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Purpose – To provide an overview of racial/ethnic disparities in human papillomavirus (HPV) infection, HPV vaccination, and cervical cancer on domestic and international levels.

Design/methodology/approach – The literature, cervical cancer prevention guidelines, and Centers for Disease Control and Prevention resources were culled to aggregate information on epidemiology, racial/ethnic disparities, and knowledge and attitudes related to HPV, HPV vaccination, and cervical cancer. Original data supplement information about HPV and HPV vaccination knowledge and attitudes.

Findings – Cervical cancer is among the leading causes of female death worldwide, with substantial racial/ethnic and geographic disparities. In the United States, African American and Hispanic women suffer disproportionate cervical cancer incidence and mortality compared to their Caucasian counterparts. Globally, the greatest burden of cervical cancer (and HPV infection) is shouldered by developing regions. Prevention efforts, such as HPV vaccination and adaption of screening programs to resource-poor areas, have the potential to reduce such disparities, but cultural context is critical to successful development and implementation of such interventions.

Research limitations/implications – As this is not a systematic review, but rather a viewpoint on issues related to disparities in cervical cancer, the literature review is not exhaustive.

Practical implications – This chapter provides a context for examining cervical cancer disparities domestically and globally and serves as a starting point for formulating future research.

Originality – This perspective on HPV and cervical cancer presents disparities both within the United States and worldwide. The chapter supplements the literature with new data that provide additional insight into knowledge and attitudes about these health issues.

Based on the examination of the roles of message framing and evidence type, this study made an analysis of the promotion methods of intention and information need towards HPV vaccination.

The study conducted a 2 (gain-framed messages vs loss-framed messages) × 2 (statistical evidence vs narrative evidence) quasi-experimental design built upon theories of message framing and evidence type. This experiment recruited college students who were not vaccinated against HPV as participants. The analysis of variance (ANOVA), the analysis of covariance (ANCOVA), and the independent sample T-test were used to test the hypotheses.

The results (N = 300) indicate that (1) Loss-framed messages will lead to a more favorable intention towards HPV vaccination than gain-framed messages. (2) Statistical evidence will lead to a more explicit information need than narrative evidence. (3) Message framing and evidence type will interact and (a) for statistical evidence, loss-framed messages will lead to a more favorable intention towards HPV vaccination than gain-framed messages and (b) for narrative evidence, gain-framed messages will lead to a more favorable intention towards HPV vaccination than loss-framed messages. (4) Message framing and evidence type will interact and (a) for loss-framed messages, statistical evidence will stimulate more explicit information need of HPV vaccination than narrative evidence and (b) for gain-framed messages, narrative evidence will stimulate more explicit information need of HPV vaccination than statistical evidence.

This paper can help to further understand the important roles of message framing and evidence type in health behavior promotion. The study contributes to the literature on how health information can be well organized to serve the public health communication and further enhance the health information service.

Most cervical cancers are caused by genital human papillomavirus (HPV). However, it can be prevented if females receive an HPV vaccine. Nevertheless, there is limited evidence of HPV vaccination and predictors of intention to obtain the vaccine among young women in Thailand. The paper aims to discuss this issue.

This cross-sectional study examined HPV vaccination and factors influencing intention to vaccinate among a convenient sample of college women in Thailand. The data collection was conducted via a self-administered “HPV and HPV vaccine-related knowledge, attitudes, and behaviors” questionnaire.

Out of 1,030 participants, 309 (30.0 percent) were aware of HPV and the HPV vaccine. Out of these, 257 participants reported that they had not obtained the vaccine and 18 participants were unsure if they had already obtained the vaccine or not. Only 34 participants confirmed that they had received the vaccine. Among those who were aware of HPV and the HPV vaccine, 56.4 percent of them did not know that most HPV-infected persons do not show any signs or symptoms, and 53.3 percent thought that the vaccine provided protection against other sexually transmitted infections as well. Most had positive attitudes toward vaccination and subjective norms. Among the participants who had not received the vaccine, the intention to obtain the vaccine was predicted by age, knowledge, attitudes toward vaccination, and subjective norms. The reasons for not being vaccinated included the cost of the vaccine, lack of knowledge, and perception of themselves being at low risk.

This study found low HPV vaccination among college women. However, those who had not received the vaccine intended to obtain the vaccine at some point in the future. An HPV vaccination campaign may be well tailored in order to increase the intention to obtain the vaccine which, in turn, may increase the HPV vaccination. Vaccination cost sharing should be discussed among Thai policy makers in order to alleviate the financial burden for women.

