1. Using the Health Belief Model to Promote the HPV Vaccine to Students: A Collaborative Campus Effort
Michelle Cohen, MPH, CHES
Health Educator
Shan Baker, MS, WHNP-BC
Women’s Clinic Supervisor

2. Objectives Identify collaborative partners on-campus
Describe formative research tasks involved with campaign
Explain development of marketing campaign and implementation of campaign

3. Getting to know Georgia Tech
19,000 students
Predominately male (70%)
Urban setting (heart of Atlanta)
Students receive technologically-based education
Consistently ranked in U.S. News & World Report's top ten public universities in U.S.
31.7% GT women report receiving the HPV vaccine (NCHA, 2009)

4. General HPV information
Human Papillomavirus (HPV)
Can lead to genital warts and cervical cancer
Most common sexually transmitted infection (STI)
50% of sexually active men and women will get HPV (CDC, 2008)
HPV vaccine (Gardasil)
FDA approved for women aged 9-26 in June 2006
Protects against types 6, 11, 16, 18 (which cause 90% of genital warts and 70% of cervical cancers)
Available at low cost from Health Services

5. Guiding principles Healthy Campus 2010
Objective 25-5 calls for a reduction of the proportion of persons with human papillomavirus (HPV) infection
Standards of Practice for Health Promotion in Higher Education
Standard 2 (collaborative practice)
Standard 4 (theory-based practice)

6. Synopsis Charged with creating a HPV vaccine campaign on-campus
Developed overarching goal of campaign
Created a plan (tasks and timeline)
Recruit members to create a committee
Conduct formative research
Create a marketing plan
Launch campaign
Conduct summative evaluation

7. Goal of campaign
To increase awareness of the availability of the HPV vaccine on-campus

8. HPV Vaccine Marketing Committee
Stamps Health Services
Health Educator
APRN from Women’s Clinic
RN from Immunization Clinic
Housing-Hall Director
Women’s Resource Center-Program Coordinator
Auxiliary Services-Marketing Coordinator
GT Communications and Marketing

9. GT Communications and Marketing
The Institute's full-service, in-house marketing and communications resource
Purpose: To promote GT’s brand identity and provide professional communications and marketing support
Resources include:
Client Manager
Student Communications Officer
Director of Market Research
Writer/Editor
Graphic Designer

10. Formative research tasks
Review of peer-reviewed literature
Review of national campaigns
Review of other campus campaigns
Conducting focus groups

11. Review of the literature
HPV vaccine acceptability literature suggests use of the Health Belief Model (HBM) (Brewer & Fazekas, 2007 and Levy, 2008)
HBM developed by group of social psychologists in the 1950’s (Glanz, Rimer, &Lewis, 2002)

12. Health Belief Model Six constructs (campaign focuses on four)
Perceived susceptibility (HPV is most common STI)
Perceived benefits (vaccine protects against genital warts and cervical cancer)
Perceived barriers (cost, availability)
Cues to action (recommendation from healthcare provider, parent, reputable health organization, or friend)

13. Review of the literature
Sexually active and those diagnosed with STIs/ abnormal Pap are more likely to become vaccinated- susceptibility (Crosby, et al., 2007; Gerend & Shepherd, 2007)
Vaccine acceptability increased if:
Vaccine prevents both cervical cancer AND genital warts-benefit (Jones & Cook, 2008 and Hoover, Carfioli, & Moench, 2000)
Vaccination is low cost-barrier (Boehner, Howe, Bernstein, & Rosenthal, 2003)
Universal vaccination/endorsement by professional organizations-cues to action (Boehner, Howe, Bernstein, & Rosenthal, 2003 and Zimet, 2005)

14. Review of literature Importance of education
Educate about HPV (Levy, 2008; Jones & Cook, 2008; and Brewer & Fazekas, 2007)
Educate about the benefits of the vaccine (Jones & Cook, 2008 and Hoover, Carfioli, & Moench, 2000)

15. National campaigns Merck Gardasil commercial Website: www.gardasil.com
Print materials
Partnership to End Cervical Cancer:
American College Health Association

19. Campus campaigns Print media Website
Information sessions for students at Health Services
Educating clinical staff

20. Focus groups
Three focus groups conducted with students (conducted by GT Communications and Marketing)
Two in housing
One at the Women’s Resource Center

21. Focus group findings Limited knowledge of HPV Frequency What it causes
Limited knowledge of HPV vaccine
Who should get it
What it protects against
Issues regarding sexual health not discussed often
Merck’s Gardasil campaign source of information

22. Create marketing plan Conduct focus group with key stakeholders
Identify target population
Identify outcomes/key messages
Develop evaluation plan
Develop marketing strategies
Implement campaign

23. Stakeholder focus group
One focus group conducted with major stakeholders
HPV Vaccine Marketing Committee
Stamps Health Services key staff
Colleges Against Cancer: student group

24. Target population
Male students
Parents
Female students

25. Outcomes/key messages
Students will be able to:
Identify HPV as the most common STI (susceptibility)
Recognize what the HPV vaccine is effective against (benefit)
Recall hearing of the HPV vaccine
Discuss the vaccine with friends/partners (cues to action)
Identify where the HPV vaccine is available (barrier)

