THEORETICAL APPLICATION

Theoretical Application Assignment

Part One: The Health Belief Model and HPV Vaccination Uptake among Young Adults

Cervical cancer is a fundamental health concern for nations globally. The World Health Organization (WHO) recommends the human papillomavirus (HPV) vaccine as an effective way to prevent HPV-related conditions, including cervical cancer (Alsulami et al., 2023). The vaccine is available for young children aged between 9 and 12, although young adults aged between 13 and 26 could also receive a catch-up immunization if they did not begin or complete the vaccination series before age 12 (Alsulami et al., 2023). According to Kamolratanakul and Pitisuttithum (2021), the HPV vaccine is 80 percent effective in preventing HPV-related infections. However, the uptake of the HPV vaccine among young adults in the United States and globally remains low. The health belief model provides a framework for understanding the possible reasons for this trend.

The Health Belief Model

The health belief model postulates that the decision to screen for, prevent, or control illnesses depends on an individuals perceived susceptibility to the disease, perceived seriousness, perceived benefits and barriers, cues to action, and self-efficacy (Alsulami et al., 2023).

Perceived Susceptibility

This is a measure of an individuals belief that they can contract the disease (Alsulami et al., 2023). Young adults are more likely to get vaccinated if they believe they are at-risk of getting infected with HPV (Calderon-Mora et al., 2020). Calderon-Mora et al. (2020) conducted a study of 599 women in the US to identify the psychosocial factors that influence HPV vaccination rates. Of the 599 women, only 93 (representing 15.5 percent) believed that they were at-risk of getting HPV, and only 13 percent believed that they were likely to get such an infection in the near future (10 years). In another study by Donadiki et al. (2014) approximately 30 percent of female university students in Greece did not see the need to get vaccinated because they did not believe the vaccines were effective in preventing cervical cancer and other conditions. Moreover, 92.5 percent did not get vaccinated because they believed their sexual behavior was safe and hence, they were not at-risk of getting HPV. Donadiki et al. (2014) conclude that there is a need to intensify efforts to increase knowledge of the overall nature of HPV and susceptibility among young adults as a way of encouraging more to get vaccinated.

Perceived Seriousness of HPV Infections

Perceived seriousness is a measure of how serious an individual perceives a disease and its consequences to be (Calderon-Mora et al., 2020). Young adults are more likely to get vaccinated if they believe HPV is bad for their health. In their study, Calderon-Mora et al. (2020) found that a majority of women in the US, over 86 percent, agreed that HPV would disrupt their physical health, romantic relationships, and overall quality of life. However, Donadiki et al. (2014) found that approximately 20 percent of university students did not understand the potential harms of HPV or that failure to obtain the vaccine increased the risk of getting cervical cancer or genital warts. This lack of awareness on the severity of HPV and its consequences reduces young adults inclination to get vaccinated.

Perceived Benefits

Perceived benefits has to do with how much one believes that taking a preventive action will reduce the risk of acquiring an illness (Donadiki et al. 2014). In the context of HPV, the perceived benefits construct focuses on how much one believes that the vaccine reduces the risk of serious consequences. The study by Calderon-Mora et al. (2020) found that most young adults have a good understanding of the perceived benefits of the HPV vaccine. For instance, 86 percent of participants believed vaccination would help them lead healthier lives. At the same time, only 72 percent of participants believed the vaccines benefits outweighed the risks (Calderon-Mora et al., 2020). Donadiki et al. (2014) reported a similar finding from a sample of female university students in Greece - 45 percent of young adults interviewed did not believe the HPV vaccine was safe, while 49 percent did not believe that taking the vaccine would protect them against cervical cancer. Generally, the study found that participants who scored higher on the specific benefits measure were more likely to be vaccinated (Donadiki et al., 2014). Thus, the authors conclude that there is need for more advocacy through public health education programs to address attitudes and risk perceptions about the vaccine. Such programs would also help spread positive information about the benefits of HPV vaccination to increase uptake among young adults (Donadiki et al., 2014).

Perceived Barriers

Perceived barriers are the psychological or physical factors that prevent young adults from getting the HPV vaccine. According to Calderon-Mora et al. (2020), the...…throughout the period to complement the instruction received.

The theory of planned behavior was useful in the article in two fundamental ways. First, it provided a means to score participants pre and post-intervention health empowerment levels by measuring their attitudes, influence of subjective norms, and percived behavioral control. Moreover, the three constructs of the theory were used to design a theory-informed educational intervention focused on improving attitudes towards health empowerment, addressing subjective and normative beliefs, and increasing behavioral control.

Of the three constructs of behavioral intention as per the theory of planned behavior, only subjective norms failed to yield a statistically significant difference when pre and post intervention scores were compared. There were no changes in scores in the component of subjective norms following the education intervention. Post-intervention results showed an improvement in the mean behavioral intention for healthcare empowerment score among intervention group participants. However, there were no differences in behavioral intention scores in the control group in the pre and post-intervention assessment. The study also reported an increase in mean scores in the construct of attitudes towards health empowerment following the intervention. An increase in attitude would ultimately lead to increased intention for healthcare empowerment. The perceived behavioral control construct yielded the greatest effect following the education intervention. This indicated an increased power to overcome obstacles to health empowerment such as cost, accessibility issues, cultural issues, and societal norms.

Generally, the authors acknowledge that the theory of planned behavior was successful in informing the design of the education intervention, leading to an improvement in attitudes and increase in behavioral control over health empowerment among Iranian women. They attribute the success of the theory to the ability to tailor their instructional methods and implementation strategies to align with the needs of the study population. For instance, the authors use short stories and relevant scenarios as part of their instruction techniques to align the theory with the practical context and hence, enhance its relevance in the study.

The theory of planned behavior has successfully been used in a range of health education topics including substance use, breastfeeding, health services utilization, drinking, and smoking (Boston University, 2022). However, these are all health behaviors in which an individual can exert self-control (Boston University, 2022). Unfortunately, the theory may not be used to successfully explain and predict health behaviors over which one cannot exert self-control, such…