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Application of theoretical frameworks on human papillomavirus vaccine interventions in the United States: systematic review and meta-analysis

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Abstract

Purpose

Theoretical frameworks are useful tools to explain the dynamics of behavioral change, develop, and implement intervention studies. The purpose of this systematic review and meta-analysis is to evaluate the application of theoretical frameworks and models to HPV vaccination intervention studies in the United States (US) from January 2006 to December 2019.

Methods

A comprehensive search across databases, including PubMed, EMBASE, ERIC, CINAHL, Academic Search Complete, Scopus, Web of Science, and PsycINFO, was conducted. Articles were included in the systematic analysis if at least one theory was used to develop the intervention phase. All intervention studies targeting populations in the US without restrictions of age, income, sex, and ethnicity were included. Articles were included in the meta-analysis if vaccine uptake and/or vaccine completion was addressed.

Results

The Health Belief Model, Motivational Interviewing, Theory of Planned Behavior, and Information–Motivation–Behavioral Skills were the most used theories. Based on theory integrity, theory rationale, and theory operationalization, most of the studies (60%) were rated high for the application of the theoretical frameworks. Our results suggest a preference for theoretical frameworks targeting individual change rather than community change and the existence of gender disparities in the application of theoretical frameworks. The association between theory and increase of likelihood in vaccine uptake and completion was not supported.

Conclusion

This review spotlights common issues in the application of theoretical frameworks in HPV vaccine interventions in the US. Our results suggest we are still in a developmental phase on several aspects of theory application to HPV vaccination.

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Data availability

As this is a systematic review and meta-analysis, this is not applicable. Data used are available in the published papers included in their respective journals.

Code availability

Not applicable.

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Authors and Affiliations

  1. Department of Public Health, Baylor University, 1621 S. 5th Street, Waco, TX, 76706, USA

    Cesia Cotache-Condor & Matthew Asare

  2. Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA

    Matthew Peterson

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Contributions

CCC conceptualized and designed the project, conducted data collection, data analysis, and interpretation, and wrote the first draft. MP conducted data analysis and interpretation and contributed to the manuscript writing. MA oversaw the project and contributed with critical revision of the manuscript for important intellectual content. All authors contributed with critical revision of the manuscript for important intellectual content. All authors attest they meet the ICMJE criteria for authorship.

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Correspondence to Cesia Cotache-Condor.

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Cotache-Condor, C., Peterson, M. & Asare, M. Application of theoretical frameworks on human papillomavirus vaccine interventions in the United States: systematic review and meta-analysis. Cancer Causes Control 33, 15–24 (2022). https://doi.org/10.1007/s10552-021-01509-y

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