We examine whether a 15-minute school-located face-to-face Human Papilloma Virus (HPV) seminar directly impacts college-level freshman students’ vaccination-record search behavior, or indirectly impacts through changes in their perceptions of safety and of risk, attitude toward, and knowledge about HPV vaccine. Through this study, we also sought to advance understanding of the factors (e.g. attitudes, concerns, intentions, and perceptions) that shape HPV vaccine uptake behavior among Hispanic college students in the medically underserved U.S. southern border region.
Methods:
Our IRB-approved study is in the form of a quasi-experiment which has both a pretest and a posttest for two groups: (i) HPV vaccine seminar attendees (n=141), and (ii) non-attendees (n=18). Study participants were n=159 college-level freshman students enrolled in UNIV 1101 classes at a university classified as a Hispanic-serving institution in a U.S. southern border city in Fall 2013. In addition to seminar attendance (our focal independent variable), other covariates included sex of participant, and whether participant ever had sex. Our mediating variables were the differences (i.e., mean posttest score – mean pretest score) in the perception of safety and of risk of HPV vaccine, in attitude toward HPV vaccine, and in knowledge about HPV vaccine. Our measures of perception of safety and of risk each comprised a 7-point 3-item Likert scale. Participants’ attitude toward HPV vaccine was measured using a 7-point 8-item semantic differential scale. Knowledge about HPV vaccine was measured using an 11-item true or false quiz. Our ultimate dependent variable, vaccination-record search behavior.
Data Analysis:
Our data analyses come in two stages. The first stage comprised of a set of normal error regression analyses wherein the mean differences between posttest and pretest for perception of safety and of risk of HPV vaccine, for attitude toward HPV vaccine, and for knowledge about HPV vaccine were each casted as dependent variables. In this stage, seminar attendance, sex of participant, and whether participant ever had sex were the independent variables. The second stage comprised a binary logistic regression analysis wherein we sequentially run two models --- model 1 (M1) and model 2 (M2). In M1, vaccination-record search behavior (i.e. did or did not search) was the dependent variable. Seminar attendance, sex of participant, and whether participant ever had sex still served as independent variables. In M2, we maintain the form of M1 except that this time we included the mean differences between posttest and pretest for perception of safety and of risk of HPV vaccine, attitude toward HPV vaccine, and knowledge about HPV vaccine as additional independent variables.
Results: Compared to non-attendees, our normal error regression results indicated that seminar attendees -- participants who attended the 15-minute HPV vaccine seminar -- tended to gain knowledge about HPV. However, there was no significant impact of seminar attendance on participants’ scores in regards to perception of safety of HPV vaccine, perception of risk of HPV vaccine, or attitude toward HPV vaccine. From our second stage analysis, binary logistic regression results indicated that seminar attendance significantly increased the likelihood of vaccination-record search behavior. Neither perceptions of safety, perceptions of risk, nor attitude toward HPV vaccine had any significant impact on record search behavior. While seminar attendance was significantly associated with increased knowledge about HPV vaccine and with record search, knowledge gained about HPV vaccine did not mediate between seminar attendance and record search behavior. In other words, gain in knowledge as a result of seminar attendance did not translated to any detectable increase in the likelihood of vaccination-record search behavior.
Conclusion:
Our findings suggest that in the context of higher education, short face-to-face seminar-type presentation on HPV has allowed the transmission of explicit knowledge and triggered record search behavior. However, the same presentation strategy failed to influence the more cerebral and subjective dimensions relating to attitudes (attitudinal change) and perceptions (perceptional change). The findings and insights from this study adds to the extant knowledge about a segment of the population in the medically underserved area of the U.S. southern border region, a region that is home to the colonias, poor communities in the U.S. southern border region with living conditions that mirror those of the poor in developing countries. It also points us to a direction that can be taken to improve health-related information and knowledge.
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