The Impact of Theory in HPV Vaccination Promotion Research: A Systematic Review and Meta-Analysis

Objective: Numerous studies examined HPV vaccination promotional strategies. However, an overview of theory use, a synthesis of strategies' effectiveness and an examination of the moderating influence of theory are absent. Data Source: We retrieved studies from Academic Search Complete, Business Source Complete, PubMed, PsycINFO, Web of Science, CMMC, CINAHL, and MEDLINE. Study Inclusion and Exclusion Criteria: 1) peer-reviewed articles written in English, 2) experimental or quasi-experimental, 3) measure HPV vaccination-related outcomes, 4) had to contain a control condition and report statistics necessary for conversion (for meta-analysis only). Data Extraction: 70 and 30 studies were included for the systematic review and meta-analysis respectively. Data Synthesis: Four major categories were coded: study information, theory use, type of theory, and outcomes. Two independent coders coded the sample (Cohen's Kappa ranged from .8 to 1). Results: Most of the studies were based in the U.S. (77%, k = 54) with convenient samples (80%, k = 56), targeted toward females (46%, k = 32), and around a quarter did not employ any theories (47%, k = 33). Among theory-driven studies, the most commonly used were Framing (22%, k = 19), Health Belief Model (HBM; 13%, k = 12), and Narrative (7%, k = 6). Among controlled studies, promotional strategies were significantly more effective compared to the control (r+ = .25, p<.001). Strategies guided by the information, motivation, behavioral skills model (IMB) were more effective (r+ = .75, p<.001) than studies guided by framing theory (r+ = .23, p < .001), HBM (r+ = .01, p<.001), and other theories (r+ = .11, p<.001). Conclusion: This review contributes to HPV vaccination promotion literature by offering a comprehensive overview of promotional strategies and practical suggestions for future research and practices.

Automated summary

This study provides a comprehensive overview of HPV vaccination promotion strategies and empirical research, finding that strategies guided by the Information, Motivation, Behavioral Skills model (IMB) are more effective than those guided by other theories. The study also offers practical suggestions for future research and practices in HPV vaccination promotion.