Behavioral frequency moderates the effects of message framing on HPV vaccine acceptability

Ann Behav Med. 2008 Apr;35(2):221-9. doi: 10.1007/s12160-008-9024-0. Epub 2008 Mar 12.


Background: Research suggests that gain-framed messages are generally more effective than loss-framed messages at promoting preventive health behaviors. Virtually all previous studies, however, have examined prevention behaviors that require regular and repeated action to be effective. Little is known about the utility of message framing for promoting low-frequency prevention behaviors such as vaccination. Moreover, few studies have identified mediators of framing effects.

Purpose: We investigated whether behavioral frequency (operationalized as the number of shots required) moderated the effect of framed health messages on women's intentions to receive the human papillomavirus (HPV) vaccine. We also sought to identify mediators of framing effects.

Method: Undergraduate women (N = 237) were randomly assigned to read an HPV vaccination booklet that varied by message frame (gain vs. loss) and behavioral frequency (one shot vs. six shots).

Results: We observed a frame-by-frequency interaction such that the loss-framed message led to greater vaccination intentions than did the gain-framed message but only among participants in the one-shot condition. Perceived susceptibility to HPV infection mediated the observed framing effects.

Conclusions: This study provides an important exception to the commonly observed gain-framed advantage for preventive health behaviors. Loss-framed appeals appear to be particularly effective in promoting interest in low-frequency prevention behaviors such as HPV vaccination.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice
  • Health Promotion / methods*
  • Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18
  • Humans
  • Immunization, Secondary / psychology*
  • Intention
  • Motivation*
  • Pamphlets*
  • Papillomavirus Vaccines / administration & dosage*
  • Patient Acceptance of Health Care / psychology*
  • Persuasive Communication*
  • Semantics
  • Students / psychology


  • Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18
  • Papillomavirus Vaccines