Degarege Abraham, Watanabe-Galloway Shinobu, Mansilla Kristyne, Sileshi Rahel M, Peters Edward S
Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA.
Vaccines (Basel). 2023 Dec 15;11(12):1856. doi: 10.3390/vaccines11121856.
Knowledge of a valid, well-designed, and targeted theory-based framework helps better characterize reasons for HPV vaccine hesitancy and identify promising approaches to increase vaccination rates for eligible individuals. This study evaluated health theories in explaining factors affecting HPV vaccination and used a theoretical framework to identify direct and indirect predictors and mediators of HPV vaccination. A cross-sectional survey regarding HPV vaccine uptake and related factors was conducted among 1306 teenagers and young adults in the Midwest, US, in March and April 2023. Structural equation modeling confirmed fit of the framework based on the Integrated Health Theory (IHT) to the HPV vaccine data (Comparative Fit Index = 0.93; Tucker-Lewis Index = 0.92; Root Mean Square Error of Approximation = 0.053). While willingness to uptake the HPV vaccine directly predicted increased uptake ( < 0.001), perceived benefits ( < 0.001) and barriers ( < 0.023) about the vaccine indirectly predicted increased and decreased uptake, respectively. In turn, beliefs about susceptibility ( = 0.005) and severity ( < 0.001) of HPV infection and associated cancers and barriers to vaccination in general ( < 0.001) indirectly predicted willingness to uptake the vaccine. In conclusion, IHT can be appropriate in examining predictors of HPV vaccine uptake in teenagers and young adults in the US, particularly in the Midwest.
了解一个有效、设计良好且目标明确的基于理论的框架，有助于更好地描述HPV疫苗犹豫的原因，并确定提高符合条件个体疫苗接种率的可行方法。本研究评估了健康理论在解释影响HPV疫苗接种因素方面的作用，并使用一个理论框架来确定HPV疫苗接种的直接和间接预测因素及中介因素。2023年3月和4月，在美国中西部对1306名青少年和青年进行了一项关于HPV疫苗接种情况及相关因素的横断面调查。结构方程模型证实了基于综合健康理论（IHT）的框架与HPV疫苗数据的拟合度（比较拟合指数=0.93；塔克-刘易斯指数=0.92；近似均方根误差=0.053）。虽然接种HPV疫苗的意愿直接预测了接种率的提高（<0.001），但对疫苗的感知益处（<0.001）和障碍（<0.023）分别间接预测了接种率的提高和降低。反过来，对HPV感染及相关癌症的易感性（=0.005）和严重性（<0.001）的信念以及总体上的疫苗接种障碍（<0.001）间接预测了接种疫苗的意愿。总之，IHT适用于研究美国青少年和青年中HPV疫苗接种的预测因素，特别是在美国中西部地区。
