Date of Award
1-1-2025
Document Type
Dissertation
Degree Name
Ph.D. in Health and Kinesiology
First Advisor
Allison Ford-Wade
Second Advisor
Marie Barnard
Third Advisor
Hannah Allen
School
University of Mississippi
Relational Format
dissertation/thesis
Abstract
Background: Human Papillomavirus (HPV) is the most common sexually transmitted infection in the United States (U.S.). Approximately 42.5 million individuals in the U.S. are infected with disease-associated HPV, and 13 million new cases occur every year. It is estimated that 85% of sexually active adults will be infected with HPV at some point during their lifetime. Most individuals infected with HPV are asymptomatic and clear the virus without any complications. However, in some individuals, the virus persists. Prolonged HPV infection has been associated with six different types of cancer and genital warts. There are approximately 37,000 cases of HPV-associated cancers diagnosed annually in the U.S. In 2006, a highly effective vaccine was approved for use in the U.S., which has been shown to be able to prevent 90% of HPV-associated cancers. Although the vaccine has displayed proven safety and efficacy, uptake of the vaccine among adolescents continues to lag. This lag in vaccination among adolescents has led to an increased need for catch-up vaccination. College students represent an ideal population to target for catch-up HPV vaccination. Previous research has examined HPV knowledge, attitudes, beliefs, and behaviors among college students; however, most of this research has occurred among students attending four-year universities. While community college students comprise 41% of all undergraduate college students in the U.S., limited HPV-related research exists among this population.
Purpose: This study sought to: 1) review the current literature on knowledge, attitudes, beliefs, and behaviors around HPV and HPV vaccination among community college students in the United States; 2) evaluate the psychometric properties of a tool developed to assess knowledge, beliefs, and behaviors related to HPV and the HPV vaccine among college students; 3) assess knowledge, beliefs, and behaviors related to HPV and the HPV vaccine among a sample of college students across Mississippi and examine potential differences between community college students and those attending a traditional, four-year institution.
Methods: The methods for this study included: 1) A scoping review was conducted in accordance with the Joanna Briggs Institute methodology using published research from PubMed, Embase, PsycINFO, and CINAHL databases that addressed knowledge, attitudes, beliefs, and behaviors around HPV and HPV vaccination among community college students in the United States; 2) Rasch modeling was utilized to determine differential item functioning, model-data fit, unidimensionality and local independence, item difficulty estimates, person ability estimates, and optimal categorization for a previously published tool; 3) A descriptive, cross-sectional study was utilized to assess student knowledge, beliefs, and behaviors related to HPV and HPV vaccination and identify factors associated with vaccination.
Results: In paper one, significant gaps in literature were identified relating to HPV-related knowledge, awareness, beliefs, and behaviors among community college students. Fourteen studies were identified that included community college students, but only 57% of these included disaggregated data specific to the community college student population. While all 14 studies examined HPV vaccine behaviors, most did not assess the knowledge, awareness, or beliefs of community college students. Following the guidelines for Rasch modeling, paper two validated instrument for effectively measuring HPV knowledge, beliefs, and behaviors across a broad sample of undergraduate college students. Paper three examined knowledge, beliefs, and behaviors among a sample of community college students across Mississippi using the newly validated instrument, and explored potential differences between community college students and those attending a university. Community college students displayed distinct healthcare beliefs and behaviors compared to university students. Community college students were less likely to have completed the HPV vaccination series compared to university students. Additionally, HPV vaccine completion was found to also be significantly impacted by HPV vaccine confidence, receiving a provider recommendation, and race, with Black students having greater odds of vaccine completion than White students.
Recommended Citation
Pittman, Eric, "Human Papillomavirus Knowledge, Beliefs, and Behaviors Among Community College Students: Why Should It Matter?" (2025). Electronic Theses and Dissertations. 3357.
https://egrove.olemiss.edu/etd/3357