Department of Public Health, Baylor University, 1621 S. 5th Street, Waco, TX, 76706, USA.
Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA.
Cancer Causes Control. 2022 Jan;33(1):15-24. doi: 10.1007/s10552-021-01509-y. Epub 2021 Oct 27.
Theoretical frameworks are useful tools to explain the dynamics of behavioral change, develop, and implement intervention studies. The purpose of this systematic review and meta-analysis is to evaluate the application of theoretical frameworks and models to HPV vaccination intervention studies in the United States (US) from January 2006 to December 2019.
A comprehensive search across databases, including PubMed, EMBASE, ERIC, CINAHL, Academic Search Complete, Scopus, Web of Science, and PsycINFO, was conducted. Articles were included in the systematic analysis if at least one theory was used to develop the intervention phase. All intervention studies targeting populations in the US without restrictions of age, income, sex, and ethnicity were included. Articles were included in the meta-analysis if vaccine uptake and/or vaccine completion was addressed.
The Health Belief Model, Motivational Interviewing, Theory of Planned Behavior, and Information-Motivation-Behavioral Skills were the most used theories. Based on theory integrity, theory rationale, and theory operationalization, most of the studies (60%) were rated high for the application of the theoretical frameworks. Our results suggest a preference for theoretical frameworks targeting individual change rather than community change and the existence of gender disparities in the application of theoretical frameworks. The association between theory and increase of likelihood in vaccine uptake and completion was not supported.
This review spotlights common issues in the application of theoretical frameworks in HPV vaccine interventions in the US. Our results suggest we are still in a developmental phase on several aspects of theory application to HPV vaccination.
理论框架是解释行为改变动态、制定和实施干预研究的有用工具。本系统评价和荟萃分析的目的是评估理论框架和模型在美国（US）从 2006 年 1 月至 2019 年 12 月期间应用于 HPV 疫苗接种干预研究的情况。
我们全面检索了包括 PubMed、EMBASE、ERIC、CINAHL、学术搜索综合版、Scopus、Web of Science 和 PsycINFO 在内的数据库。如果至少有一个理论用于开发干预阶段，则将文章纳入系统分析。所有针对美国人群的干预研究均被纳入，无论其年龄、收入、性别和种族如何。如果涉及疫苗接种率和/或疫苗完成率，则将文章纳入荟萃分析。
健康信念模型、动机访谈、计划行为理论和信息动机行为技能是最常用的理论。基于理论完整性、理论原理和理论操作性，大多数研究（60%）在理论框架的应用方面被评为高分。我们的结果表明，人们更倾向于针对个体变化而不是社区变化的理论框架，并且在理论框架的应用方面存在性别差异。理论与疫苗接种率和完成率增加之间的关联并未得到支持。
本综述强调了美国 HPV 疫苗干预中理论框架应用的常见问题。我们的结果表明，在 HPV 疫苗接种方面，我们仍处于理论应用的几个方面的发展阶段。
