scholarly journals Characterizing Trends in Human Papillomavirus Vaccine Discourse on Reddit (2007-2015): An Observational Study (Preprint)

2018 ◽  
Author(s):  
Yuki Lama ◽  
Dian Hu ◽  
Amelia Jamison ◽  
Sandra Crouse Quinn ◽  
David A. Broniatowski
Keyword(s):  
Social Media ◽  
Sexual Behavior ◽  
Human Papillomavirus ◽  
Cancer Risk ◽  
Health Communication ◽  
Sexual Activity ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Online Discussions ◽  
Significant Difference

BACKGROUND Despite the introduction of the human papillomavirus (HPV) vaccination as a preventive measure in 2006 for cervical and other cancers, uptake rates remain suboptimal, resulting in preventable cancer mortality. Social media, widely used for information seeking, can influence users’ knowledge and attitudes regarding HPV vaccination. Little is known regarding attitudes related to HPV vaccination on Reddit (a popular news aggregation site and online community), particularly related to cancer risk and sexual activity. Examining HPV vaccine–related messages on Reddit may provide insight into how HPV discussions are characterized on forums online and influence decision making related to vaccination. OBJECTIVE We observed how the HPV vaccine is characterized on Reddit over time and by user gender. Specifically, this study aimed to determine (1) if Reddit messages are more related to cancer risks or sexual behavior and (2) what other HPV vaccine–related discussion topics appear on Reddit. METHODS We gathered all public Reddit comments from January 2007 to September 2015. We manually annotated 400 messages to generate keywords and identify salient themes. We then measured the similarity between each comment and lists of keywords associated with sexual behavior and cancer risk using Latent Semantic Analysis (LSA). Next, we used Latent Dirichlet Allocation (LDA) to characterize remaining topics within the Reddit data. RESULTS We analyzed 22,729 messages containing the strings hpv or human papillomavirus and vaccin. LSA findings show that HPV vaccine discussions are significantly more related to cancer compared with sexual behavior from 2008 to 2015 (P<.001). We did not find a significant difference between genders in discussions of cancer and sexual activity (P>.05). LDA analyses demonstrated that although topics related to cancer risk and sexual activity were both frequently discussed (16.1% and 14.5% of word tokens, respectively), the majority of online discussions featured other topics. The most frequently discussed topic was politics associated with the vaccine (17.2%). Other topics included HPV disease and/or immunity (13.5%), the HPV vaccine schedule (11.5%), HPV vaccine side effects (9.7%), hyperlinks to outside sources (9.1%), and the risks and benefit of HPV vaccination (8.5%). CONCLUSIONS Reddit discourse on HPV vaccine encompasses a broad range of topics among men and women, with HPV political debates and cancer risk making up the plurality of the discussion. Our findings demonstrated that women and men both discussed HPV, highlighting that Reddit users do not perceive HPV as an issue that only pertains to women. Given the increasing use of social media as a source of health information, these results can inform the development of targeted online health communication strategies to promote HPV vaccination to young adult users of Reddit. Analyzing online discussions on Reddit can inform health communication efforts by identifying relevant, important HPV-related topics among online communities.

scholarly journals Human Papillomavirus Vaccination and Social Media: Results in a Trial With Mothers of Daughters Aged 14–17

2021 ◽  
Vol 3 ◽  
Author(s):  
David B. Buller ◽  
Sherry Pagoto ◽  
Kimberly Henry ◽  
Julia Berteletti ◽  
Barbara J. Walkosz ◽  
...  
Keyword(s):  
Social Media ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Vaccine Uptake ◽  
Drug Misuse ◽  
Relative Advantage ◽  
Control Group ◽  
Hpv Vaccines ◽  
Self Reports

