An Investigation of Cognitive Processing of Fear Appeal Messages Promoting HPV Vaccination: Predictors and Outcomes of Magnitude and Valence of Cognitive Responses

Abstract: An improvement in HPV vaccination rates is one of the primary goals of public health organizations. Toward this end, fear appeal communication is commonly used in health interventions, warning individuals of threats of HPV infection and promoting vaccination. However, little is known about how threat-related emotions, such as fear and anxiety, influence the cognitive processing of vaccination information and how this processing is associated with vaccination intention. To address this void, this study tests a model drawing upon functional emotion theories and dual-process models of persuasion. Results from an experimental study showed that fear and anxiety, which arose from exposure to threat information, triggered motivation to process HPV protection-related information, which in turn, was positively associated with depth of HPV vaccination information processing. Subsequently, greater depth of processing led to a greater number of positive cognitive responses when participants were presented with information with a high (vs. low), level of response efficacy. Finally, greater positivity of cognitive responses predicted greater intention to obtain HPV vaccination. Collectively, our findings provide a theory-based explanation about how the sequential provision and processing of threat and efficacy information in fear appeals contribute to the promotion of HPV vaccination. Implications for designing fear appeal messages are discussed.

Inadequate and incomplete: Chinese newspapers’ coverage of the first licensed human papillomavirus (HPV) vaccine in China

Abstract: Glaxo Smith Kline’s Cervarix was the first human papillomavirus (HPV) vaccine licensed for use in China in July 2016 and officially launched there on July 31, 2017. Since news media content can influence people’s vaccine-related knowledge, understanding, and intentions, a content analysis was used to examine the information conveyed to the public about the HPV vaccine by Chinese newspapers before the 2017 immunization recommendation for women 25 years old and younger. A total of 253 articles published from 2000 to 2016 met the inclusion criteria and were coded. The results showed that HPV and the HPV vaccine received very little newspaper coverage in China both before and after vaccine licensure. Most of the coverage, including after licensure, came from China Party press newspapers, with the stories predominantly using thematic rather than episodic framing. Thematic framing was also prevalent in City press newspapers. Application of the Health Belief Model to the content analysis revealed benefits, self-efficacy, and cues to action were found in most news stories. Overall, given the relative lack of Chinese newspaper coverage, public health officials and health care providers in China should assume most people, including those for whom HPV vaccination is recommended, have little or no knowledge about HPV, HPV vaccine, and the reasons for the vaccination recommendation. If news media are to be a source of HPV information for the Chinese public, significant efforts will be needed to increase attention.