JMIR Publications

ABSTRACT

Background:

With the advancement of cervical cancer elimination strategies, promoting HPV vaccination is essential to achieving this goal. The issue of how to structure and develop message content to promote HPV vaccination is a debatable issue.

Objective:

The efficacy of gain-loss framing in vaccination contexts is disputed. Our study aimed to elucidate the consequences of message framing on attitudes, intentions, and behavioral tendencies towards HPV vaccination, with the objective of refining message framing strategies and their elements.

Methods:

This systematic review adhered strictly to the preferred reporting items for systematic reviews and meta-analysis（PRISMA）guideline reporting standards to comprehensively retrieve, extract, and integrate data. We searched databases for literature published from database construction to August 15, 2023, including PubMed, Embase, Scopus, and Web of science. Two researchers performed literature screening, data extraction, and quality evaluation. Intervention studies published in English, for populations with children eligible for HPV vaccination, and involving message framing were included. Attitudes, intentions, or behaviors served as outcome evaluation criteria.

Results:

A total of 19 intervention studies were included. Gain-loss framing had no clear effect on vaccination attitudes or intentions. Loss framing showed a weak advantage in improving HPV vaccination attitudes or intentions, but the evidence was not strong enough to draw definitive conclusions. The impact of gain-loss framing on HPV vaccination behaviors could not be determined due to the limited number of studies and the qualitative nature of the analysis.

Conclusions:

Combining the gain-loss framing with other message framing approaches may be an effective way to enhance the effect of message framing. Requiring more high-quality message framing content and exploring alternative moderator or mediator variables to support the conclusion.