Predicting Human Papillomavirus Vaccine Uptake in Young Adult Women: Comparing the Health Belief Model and Theory of Planned Behavior

Abstract

Although theories of health behavior have guided thousands of studies, relatively few studies have compared these theories against one another. The purpose of the current study was to compare two classic theories of health behavior-the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB)-in their prediction of human papillomavirus (HPV) vaccination. After watching a gain-framed, loss-framed, or control video, women (N = 739) ages 18-26 completed a survey assessing HBM and TPB constructs. HPV vaccine uptake was assessed 10 months later. Although the message framing intervention had no effect on vaccine uptake, support was observed for both the TPB and HBM. Nevertheless, the TPB consistently outperformed the HBM. Key predictors of uptake included subjective norms, self-efficacy, and vaccine cost. Despite the observed advantage of the TPB, findings revealed considerable overlap between the two theories and highlighted the importance of proximal versus distal predictors of health behavior.