Human Papillomavirus Vaccine Uptake After a Tailored, Online Educational Intervention for Female University Students: A Randomized Controlled Trial. Increasing the intent to receive a pandemic influenza vaccination: Testing the impact of theory-based messages. Influenza vaccination concerns among older blacks: a randomized controlled trial. Factors associated with maternal influenza immunization decision-making What works best: objective statistics or a personal testimonial? An assessment of the persuasive effects of different types of message evidence on risk perception. The efficacy of social role models to increase motivation to obtain vaccination against hepatitis B among men who have sex with men. School-based intervention for the prevention of HPV among adolescents: a cluster randomised controlled study Influenza vaccination acceptance among diverse pregnant women and its impact on infant immunization Influenza Vaccination: The Persuasiveness of Messages Among People Aged 65 Years and Older
BACKGROUND Educational interventions may be a strategy to increase human papillomavirus ( HPV ) vaccination among female university students , but studies to date have shown mixed results . This study evaluated the effect of MeFirst , an individually tailored , online educational intervention , on HPV vaccine-related knowledge , vaccination intention , and uptake among previously unvaccinated female university students . METHODS All female students aged 18 - 26 years who reported being unvaccinated against HPV at a midwestern university were invited via email to enroll . Participants completed an online survey that assessed baseline HPV vaccine-related knowledge , attitudes and vaccination intention .  Participants ( n = 661 ) were then r and omized to receive either an educational website automatically tailored to their baseline survey responses ( MeFirst intervention ) or a st and ard CDC information factsheet on HPV vaccine ( control ) .  Vaccine uptake and repeat knowledge and attitude measures were assessed with online surveys 3 months following the intervention and analyzed using logistic regression models . RESULTS HPV vaccine uptake was similar in both the MeFirst and control groups at 3 months following the intervention ( p = 0.98 ) . Three months after the intervention , the proportion of participants with high knowledge regarding HPV vaccination increased from baseline ( 32 % to 50 % ; p < 0.0001 ) but the proportion with favorable intention was unchanged . CONCLUSIONS We found that an individually tailored , online educational tool had similar effects as a nontailored factsheet on HPV-related knowledge , intention to HPV undergo vaccination , and HPV vaccine uptake among previously unvaccinated female university students OBJECTIVE Vaccination is an effective preventive measure to reduce influenza transmission , especially important in a p and emic . Despite the messages encouraging vaccination during the last p and emic , uptake remained low ( 37.6 % in clinical risk groups ) . This study investigated the effect of different types of messages regarding length , content type , and framing on vaccination intention . METHOD An online experiment was conducted in February 2015 . A representative sample of 1424 people living in Engl and read a mock newspaper article about a novel influenza p and emic before being r and omised to one of four conditions : st and ard Department of Health ( DoH ) ( long message ) and three brief theory-based messages - an abridged version of the st and ard DoH and two messages additionally targeting p and emic influenza severity and vaccination benefits ( framed as risk-reducing or health-enhancing , respectively ) . Intention to be vaccinated and potential mediators were measured . RESULTS The shortened DoH message increased vaccination intention more than the longer one , by increasing perceived susceptibility , anticipated regret and perceived message personal relevance while lowering perceived costs , despite the longer one being rated as slightly more credible . Intention to be vaccinated was not improved by adding information on severity and benefits , and the health-enhancing message was not more effective than the risk-reducing . CONCLUSION A briefer message result ed in greater intention to be vaccinated , whereas emphasising the severity of p and emic influenza and the benefits of vaccination did not . Future campaigns should consider using brief theoretically-based messages , targeting knowledge about influenza and pre caution ary measures , perceived susceptibility to p and emic influenza , and the perceived efficacy and reduced costs of vaccination CONTEXT Vaccination can decrease the morbidity and mortality caused by influenza , yet vaccination rates remain low , especially among minority groups . Previous studies have found that important barriers to vaccination include the fear of adverse reactions and concern that the vaccine causes influenza . BACKGROUND This research aim ed to assess the effects of messages design ed to address concerns about the safety and effectiveness of vaccination among blacks aged > or=50 years . DESIGN In a r and omized controlled trial conducted in 2007 with pre-exposure and post-exposure measurements , participants were r and omly assigned to read either the vaccine safety messages ( VSM ) developed for the study ( treatment condition ) or the vaccine information statement ( VIS ) currently given to those getting the vaccine ( control condition ) . SETTING / PARTICIPANTS A total of 108 participants participated in the study . Data were collected in either participants ' residences , community setting s , or university conference rooms . MAIN OUTCOME MEASURES Influenza vaccine-related beliefs and intention to receive vaccination were assessed . RESULTS Data analysis in 2007 and 2008 found that the r and omization hypotheses of equal groups were retained . Participants exposed to the VSM showed greater improvement in post-exposure beliefs about how the vaccine works ( p=0.0006 ) and the transmission of the flu ( p=0.0034 ) as well as greater post-exposure disagreement with the belief that the vaccine causes influenza ( p=0.0411 ) . CONCLUSIONS The VSM affected beliefs about vaccine safety and effectiveness to a greater degree than did the VIS . These findings show that VSM are effective in changing beliefs empirically linked with influenza vaccination and vaccination disparities . The dissemination of VSM to older blacks may increase vaccination rates and reduce vaccination disparities Objective : We examined pregnant women 's intention to obtain the seasonal influenza vaccine  via a r and omized controlled study examining the effects of immunization history , message exposure , and sociodemographic correlates . Methods : Pregnant women ages 18–50 participated in a  r and omized message framing study from September 2011 through May 2012 . Venue-based sampling was used to recruit racial and ethnic minority women throughout Atlanta , Georgia . Key outcomes were evaluated using bivariate and multivariate analyses . Results : History of influenza immunization was positively associated with intent to immunize during pregnancy [ OR = 2.31 , 90%CI : ( 1.06 , 5.00 ) ] . Significant correlates of intention to immunize included perceived susceptibility to influenza during pregnancy [ OR = 3.8 , 90 % CI : ( 1.75 , 8.36 ) ] and vaccine efficacy [ OR = 10.53 , 90 % CI : ( 4.34 , 25.50 ) ] . Single message exposure did not influence a woman 's intent to vaccinate . Conclusions : Prior immunization , perceived flu susceptibility and perceived vaccine effectiveness promoted immunization intent among this population of pregnant minority women .  Vaccine efficacy and disease susceptibility are critical to promoting immunization among women with no history of seasonal influenza immunization , while those who received the vaccine are likely to do so again . These findings provide evidence for the promotion of repeated exposure to vaccine messages emphasizing vaccine efficacy , normative support , and susceptibility to influenza OBJECTIVE In an experimental online study we compared the effects of different types of persuasive evidence in promoting the acceptance of a personal health risk . DESIGN 118 men who have sex with men ( MSM ) at-risk for infection with the hepatitis B virus ( HBV ) were recruited via a range of websites and r and omly assigned to one of 4 conditions ( 2 experimental and 2 control ) : narrative evidence ( i.e. , a personal account ) , statistical evidence ( i.e. , abstract prevalence data ) , mere assertion of increased risk , and no risk information . MAIN OUTCOME MEASURES  Narrative evidence was expected to be more effective than statistical evidence in increasing MSM 's perceived risk of infection with HBV and intention to obtain vaccination . RESULTS AND CONCLUSION As predicted , perceptions of personal risk and intention to obtain vaccination against HBV were highest after presentation of narrative evidence , and risk perception mediated the effect of type of message evidence on intention . We propose that narrative evidence effectively promotes a sense of personal risk because it is less affected by defensive message processing result ing from the threat to important self-beliefs that seems inherent in health risk communication This study assessed the effects of role models in persuasive messages about risk and social norms to increase motivation to obtain hepatitis B virus ( HBV ) vaccination in men who have sex with men ( MSM ) . MSM at risk for HBV in The Netherl and s ( N = 168 ) were recruited online via a range of websites and were r and omly assigned to one of four conditions in a 2 ( risk communication : yes and no ) × 2 ( social norms communication : yes and no ) factorial design . In each condition , participants subsequently provided self-completed assessment s of their perceived risk of HBV infection , perceived social norms regarding HBV vaccination and their intention to obtain vaccination against HBV . Risk communication and social norms communication that used social role models were effective in significantly increasing men 's intention to obtain vaccination against HBV . No additive effect was found for a combined message . Mediation analyses showed that communications influenced intention via perceived risk and social norms . Findings extend previous theorizing and research and show that both role model-based risk communication and social norms communication can be effective in increasing intentions to obtain HBV vaccination in MSM . This knowledge contributes to the development of effective health promotion to increase HBV vaccination in MSM Objective To improve primary prevention of human papillomavirus ( HPV ) infection by promoting vaccination and increased condom use among upper secondary school students . Design Cluster r and omised controlled trial . Setting 18 upper secondary schools in Sweden . Participants Schools were first r and omised to the intervention or the control group , after which individual classes were r and omised so as to be included or not . Of the 832 students aged 16 years invited to participate during the regular individual health interview