Abstract:
Background. Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the United States. College-age males influence acquisition and transmission of HPV due to engagement in high-risk sexual behaviors. HPV vaccination is an efficacious strategy for reducing the burden of HPV-associated morbidity; yet rates of HPV vaccination remain low among college males. The purpose of this study was to operationalize the direct constructs of the theory of planned behavior (TPB) to predict the HPV vaccination behavioral intentions of male undergraduate college students attending a large public southeastern university. Methods. A non-experimental, cross-sectional study design was employed with 256 vaccine-eligible college males. Instrumentation comprised a qualitative elicitation study, face and content validity by a panel of seven experts, readability and comprehensibility by pilot test, stability reliability by test-retest, internal consistency applying Cronbach’s alpha, construct validity applying confirmatory factor analysis, and predictive validity applying structural equation modeling. Results. Approximately one third (31.3%) of the sample was unaware of HPV and nearly half (45.3%) of the sample was unaware of the HPV vaccine. The final structural model exhibited acceptable fit of the data (Chi-square test = 129.78; degrees of freedom, df = 70, p = .000; Kline’s alternative, KA = 1.854; Goodness-of-fit index, GFI = 0.932; Normed fit index, NFI = .948; Root mean square error of approximation, RMSEA = 0.054). Attitude toward the behavior and subjective norm were significant predictors of behavioral intention, accounting for 58% of the variance in behavioral intention. Perceived behavioral control was found to be a non-significant predictor of behavioral intention. Overall, college males reported low behavioral intentions to get the vaccine (M = 8.52; SD = 5.30). Discussion. A valid and reliable instrument designed to measure constructs from the TPB was developed to predict HPV vaccination intentions of college males. Findings from this study provided an instrument that may be applied in the design and evaluation of TPB-based interventions to promote HPV vaccination among undergraduate college males. Future research may examine possible mediators and moderators of TPB constructs to fully operationalize the theoretical framework.
