1-2-3! Catch-up for HPV: A Theoretically Informed Psychosocial Intervention to Increase HPV Vaccine Uptake Among Young Adults

The Human Papillomavirus (HPV) is the most common sexually transmitted infection in the United States causing a range of sequelae from genital warts to cancer. In the past 10 years, the Food and Drug Administration (FDA) licensed three vaccines that target the most common and severe strains of HPV. Current guidelines recommend the HPV vaccine be given prophylactically during adolescence; however, vaccination rates remain suboptimal. Thus, there are increased efforts to increase vaccination among the catch-up group, or individuals between 18 and 26 years of age, due to increased autonomy in healthcare decisions.

Previous research has utilized the Theory of Planned Behavior (TPB) to understand factors that impact HPV vaccination uptake. The TPB posits that attitudes, subjective norms, and perceived behavioral control contribute to one’s intent and subsequent engagement in a behavior. Recently, an affective component, anticipatory regret, was added to the model to increase utility. Despite research suggesting the TPB variables are directly related to vaccine uptake, interventions have primarily focused on education only with minimal success. Thus, the current study aimed to enhance an education-based intervention to directly target the TPB variables for increased HPV vaccination among the catch-up group.

The study was a randomized control design that compared a TPB-informed psychosocial intervention with both an education-only intervention and a no intervention control group. Results indicated that TPB variables explained 45.6% of the variance in intent to vaccinate, while increased knowledge about HPV/HPV vaccine contributed only 3.5%. Factors unique to the psychosocial intervention (attitudes, subjective norms, and anticipatory regret) were significant predictors of intent to vaccinate. The intervention model also effectively differentiated between those who did and did not endorse vaccination uptake at 6 months, explaining between 42% and 67% of the variance in vaccination status.

In conclusion, the current study demonstrated that the TPB-informed intervention was more effective than an education-only intervention in increasing both intent and vaccination uptake among the catch-up group. The current study provides support for dissemination of TPB-informed interventions across college campuses to increase uptake and reduce HPV-related sequelae among the catch-up group.