To measure adolescent girls’ preferences over features of human papillomavirus (HPV) vaccines in order to provide quantitative estimates of the perceived benefits of vaccination and potential vaccine uptake.

A discrete choice experiment (DCE) survey was developed to measure adolescent girls’ preferences over features of HPV vaccines. The survey was fielded to a U.S. sample of 307 girls aged 13–17 years who had not yet received an HPV vaccine in June 2008.

In a latent class logit model, two distinct groups were identified – one with strong preferences against vaccination which largely did not differentiate between vaccine features, and another that was receptive to vaccination and had well-defined preferences over vaccine features. Based on the mean estimates over the entire sample, we estimate that girls’ valuation of bivalent and quadrivalent HPV vaccines ranged between $400 and $460 in 2008, measured as willingness-to-pay (WTP). The additional value of genital warts protection was $145, although cervical cancer efficacy was the most preferred feature. We estimate maximum uptake of 54–65%, close to the 53% reported for one dose in 2011 surveillance data, but higher than the 35% for three doses in surveillance data.

We conclude that adolescent girls do form clear opinions and some place significant value on HPV vaccination, making research on their preferences vital to understanding the determinants of HPV vaccine demand.

DCE studies may be used to design more effective vaccine-promotion programs and for reassessing public health recommendations and guidelines as new vaccines are made available.

Although Human Papilloma Virus (HPV) is the most commonly diagnosed sexually transmitted infection in the USA, much controversy exists with respect to HPV vaccination, especially among parents of adolescents. Previous research has shown that exemplars in the media influence public opinion estimates about controversial social issues. However, little is known about the underlying psychological processes of how exemplars influence public opinion formation. The purpose of this paper is to systematically explore such psychological processes based on the projection theory. To this end, the important yet controversial public health issue, the mandatory HPV vaccination, was chosen.

A two-factor (exemplar vs proportion), between-subject experiment was conducted using online newspaper articles as main stimuli. A total of 138 participants completed the study. The analytical framework comprised the Sobel test with the Bootstrap method and a series of Ordinary Least Square hierarchical regression analyses.

The higher the proportion of exemplars against the HPV vaccination in a news article was, the greater the number of individuals who became opposed to it was. And the high personal opposition translated into negative public opinion change estimation.

The findings indicate that news exemplars may influence individuals’ personal opinion formation, and, in turn, contribute to their estimations of future public opinion climate, as suggested by the projection theory. Theoretical, methodological and practical implications for journalists, health educators and policy makers are discussed.

Effectiveness of message tactics in social marketing projects often varies across groups of individuals, which suggests the importance of tailoring communication approaches to maximize the success of promotional strategies. This study aims to contribute in this direction by using an innovative approach to promote targeted human papillomavirus vaccination, applying conjoint analysis to understand parental preferences for social media content features.

An online purpose-built quantitative survey was administered to a group of parents meeting eligibility criteria. The survey questions were designed based on inputs from formative qualitative research conducted in a previous phase of the study.

In the overall sample of 285 parents, responses show that image was the most important feature of social media posts overall, followed by source and text. Cluster analysis identified eight segments in the sample based on parental preferences for content features. Significant differences across segments were identified in terms of need for cognition, vaccine hesitancy, parental gender, concerns around side effects, trust in medical providers, information sharing behaviors on social media and information seeking online.

The application of conjoint analysis to promotional content allows to assess which features of the content are most important in persuading different individuals and provide insights on how people process the information, ultimately to inform targeted promotion based on preferences. Conjoint analysis has been widely used in consumer research to explore audience preferences for products or services, but only a few applications of conjoint analysis to the design and testing of promotional content are found in the literature.

Vaccination is widely conceded as a pivotal measure to achieve community immunization and eradicate COVID-19. The purpose of this paper is to understand vaccination behavior based on the association between the theory of planned behavior (TPB) and health belief model (HBM).

A self-administered questionnaire was designed to collect data from 438 participants through social media in Vietnam and later analyzed using SPSS and AMOS to examine the research model.

The results indicated that attitude toward vaccination is positively influenced by perceived risk and perceived benefits. Additionally, background constructs of TPB (i.e. social norms, attitude and perceived behavioral control) and HBM (i.e. perceived risk, response efficacy, perceived benefits and knowledge about COVID-19) are underlying motivations for individual intention to receive vaccine. Moreover, age is a demographic predictor of vaccination intention. Finally, vaccination intention facilitates COVID-19 vaccination.

