Predicting parents' HPV vaccination intentions and behaviors across countries and time

This study compares three models of parental human papillomavirus (HPV) vaccination intentions across United States, United Kingdom, and Germany: A model based on the theory of planned behavior (TPB), a model incorporating variables of the health belief model (HBM), and a model that adds factors identified in previous empirical research. We also examine whether these models predict vaccination behavior 1 year later in the United States and United Kingdom. The goal is to provide insights for designing targeted interventions.

A preregistered online study (February-March 2023) surveyed 1,088 parents from United States, United Kingdom, and Germany measuring variables related to the TPB (attitudes, subjective norms, and perceived behavioral control) and the HBM (risk and effectiveness perceptions), factors identified in previous empirical research (e.g., knowledge), and HPV vaccination intentions. One year later, 625 participants (United States and United Kingdom) were recontacted to assess vaccination behavior.

Structural equation modeling revealed that TPB accounted for 77% of the variance of vaccination intentions. HBM variables were associated with attitudes (85% variance accounted for). Vaccination intentions, trust in science, and HPV vaccination knowledge predicted vaccination behavior 1 year later (25% variance accounted for).

TPB was strongly associated with parental HPV vaccination intentions, with attitudes and norms as key correlates. HBM variables were associated with attitudes but did not improve behavior predictions. Trust in science and HPV knowledge directly predicted vaccination behavior 1 year later. These findings suggest that interventions should target TPB and HBM variables to shape intentions and attitudes while fostering vaccination knowledge to sustain long-term behavior. (PsycInfo Database Record (c) 2026 APA, all rights reserved).