ref. = Low level)
 Middle level 0.64 0.20~2.08 .461
 High level 0.78 0.13~4.84 .788
Experience of sexual intercourse (ref. = no)
Experience of recommendation about HPV vaccination (ref. = no) 17.15 3.31~88.76 .001 13.43 3.00~60.18 .001
Knowledge about HPV vaccination
Health belief about HPV vaccination
 Perceived sensitivity 0.47 0.26~0.86 .013
 Perceived seriousness 1.11 0.70~1.74 .661
 Perceived benefit 2.47 1.22~4.98 .012
 Perceived barrier 1.15 0.91~1.46 .238
Self-efficacy about HPV vaccination 1.30 1.02~1.66 .037
- 2 Log likelihood 98.89 46.07 52.74
Cox & snell R2 0.28 0.33 0.26
Nagelkerke R2 0.40 0.45 0.41
χ 2 (p) 36.91 (<.001) 20.15 (<.001) 20.56 (<.001)

HPV=Human papillomavirus; UA=Undecided about acting (n=33); UU=Unaware and unengaged (n=79); DA=Decide to act (n=18); AM=Acting and maintenance (n=42).

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