College students and seasonal flu vaccination intent: Comparing the health belief model and the theory of planned behavior

The seasonal flu affects millions of people every year. College students are often not considered to be a high risk population yet have been shown to contract and spread the flu quickly in high numbers. The H1N1 outbreak of 2009 saw a disproportionate amount of college students were infected (USDHHS, 2009). Over 80% of H1N1 cases in 2009 were in people under the age of 30 (Yang, 2012). While many college students contract the seasonal flu each year, less than 20% get vaccinated against the flu (Yang, 2012). Targeting college student populations with appropriate vaccination messages may help encourage college students to get vaccinated. University students and community college students were analyzed to examine psychological factors associated with vaccination intent. Both the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) were tested to see which variables from each model significantly predicted intentions to vaccinate against the seasonal flu. Results indicated that perceived susceptibility, barriers, benefits, and cues to action were significant predictors of intentions to vaccinate from the HBM. Attitudes and subjective norms from the TPB were significant predictors of intentions to vaccinate. Moral norms, when added to the TPB were also a significant predictor of intentions to vaccinate. Both theories were able to predict over 50% of the variance in vaccination intent. A combined model integrating predictors from both models explained 62% of the variance in intentions to vaccinate. Health information seeking behaviors were unrelated to vaccination intent, and seasonal flu knowledge was only indirectly related to intentions to vaccinate. The relative importance of predictor variables was different for community college and university students. The findings presented within this study have implications for the advancement of expectancy value frameworks within health behavior theory and provide practical application for designing future health campaigns