Impact of Web-Based Health Education on HPV Vaccination Uptake Among College Girl Students in Western and Northern China: A Follow-Up Study

Abstract Objective: To investigate the knowledge of human papillomavirus (HPV) and HPV vaccines, HPV vaccination uptake, and vaccination willingness among female college students, and to explore the effect of a web-based educational intervention, immediately and at one month later, on HPV knowledge, vaccine acceptability and uptake among female college students in Western and Northern China. Methods: A web-based interventional follow-up study was conducted at two universities in Western and Northern China between February and April 2020. Female freshmen were required to complete an online questionnaire, and then eligible students were randomized into intervention and control group. Students in the intervention group received 7-days of web-based health education regarding HPV and HPV vaccines, while the control group received educational materials unrelated to HPV prevention. All students were asked to complete post-intervention questionnaire to assess their awareness, uptake, and willingness regarding HPV vaccination at a 7 days and 30 days interval, respectively. Differences between intervention and control groups were compared using the Chi-square test. Multivariable logistic regression was used to analyze the influencing factors of vaccination intentions. Results: A total of 967 participants were included in this study. Prior to the intervention, 63.8%, 66.3%, and 60.8% of students had heard of HPV, HPV-related diseases, and HPV vaccines, respectively. However, only 2.2% of students had reported to have been vaccinated, and 33.0% were willing to be vaccinated against HPV. After 7-days education, students in the intervention group had higher awareness and willingness of HPV vaccines than those in the control group. Major reasons that college female students do not accept HPV vaccines were the high cost (57.7%) and concerns about the adverse events (56.0%). School location, education background of parents, history of counseling about HPV vaccines, history of sexual behavior, and having heard of HPV vaccines are influencing factors on willingness to be vaccinated. Conclusion: The female college students’ HPV vaccination uptake is insufficient, and they have minimal detailed knowledge about HPV and its vaccines. Web-based health education on HPV vaccines is an easy, feasible, and effective way to improve the awareness and acceptance of HPV vaccination among female college students, but it has limited effect on improving HPV vaccination uptake.