Introduction: Parents acquire information about human papillomavirus (HPV) vaccines online and encounter vaccine-critical content, especially on social media, which may depress vaccine uptake. Secondary analysis in a randomized trial of a Facebook-delivered adolescent health campaign targeting mothers with posts on HPV vaccination was undertaken with the aims of (a) determining whether the pre–post-change occurred in self-reports of the mothers on HPV vaccination of their adolescent daughters; (b) describing the comments and reactions to vaccine posts; (c) exploring the relationship of campaign engagement of the mothers assessed by their comments and reactions to posts to change in the self-reports of the mothers of HPV vaccination.Materials and Methods: Mothers of daughters aged 14–17 were recruited from 34 states of the US (n = 869). A social media campaign was delivered in two Facebook private groups that differed in that 16% of posts in one were focused on indoor tanning (IT) and 16% in the other, on prescription drug misuse, assigned by randomization. In both groups, posts promoted HPV vaccination (n = 38 posts; no randomization) and vaccination for other disease (e.g., influenza, n = 49). HPV and other vaccination posts covered the need for a vaccine, the number of adolescents vaccinated, how vaccines are decreasing the infection rates, and stories of positive benefits of being vaccinated or harms from not vaccinating. Guided by social cognitive theory and diffusion of innovations theory, posts were intended to increase knowledge, perceived risk, response efficacy (i.e., a relative advantage over not vaccinated daughters), and norms for vaccination. Some vaccination posts linked to stories to capitalize on identification effects in narratives, as explained in transportation theory. All mothers received the posts on vaccination (i.e., there was no randomization). Mothers completed surveys at baseline and 12- and 18-month follow-up to assess HPV vaccine uptake by self-report measures. Reactions (such as sad, angry) and comments to each HPV-related post were counted and coded.Results: Initiation of HPV vaccination (1 dose) was reported by 63.4% of mothers at baseline, 71.3% at 12-month posttest (pre/post p &lt; 0.001), and 73.3% at 18-month posttest (pre/post p &lt; 0.001). Completion of HPV vaccination (two or three doses) was conveyed by 50.2% of mothers at baseline, 62.5% at 12-month posttest (pre/post p &lt; 0.001), and 65.9% at 18-month posttest (pre/post p &lt; 0.001). For posts on HPV vaccines, 8.1% of mothers reacted (n = 162 total), and 68.4% of posts received a reaction (63.2% like; 13.2% love, 7.9% sad). In addition, 7.6% of mothers commented (n = 122; 51 unfavorable, 68 favorable, 1 neutral), and 50.0% of these posts received a comment. There were no differences in pre–post change in vaccine status by the count of reactions or comments to HPV vaccine posts (Ps &gt; 0.05). Baseline vaccination was associated with the valence of comments to HPV vaccine posts (7.2% of mothers whose daughters had completed the HPV series at baseline made a favorable comment but 7.6% of mothers whose daughters were unvaccinated made an unfavorable comment).Conclusion: Effective strategies are needed in social media to promote HPV vaccines and counter misinformation about and resistance to them. Mothers whose daughters complete the HPV vaccine course might be recruited as influencers on HPV vaccines, as they may be predisposed to talk favorably about the vaccine. Comments from mothers who have not been vaccinated should be monitored to ensure that they do not spread vaccine-critical misinformation. Study limitations included lack of randomization and control group, relatively small number of messages on HPV vaccines, long measurement intervals, inability to measure views of vaccination posts, reduced generalizability related to ethnicity and social media use, and use of self-reported vaccine status.Clinical Trial Registration:www.clinicaltrials.gov, identifier NCT02835807.

scholarly journals Kansan Guardian Perceptions of HPV and the HPV Vaccine and the Role of Social Media

2020 ◽  
Vol 13 (1) ◽  
pp. 9-18 ◽  
Author(s):  
Monique Luisi
Keyword(s):  
Social Media ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Online Survey ◽  
Hpv Vaccination ◽  
Vaccine Safety ◽  
Vaccination Rates ◽  
Media Messages ◽  
Influence Perceptions

Introduction. Human papillomavirus (HPV) vaccination rates in Kansas historically have been low among children and adolescents. How Kansas parents and guardians perceive the HPV vaccine may influence vaccination rates among Kansas youth. Social media messages also may influence perceptions, suggesting implications for current and future disease and cancer burden. Methods. Eligible Kansas guardians of children aged 9 - 17 years completed an online survey. The survey assessed their perceptions about a) HPV and the HPV vaccine, b) HPV and HPV vaccine representation on social media, and c) the effects that social media has on their perceptions about HPV and the HPV vaccine. Results. Most Kansas guardians (n = 55, 57.9%) indicated seeing information about HPV and the HPV vaccine on social media. Kansas guardians who had reported seeing information on social media about the HPV vaccine were significantly more likely to perceive that the HPV vaccine could kill their child than those who had not seen information (t(79) = 0.019). Additionally, children of wealthier Kansan guardians were vaccinated more than children of less wealthy guardians. Conclusion. Social media messages may be influencing Kansan guardians to think the HPV vaccine is lethal in their children. Future campaigns increasingly should be focused on HPV vaccine safety and effectiveness.

