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Exploring Chinese College Students’ HPV Awareness, Knowledge, Attitudes, and Intent of HPV Vaccination: a Qualitative Study

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Abstract

Human papillomavirus (HPV) infection is the world’s most prevalent sexually transmitted infection and causes cancers. In China, about 47,739 deaths occur annually from HPV-related cervical cancer, and this number continues to increase. HPV vaccines have shown promising results in preventing HPV-associated cancers; however, the vaccination rate in Chinese college students remains extremely low. This qualitative research explored Chinese college students’ HPV-related awareness, knowledge, attitudes and beliefs, and their vaccination intention as well as the strategies promoting vaccination in China. We conducted four focus groups with 18 male and 20 female students; prompts were developed based on the health belief model (HBM). Discussions were audiotaped, transcribed, and translated from Chinese to English by three bilingual researchers. Content analysis of the data revealed eight themes addressing HBM. Participants demonstrated high awareness (71% had heard of HPV) with limited knowledge. They perceived very low risks of being infected but expressed high vaccination intention if the cost was covered by the government. Participants identified reasons that facilitate and prevent vaccination and proposed culturally and developmentally congruent strategies to promote vaccination in China. It is essential to address facilitators and barriers at individual, societal, political, and cultural levels to promote HPV vaccination in Chinese college students.

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Acknowledgments

We wish to acknowledge study participants and Lihong Ou’s assistance with formatting.

Funding

We would also like to thank the Arizona State University Barrett Honors College for funding the second author for her participation in this research.

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Authors and Affiliations

  1. Edson College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, USA

    Angela Chia-Chen Chen

  2. Duke Medical Center, 10 Duke Medicine Circle, Durham, NC, USA

    Calli Astroth

  3. Edson College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, USA

    Elizabeth Reifsnider

  4. Department of Nursing, The First Affiliated Hospital of Harbin Medical University, Harbin, China

    Hui Yang

  5. School of Public Health, Department of Chronic Disease Epidemiology, Yale University, New Haven, CT, USA

    Wenlan Mao

  6. West China School of Nursing, West China Hospital, Sichuan University, Sichuan, China

    Hong Chen

Authors
  1. Angela Chia-Chen Chen
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  2. Calli Astroth
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  3. Elizabeth Reifsnider
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  4. Hui Yang
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  5. Wenlan Mao
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  6. Hong Chen
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Corresponding author

Correspondence to Angela Chia-Chen Chen.

Ethics declarations

This study was approved by the University Institutional Review Board, and all researchers received IRB training before conducting the study. We received the participants’ consent before conducting research activities. The data was secured in a HIPAA-compliant and encrypted server with multilevel password protection, enterprise-level firewalls, and antivirus barriers and could only be accessed by researchers.

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Chen, A.CC., Astroth, C., Reifsnider, E. et al. Exploring Chinese College Students’ HPV Awareness, Knowledge, Attitudes, and Intent of HPV Vaccination: a Qualitative Study. J Canc Educ 36, 1211–1218 (2021). https://doi.org/10.1007/s13187-020-01750-0

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  • DOI: https://doi.org/10.1007/s13187-020-01750-0

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