Examining predictors of intention to get HPV vaccine in women aged 18-26 in the risk group for HPV within the framework of the integrated behavior model and the precaution adoption process model

HPV is one of the most common sexually transmitted viruses that can cause physical diseases such as such as cervical cancer and genital warts. HPV infection and related diseases can also lead to psychosocial problems and make life difficult in many ways. Female university students are in the highest risk group in terms of contracting HPV infection. Although vaccination is the most effective way to protect against the virus, vaccination rates are low in this group. The aim of this study is to examine the factors affecting HPV vaccination intention of female university students aged 18-26 who are in the risk group for HPV within the framework of Integrated Behavioral Model (IBM) and Precaution Adoption Process Model (PAPM). In line with the purpose of the study, taking into account the recommendations of IBM, a qualitative preliminary study was conducted to reveal the emotions and beliefs, social norms and control beliefs of the target group about the HPV vaccination. These beliefs formed the content of the group-specific battery developed to evaluate the constructs of IBM. The battery was replied by 355 female university students who have not yet had the HPV vaccine consisting of three doses. The analyses carried out to examine the psychometric properties of the scales in the battery provided evidence that the scales have high reliability and validity. Finding about explanatory power of IBM shows that, IBM explains the college women's intention to get HPV vaccine by 68%. According to results, female university students who have more positive attitude towards vaccination, higher supportive injunctive norm that important people in the social environment will support the vaccination and higher self efficacy to be able to get the vaccine despite obstacles, have higher intention to vaccinate. Other model constructs; opposing injunctive norms, descriptive norms and perceived behavioral control did not predict intention. However, by using scales in the battery and revealing the specific beliefs that best explain the intention among the specific beliefs underlying the BDM structures, it is found that, there are important beliefs that can be targeted in interventions under all IBM constructs. Then, the intention process was phased and the stage distribution of the sample was examined according to the PAPM and it was found that the majority of the participants were at the stage of unawareness (28.7%) and indifference towards the HPV vaccine (42.5%), which are the two most distant stages to have HPV vaccine. According to the findings of the analyses based on the PAPM, the model's predictions that people can take part in different stages in the decision-making process of behavior and that people at different stages may need different interventions are supported. Considering the staging system of PAPM and the structures of IBM together, suggestions were made regarding model-based and phase-specific intervention contents for interventions that can be made with people who are unaware of, unengaged by and undecided about HPV vaccination and findings were discussed within the framework of the literature. Keywords: Integrated Behavioral Model, Precaution Adoption Process Model, HPV, HPV vaccination intention, female college students