Motivation for HPV Vaccination among Young Adult Men: Validation of TTM Decisional Balance and Self-Efficacy Constructs

Document Type


Date of Original Version



Purpose. In the United States, 36% of human papillomavirus (HPV)-related cancers occur among men. HPV vaccination can substantially reduce the risk of HPV infection; however, the vast majority of men are unvaccinated. This study developed and validated transtheoretical model-based measures for HPV vaccination in young adult men. Design. Cross-sectional measurement development. Setting. Online survey of young adult men. Subjects. Three hundred twenty-nine mostly college-attending men, ages 18 to 26. Measures. Stage of change, decisional balance (pros/cons), and self-efficacy. Analysis. The sample was randomly split into halves for exploratory principal components analysis (PCA), followed by confirmatory factor analyses (CFA) to test measurement models. Multivariate analyses examined relationships between scales. Results. For decisional balance, PCA revealed two uncorrelated five-item factors (pros α =.78; cons α =.83). For the self-efficacy scale, PCA revealed a single-factor solution (α =.83). CFA confirmed that the two-factor uncorrelated model for decisional balance and a single-factor model for self-efficacy. Follow-up analyses of variance supported the theoretically predicted relationships between stage of change, pros, and self-efficacy. Conclusion. This study resulted in reliable and valid measures of pros and self-efficacy for HPV vaccination that can be used in future clinical research.

Publication Title

American Journal of Health Promotion