Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Communication and Information



First Advisor

Elisia L. Cohen

Second Advisor

Nancy Grant Harrington


The HPV vaccine represents an important step in the primary prevention of cervical cancer, yet uptake rates for the vaccine remain below what is needed to establish "herd immunity" from the virus. While many studies have examined both psychosocial and communication factors affecting HPV vaccination decisions, this study adopts a unique approach to understand the communication environment within which this health decision happens, such as the many and sometimes conflicting messages about vaccine efficacy and safety guiding young women's decisions. Using the message convergence framework, this project identifies how further study of converging and diverging messages in the communication environment in which young women make their vaccination decision can extend research in considering optimal communication strategies to enhance demand for HPV vaccination. In Study 1, 39 unvaccinated women participated in qualitative interviews and were asked questions in order to understand the important elements of the HPV vaccination communication environment that affected their decision (i.e., common sources and content of messages, how they discussed these messages "interacting" and influencing their decision). Study 2 builds on the findings of Study 1 by employing an experimental design to test different message convergence conditions on women's intent to vaccinate (e.g., what happens when a doctor and a family member give conflicting information and recommendations about HPV vaccination?). Three hundred and nine unvaccinated women were randomly assigned to one of nine experimental message conditions and then assessed on behavioral intentions. Support was found for the message convergence framework. This project represents the first formal testing of the message convergence framework and the first time it has been used in the health context. The findings from these studies are discussed in terms of the implications for future cervical cancer research and prevention campaigns, as well as the utility of the message convergence framework for other health communication research topics in which researchers are seeking to better understand and consider the communication environment when designing health behavior interventions.