Do it or Pay it: Behavioral and Economic Indicators for HPV Vaccination— Evidence from Nepal

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Research question with some background: Human papilloma virus (HPV) infection is responsible for virtually 100% of cervical cancer diagnosed in the world. Yet, despite the wide suffering caused by this disease, this virus is vaccine preventable. While the HPV vaccine has been given considerable attention in developed countries, awareness and uptake in developing countries remains small. To better understand the current understanding and acceptance of HPV vaccine, as well as the predictors for the health behavior of vaccinate against HPV, we conducted a survey with adolescent girls and their mothers in Nepal and examined the influenced factors to the behavioral and economic indicators. Data and Statistical Methods used: Using this primary survey data, we apply the Theory of Planned Behavior and Contingent Valuation Method to analyze mothers’ and daughters’ intention and willingness to pay to predict their behavior of vaccinating against HPV when the vaccine is available in Nepal. Conventional econometrics models have been applied to analyze the intention and willingness to pay respectively, while General Structural Equation Model has been applied to simultaneously examine the intention and willingness to pay. Results: We find that Attitude, Subjective Norms and Perceived Control are significantly predictors of behavior intention, while willingness to pay is only significantly driven by Perceived Control. The measurement of risks for cervical cancer and the awareness of HPV are positively predicting the intention and Willingness to Pay for HPV vaccine, while socio-economic status is more associated with Willingness to Pay. As a baseline survey for further intervention to increase awareness and uptake to HPV vaccine in Nepal, practitioners may utilize these instruments for the development and evaluation of TPB-based interventions.

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Dec 19th, 12:00 AM

Do it or Pay it: Behavioral and Economic Indicators for HPV Vaccination— Evidence from Nepal

Research question with some background: Human papilloma virus (HPV) infection is responsible for virtually 100% of cervical cancer diagnosed in the world. Yet, despite the wide suffering caused by this disease, this virus is vaccine preventable. While the HPV vaccine has been given considerable attention in developed countries, awareness and uptake in developing countries remains small. To better understand the current understanding and acceptance of HPV vaccine, as well as the predictors for the health behavior of vaccinate against HPV, we conducted a survey with adolescent girls and their mothers in Nepal and examined the influenced factors to the behavioral and economic indicators. Data and Statistical Methods used: Using this primary survey data, we apply the Theory of Planned Behavior and Contingent Valuation Method to analyze mothers’ and daughters’ intention and willingness to pay to predict their behavior of vaccinating against HPV when the vaccine is available in Nepal. Conventional econometrics models have been applied to analyze the intention and willingness to pay respectively, while General Structural Equation Model has been applied to simultaneously examine the intention and willingness to pay. Results: We find that Attitude, Subjective Norms and Perceived Control are significantly predictors of behavior intention, while willingness to pay is only significantly driven by Perceived Control. The measurement of risks for cervical cancer and the awareness of HPV are positively predicting the intention and Willingness to Pay for HPV vaccine, while socio-economic status is more associated with Willingness to Pay. As a baseline survey for further intervention to increase awareness and uptake to HPV vaccine in Nepal, practitioners may utilize these instruments for the development and evaluation of TPB-based interventions.