scholarly journals Challenges related to human papillomavirus (HPV) vaccine uptake in Minnesota: clinician and stakeholder perspectives

2021 ◽  
Author(s):  
Nicholas Yared ◽  
Molly Malone ◽  
Estee Welo ◽  
Inari Mohammed ◽  
Emily Groene ◽  
...  
Keyword(s):  
Social Media ◽  
Human Papillomavirus ◽  
Cancer Prevention ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Negative Influence ◽  
Vaccine Uptake ◽  
Related Factors ◽  
Vaccination Rates ◽  
Hpv Vaccine Uptake

Abstract Background Human papillomavirus (HPV) vaccination rates among adolescents are increasing in Minnesota (MN) but remain below the Healthy People 2020 goal of 80% completion of the series. The goal of this study was to identify messaging and interventions impacting HPV vaccine uptake in MN through interviews with clinicians and key stakeholders. Methods We conducted semi-structured key participant interviews with providers and stakeholders involved in HPV vaccination efforts in MN between 2018 and 2019. Provider interview questions focused on messaging around the HPV vaccine and clinic-based strategies to impact HPV vaccine uptake. Stakeholder interview questions focused on barriers and facilitators at the organizational or state level, as well as initiatives and collaborations to increase HPV vaccination. Responses to interviews were recorded and transcribed. Thematic content analysis was used to identify themes from interviews. Results 14 clinicians and 13 stakeholders were interviewed. Identified themes were grouped into 2 major categories that dealt with messaging around the HPV vaccine, direct patient–clinician interactions and external messaging, and a third thematic category involving healthcare system-related factors and interventions. The messaging strategy identified as most useful was promoting the HPV vaccine for cancer prevention. The need for stakeholders to prioritize HPV vaccination uptake was identified as a key factor to increasing HPV vaccination rates. Multiple providers and stakeholders identified misinformation spread through social media as a barrier to HPV vaccine uptake. Conclusion Emphasizing the HPV vaccine’s cancer prevention benefits and prioritizing it among healthcare stakeholders were the most consistently cited strategies for promoting HPV vaccine uptake. Methods to combat the negative influence of misinformation about HPV vaccines in social media are an urgent priority.

scholarly journals Human Papillomavirus Vaccination Before 13 and 15 Years of Age: Analysis of National Immunization Survey Teen Data

2019 ◽  
Vol 220 (5) ◽  
pp. 730-734 ◽  
Author(s):  
Robert A Bednarczyk ◽  
Mallory K Ellingson ◽  
Saad B Omer
Keyword(s):  
United States ◽  
Human Papillomavirus ◽  
Sexual Activity ◽  
Advisory Committee ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
The United States ◽  
Human Papillomavirus Vaccination ◽  
National Immunization ◽  
National Immunization Survey

Abstract Human papillomavirus (HPV) vaccination is suboptimally used in the United States. Vaccination before the 13th birthday is recommended by the Advisory Committee on Immunization Practices and vaccination before the 15th birthday requires only 2 doses. We estimated the proportion of adolescents up to date for HPV vaccine using provider-verified vaccination data from the 2016 National Immunization Survey-Teen. Only 16% of US adolescents completed HPV vaccination before turning 13, and 35% completed HPV vaccination before turning 15. With sexual activity initiation increasing throughout adolescence and higher immunogenicity for younger vaccinees, vaccination before the 13th birthday can provide better protection against HPV-related cancers.

scholarly journals Surgical Treatment of Vulvar HSIL: Adjuvant HPV Vaccine Reduces Recurrent Disease

Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 83
Author(s):  
Alessandro Ghelardi ◽  
Roberto Marrai ◽  
Giorgio Bogani ◽  
Francesco Sopracordevole ◽  
Paola Bay ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hpv Vaccine ◽  
Recurrent Disease ◽  
Current Knowledge ◽  
Hpv Vaccination ◽  
Clinical Effectiveness ◽  
Hpv Infection ◽  
Control Group ◽  
Hpv Test ◽  
Significant Difference

Data suggest that adjuvant human papillomavirus (HPV)-vaccination in women treated for cervical HPV diseases reduces recurrent disease. This study investigates adjuvant HPV-vaccination and the rate of recurrence in women undergoing surgery for vulvar high-grade squamous intraepithelial lesions (HSIL). From January 2013 to April 2020, we enrolled 149 women in a prospective case-control study. The control group (NV-group) was treated by standard surgery alone, while the study group received adjuvant vaccination soon after surgery (V-group). A follow-up was performed by vulvoscopy and HPV test. Statistical analysis was performed by Fisher’s exact test. HSIL recurrence was observed in 24/76 (32%) patients in NV-group and in 8/42 patients (19%) of the vaccinated group. By analysing the recurrence rate related to the incident and reactivated latent HPV infection, we found a significant difference between (17/76) 22.3% in NV-group and (2/42) 4.8% in V-group (p = 0.01). A reduction of 78.5% in incident/reactivated HPV infections was demonstrated. Data results add to the current knowledge about the mechanism of post-surgical adjuvant HPV vaccination. Our prospective study is the first to document the vaccine clinical effectiveness in preventing “reactivation” of latent HPV infections. Quadrivalent HPV vaccine administered after the surgical treatment for vulvar HSIL appears to be useful in preventing recurrent disease.

scholarly journals Effects of a randomized controlled trial of a brief, student-nurse led, parent-based sexual health intervention on parental protective factors and HPV vaccination uptake

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
D. Santa Maria ◽  
C. Markham ◽  
S. M. Misra ◽  
D. C. Coleman ◽  
M. Lyons ◽  
...  
Keyword(s):  
Sexual Health ◽  
Health Communication ◽  
Health Knowledge ◽  
Hpv Vaccination ◽  
Control Group ◽  
Post Intervention ◽  
Adolescent Sexual Health ◽  
Significant Difference ◽  
Sexual Health Communication ◽  
Parent Child

Abstract Background Parents play a pivotal role in adolescent sexual health and Human Papillomavirus (HPV) vaccination. Nurses are on the frontlines of healthcare and play a critical role in promoting HPV vaccination and parent-child sexual health communication. We enhanced the Families Talking Together (FTT) parent-based sexual health curriculum to include adolescent vaccinations herein, FTT + HPV, and trained student nurses to provide a strong HPV vaccination and parent-child sexual health communication endorsement. Methods Using a randomized attention-controlled trial design, we examined the efficacy of FTT + HPV among 519 parents and their 11–14 year old youth recruited from medically underserved communities between 2015 and 2018. Participants were recruited from 22 after-school programs (e.g., Boys and Girls Clubs) and 19 charter schools. For parents, we examined protective factors including parent-child sexual health communication and parental involvement. For youth, we examined sexual health knowledge, parent-child sexual health communication, and parent-child connectedness. To assess HPV vaccination initiation and completion, we searched IMMTRAC immunization registry records for 85% of youth and used parental report for youth without registry records. Group differences were calculated using the estimated mean difference at one- and six months post-intervention with significance set at the p < 0.05 level. Results Baseline rates of HPV vaccination were low at 55.7%. No significant difference between the groups was seen in vaccination initiation or completion rates by one-month post-intervention. However, by six-months post intervention, there was a significant difference between the groups with 70.3% of the intervention group initiating the HPV vaccination series vs. 60.6% for the control group (p = 0.02). No difference between the groups was found for HPV series completion at six-months. There were significant differences in condom knowledge (p = 0.04), parent-child connectedness (p = 0.04), and communication frequency (p = 0.001) with greater improvement in the intervention vs. the control group. Rates of sexual activity remained low in both groups throughout the six-month follow-up period. Conclusion A brief parent-based adolescent sexual health and HPV vaccination intervention delivered by student nurses can improve sexual health outcomes including protective parental factors, adolescent sexual health knowledge, and HPV vaccination initiation rates. Trial registration ClinicalTrials.gov Identifier: NCT02600884. Prospectively registered September 1, 2015.

