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Abstract
This dissertation employs two experiments to advance understanding of stigmatization associated with HPV and how it can be reduced by examining the potential role of message-sidedness and exemplars in HPV vaccine campaign messages. With a goal of finding out effective messaging strategies for how young adults perceive HPV de-stigmatization and increase positive attitudes and behavioral intentions for HPV vaccination, Study 1 explored how message-sidedness can address belief barriers associated with stigmatization related to HPV. There are two commonly observed belief barriers among young adults for why they have not been vaccinated for HPV. These are believing: 1) “HPV is rare” and 2) “Only people with multiple sex partners can get HPV.” In Study 1, for these two common belief barriers young adults have towards HPV, a one-way ANCOVA for six between-subject message conditions was conducted (two sets of one-sided, two-sided refutational, two-sided non-refutational). HPV Knowledge, HPV vaccine safety concern, and self-disclosure were chosen as covariates. A total of 171 participants from the age of 19 to 26 were recruited through Amazon Mechanical Turk. Analysis shows that the combination of the two-sided refutational message for belief barrier 2 was found to be the most effective in achieving positive attitudes [F(5, 166) = 2.20, p < .05, ηp2 = .06] and behavioral intentions for HPV vaccination [F(5, 166) = 2.12, p < .05, ηp2 = .05] while lowering external stigma.
Based on the findings of Study 1, a one-way ANCOVA between-subject experiment with four levels (non-exemplar, exemplar with symptoms, exemplar with constructive shame approach, and exemplar with non-constructive shame approach) was conducted. HPV Knowledge, HPV vaccine safety concern, and self-disclosure were chosen as covariates. Study 2 incorporated concepts from the theory of exemplification to find out the most effective messaging in persuading young adults to receive an HPV vaccine with lowering both perceptions of internal and external stigma. Study 2 recruited 141 participants from the age of 19 to 26 using Amazon Mechanical Turk. Participants in the constructive shame approach condition expressed positive attitudes and behavioral intentions for HPV vaccination, and these were mediated by lower level of internal [point estimate = .12, SE = .07, 95% CI (.07, .17)] and external stigma [point estimate = .23, SE = .19, 95% CI (.06, .39)].
For practical implications, these findings can contribute directly to increase HPV vaccination behavioral intentions for health organizations’ HPV vaccination campaign messaging strategies on social media platforms. Theoretically, these findings show when the message is two-sided and refutational in a form of exemplar with constructive shame approach, low level of internal and external stigma can be mediators to increase the persuasive outcomes for HPV vaccination. More theoretical and practical implications for social media mediated communication and health communication for HPV vaccination will be discussed.
INDEX WORDS: Stigma, Internal stigma, External stigma, Susceptibility, Attitude,
Behavioral intention, HPV, HPV vaccine, HPV vaccination,
vaccine, vaccination, Health communication, Health campaigns
Based on the findings of Study 1, a one-way ANCOVA between-subject experiment with four levels (non-exemplar, exemplar with symptoms, exemplar with constructive shame approach, and exemplar with non-constructive shame approach) was conducted. HPV Knowledge, HPV vaccine safety concern, and self-disclosure were chosen as covariates. Study 2 incorporated concepts from the theory of exemplification to find out the most effective messaging in persuading young adults to receive an HPV vaccine with lowering both perceptions of internal and external stigma. Study 2 recruited 141 participants from the age of 19 to 26 using Amazon Mechanical Turk. Participants in the constructive shame approach condition expressed positive attitudes and behavioral intentions for HPV vaccination, and these were mediated by lower level of internal [point estimate = .12, SE = .07, 95% CI (.07, .17)] and external stigma [point estimate = .23, SE = .19, 95% CI (.06, .39)].
For practical implications, these findings can contribute directly to increase HPV vaccination behavioral intentions for health organizations’ HPV vaccination campaign messaging strategies on social media platforms. Theoretically, these findings show when the message is two-sided and refutational in a form of exemplar with constructive shame approach, low level of internal and external stigma can be mediators to increase the persuasive outcomes for HPV vaccination. More theoretical and practical implications for social media mediated communication and health communication for HPV vaccination will be discussed.
INDEX WORDS: Stigma, Internal stigma, External stigma, Susceptibility, Attitude,
Behavioral intention, HPV, HPV vaccine, HPV vaccination,
vaccine, vaccination, Health communication, Health campaigns