A systematic review on the effects of message framing on HPV vaccine acceptability

Abstract

Introductions: Cervical cancer has been the second most frequent cancer among females worldwide. Over 85% of women’s deaths from the disease are living in developing countries in 2008. Human papillomavirus (HPV) vaccination may provide a feasible strategy for cervical cancer prevention so as to reduce the disease burden. However the uptake of HPV vaccination is low. To promote HPV vaccination, the design of message frame, may be important. However, little research has been conducted to provide a clear interpretation of the effectiveness of health message frame on uptake of HPV vaccination.

Objectives: To evaluate the effects of gain- and loss-framing message on HPV vaccination acceptability and explore the factors that might influence the acceptability of HPV vaccination.

Methods: Literature search on the studies investigating gain- and loss-framed message on HPV vaccination. PubMed and Google Scholar during 2006 to 2013.

Results: Ten articles, seven from U.S.A, two from Canada, and one from Ireland, were included in the systematic review. The effectiveness between message framing and the context of HPV vaccination were different by studies; the different effect of message framing may be due to in the studies population. Age, sex, culture and individuals’ risk perceiving level might have influence on the effect of gain- and loss-message framing. Four of five articles, which targeted at young population, showed that loss-farmed message is more effective to increase individual’s positive attitude and response to HPV vaccination.

Participants with a greater number of sexual partner with higher avoidance-oriented attitudes, or are less likely to use protection; loss-framed message is more effective. In turn, when young people, particularly female with a lower number of sexual partner, with approach-oriented attitudes, or are more likely to use protection, both gain-and loss-framed message have no effect on their intention to vaccinate. However, another five articles in this review targeted at parents with young children found inconsistent results of framing effects on HPV vaccine acceptability.

Discussion: The effect of gain- or loss-framed tends to be different, depending on types of health behavior promoted. Loss- and gain-framed messages might have different effect to different audience. Framing message selection is matching on individuals’ motivational orientation may help in prompting HPV vaccine acceptability. However, there is a lack of studies on the association between message framing effects and HPV vaccine acceptability, especially for Chinese population. Further investigations of message framing effects on acceptance of HPV vaccination in Chines population are necessary.