Objectives: Although a safe and effective human papillomavirus (HPV) vaccine exists, HPV remains prevalent and vaccine uptake remains suboptimal especially among young adults. This study aimed to determine the salient beliefs of college students regarding HPV vaccination.

Methods: The Theory of Planned Behavior (TPB) served as the theoretical framework for this study. Three virtual focus group sessions were conducted with a convenience sample of college students in central Texas. Participants were asked nine open ended questions in accordance with the TPB constructs including attitudes (behavioral beliefs), subjective norms (normative beliefs), and perceived behavioral control (control beliefs). The sessions were recorded on Zoom and transcribed on otter.ai. Participants completed a consent form and demographic survey via google forms at the beginning of the sessions. Two investigators conducted a content analysis of the qualitative data to identify emerging beliefs and reached consensus on coding discrepancies.

Results: A total of 24 students aged 18 to 31 years (mean age = 22.1±3.2 years) participated. Participants were mostly female (54%), Asian (42%), undergraduate (54%), on private insurance (71%) and fully vaccinated against HPV (42%). A total of 15 behavioral beliefs, 10 normative beliefs and 20 control beliefs were identified. The most prevalent behavioral belief was that getting vaccinated against HPV decreases cancer risk. Regarding normative beliefs, students identified parents and religious groups as having the most influence on their decision to get vaccinated. The multiple dosing schedule of the HPV vaccine was the most cited control belief.

Conclusions: The TPB was useful in identifying college students’ beliefs regarding HPV vaccination. Understanding the most salient beliefs may be valuable in developing more effective interventions tailored to the needs of young adults, which may improve HPV vaccination rates in this population.