Hepatitis A and B vaccination in matriculating college students : knowledge, self-perceived risk, health risk behaviors, and theory of planned behavior constructs Public Deposited

http://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/wh246v65q

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  • At a state university in the Pacific Northwest, the authors surveyed 477 matriculating college students about their immunization status, knowledge, self-perceived risk, and health risk behaviors for hepatitis A and B vaccinations. Review of immunization records revealed that 10% of these students were completely immunized for hepatitis A and 58.8% were completely immunized for hepatitis B. Although their knowledge about hepatitis A and B was very good, there were no significant differences in immunization status or health risk behaviors based on their knowledge or their self-perceived risk of hepatitis A and B. About 66% of students perceived they had no risk or low risk for hepatitis A and B and only 5% felt they had a high risk. In spite of the low self-perceived risk, health risk behaviors for hepatitis A and B were common in this population of college students. In the past twelve months, 56.2% of these students reported being sexually active (vaginal, oral, anal sex), including 20.5% who had two or more sexual partners. Students with multiple sexual partners reported having unprotected sex at a high frequency: 61.3% vaginal, 81.1% oral-genital, and 13.2% anal. The non-sexual health risk behaviors were also common in this population: 53.2% had body piercing/tattoos, and 26.5% traveled internationally to regions with intermediate to high rates of hepatitis A (Africa, SE Asia, Central/South America). These students who traveled internationally were more likely to be immunized for hepatitis A, although 70% remained unimmunized. In addition, students with multiple sexual partners or with a body piercing/tattoo were more likely to be immunized for hepatitis B. However, about one-third of these students with multiple sexual partners or body piercing/tattoo have not completed the hepatitis B series. The theory of planned behavior was applied to determine factors that are associated with college students' decision to be vaccinated for hepatitis A and B. For hepatitis A and B vaccinations, important attitude constructs identified were 'vaccine effectiveness, vaccine adverse effects, anticipation anxiety, inconvenience, and vaccine expense.' The subjective norm constructs with the greatest influence for college students were: 'parents, family doctor, and student health services staff'. The significant perceived behavioral constructs were 'parents reminder, student health services (SHS) reminder, and SHS hepatitis vaccine clinic.' In conclusion, there is still a sizable portion of unvaccinated college students who possess health risk behaviors for hepatitis A and B, such as multiple sexual partners, unprotected sexual behaviors, body piercing/tattoos, and international travel. With a greater understanding of college students' attitudes, subjective norms, and perceived behavioral control college health services could develop more effective strategies to educate unvaccinated college students about these risks and motivate them to be immunized.
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