Messaging Strategies for Promoting HPV Vaccination among Bilingual Males in Hong Kong

Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide and is linked to cervical, anogenital, and oropharyngeal cancers. The rising rate of HPV infection among males, as well as their poorer immune response to and lower literacy about the virus compared to females, has prompted alarm among health experts. There is an urgent need to promote HPV vaccination among males, and evidence-based communication strategies can play an important role in this promotion. One solution is to examine evidence-based health intervention strategies by experimentally testing the intrinsic correspondence between strategic language use and recipients’ change in attitudes and behavioral intentions. However, the vast majority of studies investigating HPV communication strategies have focused on attitude change in North American participants, leaving the Hong Kong context largely underexplored. Different from American samples who are mostly L1 English speakers, Hong Kong residents are mostly bilingual speakers of L1 Chinese and L2 English. This is an essential difference in understanding health messaging because L1 English speakers tend to follow an individualistic cultural orientation and attend to their own health concerns, whereas L1 Chinese speakers tend to follow a collectivist cultural orientation and care for both the self and related ones.Building on the PI's previous work on persuasive health message design, this project will employ a between-subject factorial design to experimentally test main and interaction effects of four evidence-based linguistic strategies on recipients' health beliefs and behavioral intentions regarding HPV vaccination. These four strategies are selected because of their demonstrated impact on people’s attitudes toward HPV or similar health threats. The persuasive mechanism of these messages derives from the Extended Parallel Process Model (EPPM), which describes how people can be motivated to adopt prosocial actions by taking advantage of their natural tendency to control fearful emotions. The primary efficacy hypothesis is that the aforementioned four message influence strategies, individually and in combination, will encourage accurate beliefs about HPV among the participants (e.g., consider HPV as more threatening, more susceptible, and more willing to get vaccinated). These hypotheses will be tested using an online survey of 800 male adults from Hong Kong.On a theoretical level, this project experimentally tests the applicability of EPPM in the bilingual Hong Kong context, contributing to a culturally sensitive health communication model. On a practical level, this project offers evidence-based health intervention strategies that can be easily employed by healthcare providers, pharmacists, and governmental agencies.