Predicting human Papilloma virus vaccination and Pap smear screening intentions among young singaporean women using the theory of planned behavior

We used the Theory of Planned Behavior (TPB) to analyze the role of attitudes, subjective norms, and perceived behavioral control as predictors of intentions to obtain Human Papillomavirus (HPV) vaccinations or a Papanicolaou(Pap) smear in a sample of young Singaporean women. A further aim was to evaluate knowledge of cervical cancer and preventive measures as a possible additional predictor of intentions. A purpose-designed TPB and knowledge questionnaire was completed by 206 women aged 18 to 26 years living in Singapore. Descriptive analyses and structural equation modeling revealed subjective norm as the best predictor, while perceived behavioral control had moderate predictive power. Attitude and knowledge were not significant predictors of intentions. The findings suggest the importance of focusing on subjective norms, rather than factual knowledge, in educational and awareness campaigns that encourage HPV vaccination and Pap smear screening in Singapore.