The Effect of a Transtheoretical Model-Based Educational Intervention on First-Year Nursing Students' HPV Knowledge, Health Beliefs, and Vaccination Behavior Intentions

March 26, 2026 updated by: MÜJDE KERKEZ, Cukurova University

The purpose of this study is to examine the impact of a structured educational program based on the Transtheoretical Model (TTM) on HPV knowledge, health beliefs, and vaccination behavioral intentions among first-year nursing students. The study will also evaluate how the intervention affects students' HPV vaccine readiness compared to the TTM.

The primary questions addressed by the study are:

  • Does the TTM-based educational intervention increase students' knowledge about HPV and the HPV vaccine?
  • Does the program change students' health beliefs regarding susceptibility, severity, benefits, and barriers to HPV and the HPV vaccine?
  • Does the program improve students' intentions and readiness to receive the HPV vaccine?
  • Do students move to a higher behavioral readiness stage (from Precontemplation to Contemplation, Preparation, Action, or Maintenance) after the intervention?

The researcher will compare the TTM-based educational intervention with a control group that did not receive structured education to determine whether a personalized, stage-based approach is more effective in improving HPV-related outcomes among nursing students.

Participants will:

  • Complete baseline questionnaires measuring HPV knowledge, health beliefs, and vaccination intention.
  • The experimental group (intervention group) will receive personalized TTM-based education, face-to-face instruction in modules aligned with the five TTM phases (Precontemplation, Contemplation, Preparation, Action, and Maintenance).
  • The experimental group will participate in educational sessions designed to raise awareness, correct misinformation, support decision-making, and encourage protective behaviors.
  • The control group will not receive any educational program.
  • All participants in the experimental and control groups will complete the same questionnaires again to assess changes after the intervention.

The TTM-based educational intervention provides:

  • Staged counseling
  • Information about HPV and the HPV vaccine
  • Activities to raise awareness, strengthen motivation, and support vaccination adoption
  • Personalized feedback based on student readiness
  • Structured modules focusing on knowledge, belief, and behavior change strategies

The study population included first-year nursing students enrolled in the Faculty of Health Sciences. A total of 88 participants will be recruited and randomly assigned to either the intervention (n=44) or control (n=44) groups through simple randomization.

The results of this study are expected to contribute to the development of evidence-based education strategies in nursing, support of behavioral change models in health education, and strengthen the role of future nurses in HPV prevention, vaccine advocacy, and public health practice.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

88

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Turkey (Türkiye)
      • Adana, Turkey (Türkiye)
        • Recruiting
        • Çukurova University
        • Contact:
    • CUKUROVA
      • Adana, CUKUROVA, Turkey (Türkiye)
        • Not yet recruiting
        • Faculty of Health Sciences
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • First-year students enrolled in the Nursing Department of the Faculty of Health Sciences
  • Provide written informed consent to participate
  • Agree to attend all educational sessions and data collection appointments during the study period
  • Have sufficient Turkish literacy to read and understand study materials
  • Have not previously received any comprehensive education about HPV infection or HPV vaccination

Exclusion Criteria:

  • Students who do not agree to participate in the study
  • Students who do not provide written informed consent

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention Group
TTM-based structured educational program tailored to the participant's stage of readiness for HPV vaccination
Behavioral: TTM-Based Educational Program
A structured, stage-matched educational intervention based on the Transtheoretical Model, delivered face-to-face in five modules aligned with Precontemplation, Contemplation, Preparation, Action, and Maintenance stage
No Intervention: Control Group
No structured education; participants receive no TTM-based training during the study period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Vaccination Behavior Intention Scale
Time Frame: Baseline and after completion of the 10-week intervention (5 sessions delivered every 2 weeks)
Behavioral intention to receive the HPV vaccine will be assessed using the HPV Vaccination Intention Scale, a 6-item instrument developed based on the Theory of Planned Behavior. The scale evaluates participants' intention to receive the HPV vaccine, with higher scores indicating stronger intention to be vaccinated. The secondary outcome is the change in intention score from baseline to post-intervention.
Baseline and after completion of the 10-week intervention (5 sessions delivered every 2 weeks)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
HPV Knowledge Scale
Time Frame: Baseline and after completion of the 10-week intervention (5 sessions delivered every 2 weeks)
HPV knowledge will be measured using the HPV Knowledge Scale (HPV-BS), a validated 33-item instrument consisting of four subscales: general HPV knowledge (16 items), HPV screening knowledge (6 items), HPV vaccine knowledge (5 items), and HPV vaccination program knowledge (6 items). Total scores range from 0 to 35, with higher scores indicating greater knowledge about HPV infection, transmission, screening, and vaccination. A Cronbach's alpha coefficient of 0.96 was reported in the Turkish validity and reliability study. The primary outcome is the change in total HPV knowledge score from baseline to postintervention.
Baseline and after completion of the 10-week intervention (5 sessions delivered every 2 weeks)
Health Belief Model Scale regarding HPV and vaccination
Time Frame: Baseline and after completion of the 10-week intervention (5 sessions delivered every 2 weeks)
Health beliefs regarding HPV and HPV vaccination will be measured using the Health Belief Model Scale (HBM-HPV), a validated instrument developed by Kim (2016) and adapted into Turkish by Guvenc et al. (2016). The scale consists of four subscales: perceived benefits (items 1-3), perceived susceptibility (items 4-5), perceived severity (items 6-9), and perceived barriers (items 10-13 and 15). Higher scores indicate stronger beliefs within each construct. Except for perceived barriers, all subscales are positively associated with HPV vaccination intention. Cronbach's alpha values for the subscales range from 0.71 to 0.78. The secondary outcome is the change in subscale scores from baseline to post-intervention.
Baseline and after completion of the 10-week intervention (5 sessions delivered every 2 weeks)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Cukurova University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 16, 2026

Primary Completion (Estimated)

March 30, 2026

Study Completion (Estimated)

April 30, 2026

Study Registration Dates

First Submitted

November 18, 2025

First Submitted That Met QC Criteria

November 18, 2025

First Posted (Actual)

November 25, 2025

Study Record Updates

Last Update Posted (Actual)

March 27, 2026

Last Update Submitted That Met QC Criteria

March 26, 2026

Last Verified

November 1, 2025

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • TTM-HPV-001

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared because the study involves identifiable student information, and sharing raw data may pose confidentiality and privacy risks. Data will be stored securely and used only for the purposes approved by the ethics committee. Only aggregated and de-identified results will be reported in publications.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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