The effectiveness of promotion of human papillomavirus vaccination program among female medical students in Hubei province, China

Abstract

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide, with the highest incidence occurring shortly after initial sexual contact. Emerging evidence underscores the heightened vulnerability of college-year students to HPV infection. However, intention to initiate HPV vaccination among college-year students is not high in China, posing a significant challenge to the goal of eliminating cervical cancer as a public health problem. Protection Motivation Theory (PMT), a widely applied model of motivation to respond to threats. Thus, this study aim to explore the intention and the factors associated with intention to initiate HPV vaccination among medical college students; and to develop a HPV vaccination program to promote intention to initiate HPV vaccination.

Method: In phase I, both quantitative and qualitative methods were used in this study. In quantitative study, a cross-sectional study was conducted on 1148 female medical college students from six colleges in Hubei Province with a multistage sampling method. The data were collected by web-based online software. Multiple logistic regression was applied to explore the intention to initiate HPV vaccination and factors associated with it. Also, an in-depth interviewing was conducted with 24 participants including 10 medical college students, 8 healthcare providers from the college clinics, and 6 teachers of college. The qualitative data was analyzed using the 7-step method proposed by Colaizzi's.

In phase II, a promotion of the HPV vaccination program based on the significance variables from Phase I and the PMT theory was developed. Then, a total of 204 medical college students were randomly assigned to intervention group (n = 102) and control group (n = 102) to explore the effect of this program. The intervention group received a PMT-based HPV vaccination online education program, while the control group received regular vaccine education program. Data were collected through an online software with a structured questionnaire. The chi-square test, independent samples t-test, repeated measure ANOVA, Cochran’s Q test, were applied for data analyses.

Results: In phase I, the quantitative study found that (1) 85.5% of female medical college students posed a high intention for HPV vaccination in Hubei province. (2) Factors associated with the intention to initiate HPV vaccination among female medical college students, including social demographic factors (willingness to pay for HPV vaccine), knowledge and information received about HPV and HPV vaccine, and three PMT scale factors (including perceived severity, perceived response efficacy, and perceived self-efficacy).Three themes were generated from content analysis after interview, which were perception toward HPV vaccine based on PMT model, barriers to receiving HPV vaccine, and how to promote HPV vaccination.

In phase II, a PMT-based HPV vaccination online health program were develop. The results revealed that in the intervention group, HPV vaccine intention, the knowledge of HPV and HPV vaccine scores, and HPV vaccine communication competency scores were significantly higher than those before intervention (P

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