Willingness to Accept Human Papillomavirus Vaccination and its Influencing Factors Using Information–Motivation–Behavior Skills Model: A Cross-Sectional Study of Female College Freshmen in Mainland China

Abstract

Background This study aimed to assess the awareness and attitudes toward human papillomavirus (HPV) vaccination among female college freshmen and explore their willingness and associated factors to receive the HPV vaccine based on the information–motivation–behavior skills (IMB) model. Methods From February 21 to April 30, 2020, a cross-sectional survey was conducted among female freshmen in seven colleges in mainland China. Socio-demographic characteristics, health-related awareness, knowledge of HPV, motivation, and behavioral skills toward HPV vaccination were assessed using questionnaires. Univariate and multivariate logistic regression analyses were performed to identify the influencing factors of willingness to receive the HPV vaccine in the next 6 months. Results Among the 3867 students invited to participate in this study, 102 (2.64%) reported having taken the HPV vaccine. Among the unvaccinated participants, 59.89% had previously heard of HPV, and 32.08% were willing to take the HPV vaccine in the next 6 months. Willingness to get the HPV vaccine was associated with sexual experience(s) (AOR = 1.96, 95% CI: 1.25–3.08), family or friends with cancer (AOR = 1.24, 95% CI: 1.04–1.48), having heard of HPV (AOR = 1.23, 95% CI: 1.03–1.47), and having actively searched for or having consulted on issues concerning HPV vaccine (AOR = 1.22, 95% CI: 1.02–1.45). In the dimensions of the IMB model, “perceived susceptibility” (AOR = 1.20, 95% CI: 1.09–1.31), “perceived severity” (AOR = 1.24, 95% CI: 1.11–1.39), “subjective norms” (AOR = 2.09, 95% CI: 1.75–2.49), and “self-efficacy” (AOR: 2.95, 95% CI: 2.44–3.58) were positively associated with HPV vaccination acceptance, while “perceived barriers” (AOR = .60, 95% CI: .52–.69) negatively affected intention to get HPV vaccination. Conclusion HPV vaccination rates and willingness to receive the HPV vaccine in the next 6 months were found to be poor among female college freshmen in mainland China. Having a positive attitude toward HPV vaccination, creating vaccine-friendly social norms, and removing related barriers are important measures to promote HPV immunization.

Awareness, attitudes and acceptability of the HPV vaccine among female university students in Morocco

“…A similar figure was reported in a study of ethnically diverse female university students (21.7%) [15]. However, a far higher level of awareness of HPV (59.89%) was reported in a previous study conducted within a young population in Mainland China which is also considered as a developing country [16]. A higher levels of awareness of cervical cancer have been reported in college students in South Carolina (95.3%) [13].…”

Willingness to human papillomavirus (HPV) vaccination and influencing factors among male and female university students in China

“…This cross‐sectional study used an online questionnaire containing 35 questions to measure the knowledge, attitude, and willingness to HPV vaccination. In the part of knowledge and attitude, we included two aspects of measures: (1) knowledge and attitude to health and sexual behavior (six items, e.g., “Vaccines can effectively prevent diseases,” “I accept premarital sex”), and (2) knowledge and attitude to HPV‐ related issues (nine items, e.g., “I have ever heard of HPV related diseases, such as genital warts and cervical cancer,” “HPV infection is very serious and will affect my life on campus”) 27–30 . In the part of willingness, we chose a single item to measure whether one is willing to be vaccinated against HPV (“Yes” or “No”).…”

“…In the part of knowledge and attitude, we included two aspects of measures: (1) knowledge and attitude to health and sexual behavior (six items, e.g., “Vaccines can effectively prevent diseases,” “I accept premarital sex”), and (2) knowledge and attitude to HPV‐ related issues (nine items, e.g., “I have ever heard of HPV related diseases, such as genital warts and cervical cancer,” “HPV infection is very serious and will affect my life on campus”). 27 , 28 , 29 , 30 In the part of willingness, we chose a single item to measure whether one is willing to be vaccinated against HPV (“Yes” or “No”). For female students, the item was “Do you want to be vaccinated against HPV in the next 6 months?,” while for male students was “Are you willing to receive HPV vaccine when it is approved among men in mainland in the future?”.…”

Discrepancy of human papillomavirus vaccine uptake and intent between girls 9–14 and their mothers in a pilot region of Shanghai, China

“…An online questionnaire was used to investigate the HPV vaccine uptake and intent. Based on the previous studies, 17 we designed a questionnaire, including the questions on the HPV vaccination status stratified for mothers and daughters, general knowledge and awareness toward HPV and HPV vaccination, in addition to demographics such as age, educational level, and monthly household income (supplementary file).…”