Yuanli Liu

An Internet-Based Education Program for Human Papillomavirus Vaccination Among Female College Students in Mainland China: Application of the Information-Motivation-Behavioral Skills Model in a Cluster Randomized Trial

Background Patients diagnosed with cervical cancer in the last 2 decades were mainly young females. Human papillomavirus (HPV) vaccination is the most radical way to prevent HPV infection and cervical cancer. However, most female college students in mainland China have not yet been vaccinated, and their relevant knowledge is limited. Theory-based education delivered via the internet is a potentially accessible and useful way to promote HPV vaccination among this population. Objective This 3-month follow-up study intended to identify the feasibility and efficacy of an information-motivation-behavioral skills (IMB) model–based online intervention for promoting awareness and willingness regarding HPV vaccination among female college students. Methods A 7-day online HPV education program for female college students in mainland China was developed using a cluster randomized trial design. Recruitment and questionnaire surveys were performed online without face-to-face contact. SPSS 23.0 was used for statistical analysis. The chi-square test and t test were used to compare differences in qualitative and continuous variables between intervention and control groups. The generalized estimating equation was used to test the effectiveness of the intervention with a consideration of the time factor. Results Among 3867 participants, 102 had been vaccinated against HPV before the study (vaccination rate of 2.6%). A total of 3484 participants were followed up after the baseline survey, with no statistical difference in the loss rate between the intervention and control groups during the intervention and follow-up periods. At different follow-up time points, HPV-related knowledge, and the motivation, behavioral skills, and willingness regarding HPV vaccination were higher in the intervention group than in the control group. HPV-related knowledge was statistically different between the 2 groups, while the motivation, behavioral skills, and willingness regarding HPV vaccination only showed statistical differences right after the intervention, reaching a peak right after the intervention and then gradually reducing over time. Furthermore, there was no statistical difference in the HPV vaccination rate between the 2 groups. Conclusions IMB model–based online education could be a promising way to increase the HPV vaccination rate and reduce the burden of HPV infection and cervical cancer among high-risk female college students in China. Trial Registration Chinese Clinical Trial Registry ChiCTR1900025476; http://www.chictr.org.cn/showprojen.aspx? proj=42672 International Registered Report Identifier (IRRID) RR2-DOI:10.1186/s12889-019-7903-x

A national survey on HPV vaccination status among 42,800 female physicians and nurses in China, 2021

Human papillomavirus (HPV) vaccination is the most effective method to prevent cervical cancer. This study aimed to investigate the status of HPV vaccination and associated factors among Chinese females. Between January and March 2021, we conducted a large national survey among female doctors and nurses in 181 public tertiary hospitals across all 31 provinces of China. In the survey, we asked three questions: "Have you ever received an HPV vaccination? If yes, what type and in which year?" We described and compared the proportion of vaccination coverage according to occupation, age, geographic region, education, marital status, among other factors. Among 42,800 participants, 6185 (14.45 %) reported receiving HPV vaccination. Physicians showed a slightly higher vaccination rate (2064/13,804; 14.95 %) than nurses (4121/28,996, 14.21 %). Factors significantly associated with higher vaccination rates included younger age, being never married or divorced, higher education, better self-reported health status, residing in the western region, working in Obstetrics and Gynecology or Surgery departments, working at cancer hospitals, and being nulliparous. Regarding vaccine types, the 4-valent vaccine accounted for 50.3 %, followed by the 9-valent (33.7 %), imported 2-valent (16.0 %). Understanding the characteristics of the likelihood of receiving HPV vaccination among female physicians and nurses in China indicates their awareness of the risk for cervical cancer, which could help us better develop primary prevention strategies.