scholarly journals A comparison of health communication effectiveness and the improvement of management strategies: taking two Chinese traditional medicine hospitals’ WeChat public accounts as examples

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jie Wang ◽  
Lanting Wu
Keyword(s):  
Public Health ◽  
Social Media ◽  
Health Communication ◽  
Traditional Medicine ◽  
Health Knowledge ◽  
Health Care Service ◽  
Mobile Internet ◽  
Chinese Traditional Medicine ◽  
Public Account ◽  
Significant Difference

Abstract Background In the light of “Internet plus”, hospitals are following the trend of using mobile internet and adopting a strategy of spreading public health knowledge through mobile terminals. WeChat is a social media with the largest number of users in China. Its public account has become the most popular service among the public. Methods We examine the health communication of medical institutions on social media platforms. The WeChat public accounts of Zhejiang Provincial Chinese Traditional Medicine Hospital and Jiangxi Provincial Chinese Traditional Medicine Hospital were taken as cases to measure the communication effect from the following dimensions: update interval, content positioning and design, numbers of clicks and likes as well as topic types. Results The update interval of WeChat public account of Jiangxi Provincial Hospital of Traditional Chinese Medicine was regular, compared with that of the other hospital. The accounts of the two hospitals both set up special sections to facilitate patients to obtain medical services online. There is an extremely significant difference between the two hospitals’ mean numbers of clicks (p < 0. 001), compared with no significant difference between their mean numbers of likes. One-way analysis of variance suggests the type of topic on posts is significantly correlated with the number of clicks. Moreover, there is an extremely significant difference between public health knowledge and news propaganda. Conclusion The development of hospitals’ WeChat public accounts can promote people’s health and equity in accessing medical information and service, and also boost “Internet plus health care” service. The topic type of hospital’s news publicity is paid a relatively lower attention by users. Therefore, hospitals’ WeChat public accounts need to adjust their strategy from propaganda-oriented to users-centered, with topic planning and posts designed to fulfill users’ needs.

scholarly journals Stakeholders’ Understandings of Human Papillomavirus (HPV) Vaccination in Sub-Saharan Africa: A Rapid Qualitative Systematic Review

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 496
Author(s):  
Caroline Deignan ◽  
Alison Swartz ◽  
Sara Cooper ◽  
Christopher J. Colvin
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Qualitative Systematic Review ◽  
Sub Saharan ◽  
And Gender

Cervical cancer rates in Sub-Saharan Africa (SSA) are amongst the highest worldwide. All three of the Human Papillomavirus (HPV) vaccines (9-valent, quadrivalent and bivalent HPV vaccine) provide primary protection against the most common cancer-causing strains of HPV (types 16 and 18) that are known to cause 70% of cervical cancers. Over the last five years, there has been an increase in Sub-Saharan African countries that have introduced the HPV vaccine. The majority of research has been conducted on supply-side barriers and facilitators to HPV vaccination uptake in SSA, yet little research has been conducted on demand-side or end-user perspectives of, and decisions around, HPV vaccination. In order to complement existing research, and inform current and future HPV vaccination implementation approaches, this qualitative systematic review explored Stakeholders’ understandings of HPV vaccination in SSA. This review searched the following databases: Embase (via Scopus), Scopus, MEDLINE (via PubMed), PubMed, EBSCOhost, Academic Search Premier, Africa-Wide Information, CINAHL, PsycARTICLES, PsycINFO, SocINDEX, Web of Science, and the Cochrane Controlled Register of Trials (CENTRAL) and found a total of 259 articles. Thirty-one studies were found eligible for inclusion and were analyzed thematically using Braun and Clarke’s methods for conducting a thematic analysis. The quality of included studies was assessed using the Critical Appraisal Skills Programme (CASP) checklist. Three major themes emerged from this analysis; knowledge of HPV vaccination and cervical cancer is intertwined with misinformation; fear has shaped contradictory perceptions about HPV vaccination and gender dynamics are relevant in how stakeholders understand HPV vaccination in SSA.

