Factors Associated with Intention to receive Human Papillomavirus Vaccine in Undergraduate Women: An Application of the Theory of Planned Behavior

계획된 행위 이론을 적용한 여대생의 인유두종 바이러스 백신 접종의도 영향요인

  • Lee, Kyu Eun (Department of Nursing, Catholic Kwandong University)
  • 이규은 (가톨릭관동대학교 간호학과)
  • Received : 2014.06.30
  • Accepted : 2014.11.03
  • Published : 2014.11.30


Purpose: The purpose of this study was to apply Ajzen's theory of planned behavior to identify factors that affect undergraduate women's decisions to receive human papillomavirus(HPV) vaccination. Method: The research design for this study was a descriptive survey design using convenience sampling. Data collection was done using self-report questionnaires with 254 undergraduate students in G city. Data were analyzed using percentage, mean, standard deviation, t-test, ANOVA, Mann-Whitney U test, Pearson correlation analysis and multiple regression with the SPSS Win 20.0 Program. Results: The mean score of intention to receive HPV vaccine was $3.88{\pm}1.05$ out of a possible 7. Intention to receive HPV vaccine showed a significantly positive correlation with attitudes (r=.26, p<.001), subjective norm (r=.51, p<.001), perceived behavior control (r=.41, p<.001) to receive HPV vaccination. In the multiple regression analysis, subjective norm and perceived behavior control to receive HPV vaccine were significant predictors and explained 33.7% of intention to receive HPV vaccine. Conclusion: Results of this study show that there are significant factors affecting the intention of undergraduate women to receive HPV vaccination. Also, strategies emphasizing subjective norm and perceived behavior control in obtaining HPV vaccination should be taken into account in developing educational programs.


