Date of Award


Publication Type

Doctoral Thesis

Degree Name




First Advisor

Kathryn Lafreniere


Behavioral psychology, Public health



Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.


The HPV vaccine was first made available to girls and women in 2006. Despite support for the vaccine from health care professionals and governments, vaccination rates remain lower than anticipated. This study had two goals: (1) To investigate factors that predict actual and intended vaccinations, and (2) to test a model of HPV vaccination intentions. An adapted Health Belief Model was used as the theoretical framework to guide this study. The model components assessed in this study were: Perceived severity, perceived susceptibility, perceived barriers, perceived benefits, cues to action, self-efficacy, knowledge, and subjective norms. Each model component was assessed by at least one variable, with some model components being assessed with multiple variables. Participants were 374 women, aged 18 to 30, residing in Canada. Data were collected using an online questionnaire. Logistic regression analyses revealed that actual vaccination decisions were directly influenced by the following model components and variables: Perceived severity (severity of treatment), perceived barriers (vaccine safety concerns, fear of doctor stigma, insurance coverage), and cues to action. Multiple regression analyses revealed that vaccination intentions were influenced by: Perceived benefits (vaccine positive beliefs, vaccine effectiveness), barriers (vaccine safety concerns), cues to action, self-efficacy, and subjective norms. A structural equation model to assess HPV vaccination intentions was tested. With a few modifications, support for the model was found. This model revealed that all of the theoretical components measured in this study contributed directly or indirectly to vaccination intentions. This study revealed that actual and intended HPV vaccinations are predicted by different variables. In addition, it also found support for a complex model of vaccination intentions. A unique contribution was the finding that women's fear of experiencing stigma from doctors by asking for the vaccine impacted actual vaccination decisions. Vaccine safety concerns were also found to impact actual uptake. Finally, healthcare professionals may also benefit from understanding that cues to action were found to be predictive of behaviours, suggesting that women who are exposed to more cues are more likely to get vaccinated.