with the school nurse , 751 ( 90.2 % ) agreed to participate and 741 ( 89.1 % ) students completed the study . Interventions The intervention was based on the Health Belief Model ( HBM ) . According to HBM , a person 's health behaviour can be explained by individual beliefs regarding health actions . School nurses delivered 30 min face-to-face structured information about HPV , including cancer risks and HPV prevention , by propagating condom use and HPV vaccination . Students in the intervention and the control groups completed question naires at baseline and after 3 months . Main outcome measures Intention to use condom with a new partner and beliefs about primary prevention of HPV , and also specifically vaccination status and increased condom use . Results All statistical analyses were performed at the individual level . The intervention had a significant effect on the intention to use condom ( p=0.004 ) . There was also a significant effect on HBM total score ( p=0.003 ) , with a 2.559 points higher score for the intervention group compared to the controls . The influence on the HBM parameters susceptibility and severity was also significant ( p<0.001 for both variables ) . The intervention also influenced behaviour : girls in the intervention group chose to have themselves vaccinated to a significantly higher degree than the controls ( p=0.02 ) . No harms were reported . Conclusions The school-based intervention had favourable effects on the beliefs about primary prevention of HPV , and increased the HPV vaccination rates in a diverse population of adolescents . Trial registration number NCT02280967 ; Results Objective : We examined pregnant women ’s likelihood of vaccinating their infants against seasonal influenza via a r and omized message framing study . Using Prospect Theory , we tested gain- and loss-frame message effects and demographic and psychosocial correlates of influenza immunization intention . We also explored interactions among pregnant women who viewed “ Contagion ” to underst and cultural influences on message perception . Methods : Pregnant women ages 18–50 participated in a r and omized message framing study from September 2011 through May 2012 that included exposure to intervention or control messages , coupled with question naire completion . Venue-based sampling was used to recruit racial and ethnic minority female participants at locations throughout Atlanta , Georgia . Bivariate and multivariate analyses were conducted to evaluate key outcomes . Results : The study population ( n = 261 ) included many lower income ( ≤ $ 20 000/yearly household earnings ) pregnant participants ( 69.2 % , n = 171 ) inclusive of Black/African Americans ( 88.5 % , n = 230 ) , Hispanic/Latinas ( 7.3 % , n = 19 ) , and Other/Multicultural women ( 4.2 % , n = 11 ) . Both gain [ OR = 2.13 , 90 % CI : ( 1.120 , 4.048 ) ] and loss-frame messages [ OR = 2.02 , 90 % CI : ( 1.083 , 3.787 ) ] were significantly associated with infant influenza vaccination intention compared with the control condition . Intention to immunize against influenza during pregnancy had a strong effect on intent to immunize infants [ OR = 10.83 , 90%CI : ( 4.923 , 23.825 ) ] . Those who had seen the feature film “ Contagion ” ( n = 54 , 20.69 % ) viewed gain- and loss-framed messages as appealing ( x2 = 6.03 , p = 0.05 ) , novel ( x2 = 6.24 , p = 0.03 ) , and easy to remember ( x2 = 16.33 , P = 0.0003 ) . Conclusions : In this population , both gain- and loss-framed messages were positively associated with increased maternal intent to immunize infants against influenza . Message resonance was enhanced among those who saw the film “ Contagion . ” Additionally , history of immunization was strongly associated with infant immunization intention About 90 % of all influenza-related deaths occur among people aged 65 years and older .  Vaccination remains the primary option for preventing influenza infection . This study examined the efficacy of messages design ed to increase the uptake of influenza vaccination . Two messages , narrative and didactic , were created based on the Extended Parallel Process Model ( EPPM ) . The study employed a one-factor between-subjects experimental design with participants assigned r and omly to three conditions : no message , didactic communication , and narrative communication .  Participants were 311 Italian people aged 65 years or older . The results showed that , compared to no message and didactic communication , narrative communication was related to higher risk perception of influenza , to higher perception of the efficacy of the vaccine , and to self-efficacy related to vaccination , controlling for social trust , previous flu shot , and demographic variables . There were no differences among the three conditions with respect to the intention to receive the influenza vaccine . Findings suggest that narrative communication based on EPPM may have a persuasive effect on people aged 65 years or older
PURPOSE There is good evidence that for many behaviours , increasing risk appraisal can lead to a change in behaviour , heightened when efficacy appraisal s are also increased .
The present systematic review addressed whether interventions presenting a risk message increase risk appraisal  and an increase in vaccination intentions and uptake .
Previous research indicates that an increase in  risk appraisal  is associated with increased uptake in health-related behaviours .
Research suggests that interventions increasing risk appraisal have a greater effect on intention when elements of efficacy appraisal s are simultaneously increased .