  1. Crosbie EJ, Einstein MH, Franceschi S, Kitchener HC. Human papillomavirus and cervical cancer. Lancet. 2013;382(9895):889-899.
  2. Dunne EF, Unger ER, Sternberg M, McQuillan G, Swan DC, Patel SS, et al. Prevalence of HPV infection among females in the United States. Journal of the American Medical Association. 2007;.297(8):813-819.
  3. Franceschi S, Herrero R, Clifford GM, Snijders PJ, Arslan A, Anh PT, et al. Variations in the age-specific curves of human papillomavirus prevalence in women worldwide. International Journal of Cancer. 2006;119(11):2677-2684.
  4. Jung KW, Won YJ, Kong HJ, Oh CM, Seo HG, Lee JS. Cancer statistics in Korea: Incidence, mortality, survival, and prevalence in 2011. Cancer Research and Treatment. 2014;46(2):109-123.
  5. Wong MCS, Lee A, Ngai KLK, Chor JCY, Chan PKS. Knowledge, attitude, practice and barriers on vaccination against human papilomavirus infection: A cross-sectional study among primary care physicians in Hong Kong. Public Library of Science. 2013;8(8):e71827.
  6. Kim CJ, Park TC, Park JS. Efficacy of human papillomavirus vaccines including cross protection: A review of recent evidence. Korean Journal of Obstetrics and Gynecology. 2010;53(2):103-118.
  7. Ratanasiripong NT. A review of human papillomavirus (HPV) infection and HPV vaccine-related attitudes and sexual behaviors among college-aged women in the United States. Journal of American College Health. 2012;60(6):461-470.
  8. Taylor LD, Hariri S, Sternberg M, Dunne EF, Markowitz LE. Human papillomavirus vaccine coverage in the United States, National Health and Nutrition Examination Survey, 2007-2008. Preventive Medicine. 2011;52(5):398-400.
  9. Bang KS, Sung SM, Koo BY, Kim MJ, Kim YN, Kim JS, et al. Female university students' HPV-related knowledge and influencing factors on HPV vaccination. Journal of Korean Oncology Nursing. 2011;11(3):186-192.
  10. Park JS, Lee EJ. Predictors of human papillomavirus vaccination in female university students. Korean Journal of Women Health Nursing. 2011;17(4):346-358.
  11. Yoo SJ, Jeong HJ, Park HS. The analysis on factors affecting the intention for H1N1 virus vaccination and the impact of negative news reports the comparison between HBM and TPB. Korean Association for Advertising and Public Relations. 2010;12(3):283-319.
  12. Hwang SW. Structural equation modeling on contraceptive behaviors of unmarried men and women in Korea [dissertation]. Seoul: Seoul National University; 2013. p. 2.
  13. Ajzen I. The theory of planned behavior. Organizational Behavior and Human Decision Processes. 1991;50(2):179-211.
  14. Juraskova I, O'Brien M, Mullan B, Bari R, Laidsaar-Powell R, McCaffery K. HPV vaccination and the effect of information framing on intentions and behaviour: An application of the theory of planned behaviour and moral norm. International Journal of Behavioral Medicine. 2012;19(4):518-525.
  15. Park HM. Factors associated with the intention of human papillomavirus vaccination among mothers of junior high school daughters: An analysis based on the theory of planned behavior [master's thesis]. Gwangju: Chosun University; 2013. p. 13.
  16. Askelson MN, Campo C, Lowe BJ, Smith S, Dennis KL, Using the theory of planned behavior to predict mother' intention to vaccinate their daughters against HPV. The Journal of School Nursing. 2010;26(3):194-202.
  17. Gerend MA, Shepherd JE. Predicting human papillomavirus vaccine uptake in young adult women: Comparing the health belief model and theory of planned behavior. Annals of Behavioral Medicine. 2012;44(2):171-180.
  18. Kline RB. Principles and practice of structural equation modeling. 2nd ed. New York: Guilford Press; 2005. p111.
  19. Ajzen, I. Constructing a theory of planned behavior questionnaire [Internet]. Ireland: Measurement instrument Database for the Social Sciences Ireland; 2013 [cited 2014 May 2]. Available from:
  20. Lee SH. Undergraduate students' sexual behavior and influencing factors: An analysis based on the theory of planned behavior [master's thesis]. Chungju: Konkuk University; 2005. p. 15-16.
  21. Samkange-Zeeb F, Spallek L, Klug SJ, Zeeb H. HPV infection awareness and self-reported HPV vaccination coverage in female adolescent students in two German cities. Journal of Community Health. 2012;37(6):1151-1156.
  22. Bendik MK, Mayo RM, Parker VG. Knowledge, perceptions, and motivations related to HPV vaccination among college women. Journal of Cancer Education. 2011;26(3):459-464.
  23. Kahn JA, Rosenthal SL, Hamann T, Bernstein DI. Attitudes about human papillomavirus vaccine in young women. International Journal of STD & AIDS. 2003;14(5):300-306.
  24. Kim KS, Kim BJ, Kim KH, Kwon SH, Kim SK. Factors associated with intention for additional vaccination in mothers with children aged 4-6 years. Child Health Nursing Research. 2007;13(4):478-485.
  25. Casey BR, Crosby RA, Vanderpool RC, Dignan M, Bates W. Predictors of initial uptake of human papillomavirus vaccine uptake among rural Appalachian young women. Journal of Primary Prevention. 2013;34(1-2):71-80.
  26. Kim HW. Factors influencing mothers' acceptance of human papillomavirus vaccination to prevent cervical cancer in their daughters. Korean Journal of Women Health Nursing. 2011;17(2):137-147.
  27. Weisberg E, Bateson D, McCaffery K, Skinner SR. HPV vaccination catch up program -Utilisation by young Australian women. Australian Family Physician. 2009;38(1-2):72-76.
  28. Conroy K, Rosenthal SL, Zimet GD, Jin Y, Bernstein DI, Glynn S, et al, Human papillomavirus vaccine uptake, predictors of vaccination, and self-reported barriers to vaccination. Journal of Women's Health. 2009;18(10):1679-1686.
  29. Allen JD, Mohllajee AP, Shelton RC, Othus MKD, Fontenot HB, Hanna R. Stage of adoption of the human papillomavirus vaccine among college women. Preventive Medicine. 2009;48(5):420-425.
  30. Bang SH, Yoo AR, Cho SY, Choi IS, Kim SW, Jeong Y, et al. Human papillomavirus vaccination status and related factors among some female college students. Journal of the Korean Society of Maternal and Child Health. 2012;16(2):186-194.

Cited by

  1. Heat Application According to Nurse's Belief on Evidence-Based Practice and Behavioral Intention Related to Research vol.23, pp.3, 2016,
  2. Factors Associated with Human Papillomavirus Vaccination and Intention among Male and Female College Students vol.15, pp.3, 2015,
  3. Factors involved in human papillomavirus (HPV) vaccine hesitancy among women in the South-East Asian Region (SEAR) and Western Pacific Region (WPR): A scoping review 2017,
  4. Predictors of HPV Vaccination Status in Female Nursing University Students: HPV related Knowledge and Perception vol.29, pp.3, 2016,
  5. Factors affecting Human Papillomavirus Vaccination among College Nursing Students vol.17, pp.3, 2016,
  6. Factors influencing Human Papillomavirus Vaccination intention in Female High School Students: Application of Planned Behavior Theory vol.24, pp.1, 2018,