26. Evaluation plan Create research protocol
Administer survey to assess knowledge of HPV vaccine before and after campaign implementation
Survey female patients* seen in Primary Care Clinic at Stamps Health Services (n=111)
Surveys administered by Medical Records and Nursing staff
*Women’s Clinic patients not surveyed as they are most likely more educated about HPV vaccine

27. Evaluation plan (cont.)
Create survey instrument based on campaign outcomes
Consult with Communications and Marketing
Pilot with students
Submit research protocol and instrument to IRB
Administer pre-survey for three weeks (Time 1)
Implement campaign for one month
Administer post-survey for three weeks (Time 2)
Analyze data and create report
Share findings

28. Strategies Buzz bags Tablings (SHS, Vagina Monologues, Student Center)
Webpage:
Facebook fansite

31. Promotional materials
Print materials*
Flyers
Posters
Postcards
Plasma screen promotions
*Posted in Stamps Health Services, residence halls, Campus Recreation Center, and Student Center (including Food Court)

35. Promotional materials
Promotional items
Buttons, magnets
Safer sex kits
Body sprays
Tampons

36. Survey results Outcome Question Time 1 (n=62) Time 2 (n=49)
Identify HPV as the most common STI (susceptibility)
1. Which sexually transmitted infection (STI) is the most common?
___Syphilis
___Gonorrhea
___Herpes
___HPV
40.3%
61.2%
Recognize what the HPV vaccine is effective against (benefit)
2. What can HPV cause? Check all that apply.
___Cervical cancer
___Genital warts
___Chlamydia
32.3%
16.3%
Recall hearing of the HPV vaccine
3. Have you heard of Gardasil, the HPV vaccine? YES NO
85.5%
91.8%
Discuss the HPV vaccine with friends/partners (cues to action)
4. Have you had conversations with your friends about the HPV vaccine? YES NO
58.5%
73.3%
5. Have you had conversations with your partners about the HPV vaccine? YES NO
22.6%
53.3%
Identify that the vaccine is available at SHS (barrier)
9. Where is the HPV vaccine available?
___Stamps Health Services
83%
97.8%

37. Survey results (cont.) Question Time 1 (n=62) Time 2 (n=49)
10. Where have you received information about the HPV vaccine?
___Internet
32.1%
22.2%
___Stamps Health Services
54.7%
75.6%
___Residence Halls 0%
2.2%
___Campus Recreation Center
8.9%
___Student Center
11.1%

38. Limitations Formative research
Limited research on effective HPV vaccine campaigns
Limited focus groups
Campaign
Limited message testing
Length of implementation
Models not Georgia Tech students

39. Limitations (cont.) Evaluation Nature of the sample
Only knowledge measured (not attitudes or behaviors)
Limited information about number of women on-campus vaccinated

40. Next steps Additional data analysis Sharing findings
Developing additional phases of the campaign

41. References
Boehner, C., Howe, S.R., Bernstein, D.I., & Rosenthal, S. (2003). Viral sexually transmitted disease vaccine acceptability among college students. Sexually Transmitted Diseases, 30 (10),
Brewer, N. & Fazekas, K.I. (2007). Predictors of HPV vaccine acceptability: a theory-informed, systematic review. Preventive Medicine, 45,
Centers for Disease Control and Prevention. (2008). Human papillomavirus (HPV) infection Retrieved July 16, 2008 from
Crosby, R. et al. (2007). Correlates of intent to be vaccinated against human papillomavirus: an exploratory study of college-aged women. Sexual Health, 4,
Gerend, M. & Shephard, J.E. (2007). Using message framing to promote acceptance of the humanpapillomavirus vaccine. Health Psychology, 26 (6),
Glanz, K., Rimer, B,K., & Lewis, F.M. (Eds.) (2002). Health Behavior and Health Education. San Francisco: John Wiley and Sons, Inc.
Hoover, D.R., Carfioli, B., & Moench, E.A. (2000). Attitudes of adolescent/young adult women toward human papillomavirus vaccination and clinical trails. Health Care for Women International, 21,
Jones, M. & Cook, R. (2008). Intent to receive an HPV vaccine among university men and women and implications for vaccine administration. Journal of American College Health, 57(1),
Levy, E. (2008, March). HPV vaccine acceptability among college students. Presented at the National Immunization Conference, Atlanta, GA.
Zimet, G.D. (2005). Improving adolescent health: focus on HPV vaccine acceptance. Journal of Adolescent Health, 37, S17-S23.

42. Special thanks! HPV Vaccine Marketing Committee
Stamps Health Services staff
GT Communications and Marketing

43. Discussion questions
Who have you partnered with to do similar campaigns?
What other theories have been used to develop similar campaigns?
How have you evaluated the effectiveness of educational campaigns?

44. Michelle Cohen, MPH, CHES Health Educator michelle. cohen@health
Michelle Cohen, MPH, CHES Health Educator Shan Baker, MS, WHNP-BC Women’s Clinic Supervisor