scholarly journals Predictors of Human Papillomavirus Vaccine uptake or intent among parents of preadolescents and adolescents

2017 ◽  
Vol 7 (6) ◽  
pp. 35 ◽  
Author(s):  
Kimberlee Dayal ◽  
Sarah Robinson ◽  
Jessica Schoening ◽  
Mary Catherine Smith ◽  
Son Chae Kim
Keyword(s):  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Parental Education ◽  
Hpv Vaccination ◽  
College Education ◽  
Vaccine Effectiveness ◽  
Vaccine Uptake ◽  
Human Papillomavirus Vaccine ◽  
Hpv Knowledge ◽  
Hpv Vaccine Uptake

Aim: The aim of this study was to examine predictors of human papillomavirus (HPV) vaccine uptake or intent among parents of pre-adolescents and adolescents.Methods: A cross-sectional descriptive study was conducted among parents of girls aged 9 to 18 years, visiting two primary care clinics in central Texas from September to November 2015. Pearson’s product-moment correlation procedures and path analyses based on Health Belief Model were performed.Results: Path analysis showed that provider recommendation for HPV vaccination (β = 0.37; p < .001) and perceived HPV vaccine harm (β = -0.48; p < .001) had statistically significant direct effects on HPV vaccine uptake or intent. The perceived HPV vaccine effectiveness was directly influenced by HPV knowledge (β = 0.39; p < .001), empowerment in parent-provider relationships (β = 0.30; p = .006) and parental college education (β = 0.23; p = .039).}Conclusions: Together with parental empowerment fostering an equal partnership with providers, targeted education to improve parental HPV knowledge may convince them of the HPV vaccine effectiveness. This, in turn, may help them put the perceived HPV vaccine harm in proper perspective and allow them to make informed decisions regarding the timely HPV vaccination of their children. Because provider recommendation is one of the most important contributing factors for HPV vaccine uptake or intent, parental education and recommendations from nurses will help reduce the knowledge gaps and empower parents to make the timely decisions to vaccinate their children.

scholarly journals Awareness and knowledge of human papillomavirus vaccination and their influential factors among Chinese women: a systematic review

2019 ◽  
Vol 6 (4) ◽  
pp. 317-326
Author(s):  
Gui-Dan Tang ◽  
Gu-Qing Zeng ◽  
Bi-Xia Zhao ◽  
Yun-Li Li ◽  
Rong Wang ◽  
...  
Keyword(s):  
Public Health ◽  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Chinese Women ◽  
Hpv Vaccination ◽  
Influential Factors ◽  
Perceived Behavioral Control ◽  
Human Papillomavirus Vaccination ◽  
Female Population ◽  
Multi Level

Abstract Objectives To systematically review the knowledge attitudes and the influential factors on human papillomavirus (HPV) vaccination among Chinese women. Methods Published studies on knowledge and attitudes of HPV vaccination for preventing cervical cancer among Chinese female population were retrieved using the major Chinese and English databases. Meanwhile, handwork retrieval was also conducted and the references including in the literature were retrieved. The quality of the literature was rigorously evaluated and extracted independently by two researchers and the data were analyzed and described by review manager 5.3 (RevMan5.3) software. Results In all, 19 articles including 8 articles in Chinese and 11 in English were chosen. A total of 30,176 participants were included and the sample size ranged from 64 to 6,024. The overall awareness of HPV and HPV vaccine among Chinese women was at a low level. Chinese women generally showed poor knowledge about HPV and HPV vaccine. Acceptance of HPV vaccination among Chinese women was at a high level. Vaccination intentions were influenced by the theory of planned behavior (TPB) and measured by attitudes subjective norms and perceived behavioral control. Conclusions The health authorities may evaluate and develop TPB-based interventions to increase HPV vaccination intentions of Chinese women. HPV vaccination programs should focus on carrying out multi-level and targeted health education and developing effective public health strategies after balancing the cost and benefit of HPV vaccine program. Medical staff should play the positive role in promoting the use of HPV vaccines in China. Integration of policy and community perspectives and multi-level interventions are essential to maximize the public health benefits of HPV vaccination.

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