Effect of Health Intervention via Web-Based Education on Improving Information-Motivation-Behavioral Skills Related to HPV Vaccination Among Chinese Female College Students

A theory-based educational intervention to increase mothers' intention to vaccinate their daughters against human papillomavirus: A randomised controlled trial

OBJECTIVE

The current study aimed to examine the effectiveness of a web-based educational intervention based on the theory of planned behaviour (TPB) in enhancing mothers' knowledge of human papillomavirus (HPV) and its vaccine, attitudes towards the HPV vaccine, subjective norms, perceived behavioural control, and intention to vaccinate their daughters against HPV.

METHOD

A randomised controlled trial was conducted. The sample comprised 214 mothers of adolescents from 10 intermediate schools in Saudi Arabia. After collecting baseline data, the participants were randomly assigned to control and intervention groups. The TPB-based intervention was delivered online to the intervention group, and post-test data were collected from both groups. A mixed-effects model of covariance was used to test the effect of the intervention.

RESULTS

There were no significant differences between the two groups at baseline. One month after delivery, the intervention was found to have a significant effect on mothers' knowledge (F (1, 211.15) = 72.40, p < .001), attitudes (F (1, 211.11) = 110.57, p < .001), subjective norms (F (1, 211) = 34.55, p < .001), perceived control behaviour (F (1, 211.12) = 144.01, p < .001), and intention to vaccinate their daughters against HPV (F (1, 211.05) = 113.64, p < .001).

CONCLUSION

The study showed that the web-based intervention based on the TPB was effective in increasing mothers' knowledge, attitude, subjective norms, perceived control behaviour, and intention to vaccinate their daughters after 1 month.

PRACTICE IMPLICATIONS

The findings underscore the significance of popularising and implementing such interventions to boost HPV vaccine coverage among adolescents.

Opportunities and challenges for human papillomavirus vaccination in China

Current estimates of the HPV infection rate in China vary by geographic region (9.6-23.6%), with two age peaks in prevalence in women ≤20-25 years of age and 50-60 years of age. HPV-16, 52 and 58 are the most commonly-detected HPV genotypes in the Chinese population. In China, five HPV vaccines are licensed and several others are undergoing clinical trials. Multiple RCTs have shown the efficacy and safety of the bvHPV (Cervarix), Escherichia coli-produced bvHPV (Cecolin), Pichia pastoris-produced bvHPV (Walrinvax), qvHPV (Gardasil) and 9vHPV (Gardasil-9) vaccines in Chinese populations, including two studies showing long-term efficacy (≥8 years) for the bvHPV and qvHPV vaccines. Real-world data from China are scarce. Although modeling studies in China show HPV vaccination is cost-effective, uptake and population coverage are relatively low. Various policies have been implemented to raise awareness and increase vaccine coverage, with the long-term aim of eliminating cervical cancer in China.