Do Intentions Vary? A Comparative Study of College Students’ HPV Vaccine Intentions in a Kenyan University and a Large Midwestern USA University

This dissertation aimed at examining the predictors of HPV vaccination intentions of college students in a Kenyan university and those in a Midwest university in the United States of America (USA). Using the theory of planned behavior (TPB), the dissertation investigated the most salient factors that predict the vaccination intentions of college male and female students in Kenya and the USA. A mixed method approach was utilized to collect data from the participants. Specifically, interviews with 43 students (22 from Kenya and 21 from USA) were used to collect the qualitative data from the students. The quantitative data were collected using closed-ended surveys with 512 Kenyan students at a large university in Uasin Gishu County and 522 students at the Midwestern university, USA. The qualitative findings revealed that identification had a major influence on how students sought health, ate, and related with their peers. In particular, identification through religiosity influenced the students’ attitudes toward sex and perception of oneself. Thus, many respondents reported viewing their bodies as the temple of God and sex as an activity for married couples. Thus, when they engaged in premarital sex, they often felt disconnected with God and they resulted to seeking forgiveness, minimizing their actions, and normalizing their actions. Overall, the quantitative results suggested that college students in Kenya and the USA converged in certain health trends but differed in several others. For example, the Kenyan participants depicted a low understanding of HPV and HPV vaccine compared to the participants at the Midwestern university. The country of the participant also moderated the relationships between subjective norms and intentions, sex attitudes, vaccine attitudes, and intention to get vaccinated. The participants from the USA, for example, reported a stronger relationship between subjective norms and the intention to be vaccinated compared to the participants from Kenya. The results of this study also showed that the gender of the participant had an influence on the attitudes of students toward sex, with male participants having more favorable attitudes toward sex compared to female participants. Overall, subjective norms and cancer worry were the only common vaccine predictors among both female and male participants from Kenya and the USA. Surprisingly, although religiosity was correlated with other variables under consideration, it did not emerge as a direct predictor of the intention to get vaccinated. This might suggest it as a probable indirect predictor. Being a comparative study of students in two countries, this dissertation offers unique insights that can inform theory, research, practice, and policy development. Specifically, the results point to the need for health practitioners designing health campaigns to consider the unique differences that exist among male and female students in Kenya and the USA. Some of the weaknesses of the study include use of self-report measures, which are limited to the memory of participants. This study suggests that researchers continue to explore the role of religiosity in influencing health-seeking behaviors among college students