title: An appraisal of theoretical approaches to examining behaviours in relation to Human Papillomavirus (HPV) vaccination of young women.
abstract: BACKGROUND
  Interventions to increase uptake of Human Papillomavirus (HPV) vaccination by young women may be more effective if they are underpinned by an appropriate theoretical model or framework. The aims of this review were: to describe the theoretical models or frameworks used to explain behaviours in relation to HPV vaccination of young women, and: to consider the appropriateness of the theoretical models or frameworks used for informing the development of interventions to increase uptake.
  
  
  METHODS
  Primary studies were identified through a comprehensive search of databases from inception to December 2013.
  
  
  RESULTS
  Thirty-four relevant studies were identified, of which 31 incorporated psychological health behaviour models or frameworks and three used socio-cultural models or theories. The primary studies used a variety of approaches to measure a diverse range of outcomes in relation to behaviours of professionals, parents, and young women. The majority appeared to use theory appropriately throughout. About half of the quantitative studies presented data in relation to goodness of fit tests and the proportion of the variability in the data.
  
  
  CONCLUSIONS
  Due to diverse approaches and inconsistent findings across studies, the current contribution of theory to understanding and promoting HPV vaccination uptake is difficult to assess. Ecological frameworks encourage the integration of individual and social approaches by encouraging exploration of the intrapersonal, interpersonal, organisational, community and policy levels when examining public health issues. Given the small number of studies using such approach, combined with the importance of these factors in predicting behaviour, more research in this area is warranted.
authors: School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, United Kingdom. Electronic address: Harriet.Batista@bristol.ac.uk.
authors: Harriet
authors: H
authors: Batista Ferrer
authors: School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, United Kingdom. Electronic address: Suzanne.Audrey@bristol.ac.uk.
authors: Suzanne
authors: S
authors: Audrey
authors: Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, United Kingdom. Electronic address: clt56@cam.ac.uk.
authors: Caroline
authors: C
authors: Trotter
authors: School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, United Kingdom. Electronic address: Matthew.Hickman@bristol.ac.uk.
authors: Matthew
authors: M
authors: Hickman
mesh_terms: D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008962:Models, Theoretical; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010290:Parents / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D053918:Papillomavirus Vaccines
keywords: Adolescent; HPV vaccines; Models Theoretical