The findings will assist health-care bodies and authorities to understand public perceptions, attitude and behaviors and encourage their participation in vaccination campaigns.

To date, this is the first investigation of how disease knowledge and perceived benefits drive vaccination intention in Vietnam. Moreover, this study may be initially successful in adding current health-care behavior literature by combining TPB with HBM. With most studies on vaccination intention at the early stage of COVID-19 outbreak in developed nations, this work provides new insights by testing vaccination behavior in the fourth wave of COVID-19 outbreak and in a developing nation.

The purpose of this paper is to present a three-part framework of information engagement for situated gynecological cancers. These particular cancers intertwine with medicalization of sexuality and gender power dynamics, situating information behaviors and interactions in women’s socio-health perceptions. Using Kavanagh and Broom’s feminist risk framework, the framework establishes functional and temporal parameters for sense-making and information engagement.

This paper employs a structured, reiterative literature review with emergent thematic analysis. Nine indices from medicine, information studies, and sociology were searched using combinations of five terms on cervical cancer (CC) and 14 terms on information engagement in the title, abstract, and subject fields. Results were examined on a reiterative basis to identify emergent themes pertaining to knowledge development and information interactions.

Environmentally, social stigma and gender roles inhibit information seeking; normalizing CC helps integrate medical, moral, and sexual information. Internally, living with the dichotomy between “having” a body and “being” a body requires high-trust information resources that are presented gradually. Actively, choosing to make or cede medical decision-making requires personally relevant information delivered in the form of concrete facts and explanations.

The study covers only one country.

This study’s information framework and suggestions for future research encourage consideration of gender power dynamics, medicalization of sexuality, and autonomy in women’s health information interactions.

The aim of the paper is to investigate the impact of pre‐existing audience mood on responses to health public service advertisements (PSAs). The paper also aims to show the practical and theoretical importance of mood as a variable in health communication.

Hypotheses regarding the impact of audience mood on the outcome of health PSAs were tested experimentally using health PSAs about vaccination and virus detection behaviors.

The influence of pre‐existing mood was mediated by the perceived risk of contracting the illness mentioned in the health advertisement. Personal estimations of risk mediated the impact of audience mood on behavioral intent and actual behavior. The more negative one's mood, the higher the perceived risk of contracting the disease mentioned in the message, and the more likely one was to adopt the precautionary behavior recommended by the PSA. Positive mood had opposite effects.

The findings suggest a novel media planning approach to maximizing the effectiveness of health risk messages. Due to the impact of context‐induced mood on perceptions of risk, messages could be more effective if placed in editorial contexts which induce negative mood (e.g. crime investigation reports) versus environments which induce positive mood (e.g. sitcoms), because negative mood makes people think they are more at risk and motivates them to act.

The mood‐and‐risk mediation hypothesis proposed here has never been examined in public health marketing. Findings call for further research on the impact of contextual affect on responses to public health communication. The paper suggests a new placement technique for media planners working in public health advertising.

Cervical cancer (CxCa) incidence and mortality remain unacceptably high in South Carolina, USA, presenting an ideal opportunity for intervention. To address this need, Cervical Cancer-Free South Carolina developed an academic-community partnership with researchers and students at a public university to design, implement, and evaluate a theory-based CxCa communication campaign, It’s My Time. The paper aims to discuss this issue.

The goal of this campaign was to decrease CxCa by increasing human papillomavirus (HPV) vaccination and appropriate screening. This paper describes the development, implementation, and evaluation of a successful theory-based CxCa prevention communication campaign for college women based on formative audience research and targeted messages delivered to audience segments through new and traditional communication channels. The health belief model (HBM) served as a theoretical framework for the campaign throughout development, implementation, and evaluation.

This campaign demonstrated the effectiveness of the HBM to address CxCa prevention, including HPV vaccine acceptability. The campaign aimed to increase perceptions of susceptibility, which were low, by emphasizing that HPV is a sexually transmitted infection. A community-based grassroots approach to addressing disparities in CxCa prevention increased benefits and decreased barriers. Social media emerged as a particularly appropriate platform to disseminate cues to action. In total, 60 percent of participants who responded to an anonymous web-based survey evaluation indicated that they received the HPV vaccine as a result of campaign messages.

This paper offers practical suggestions to campaign planners about building academic-community partnerships to develop theory-based communication campaigns that include conducting formative research, segmenting target audiences, engaging with young people, and incorporating social media.