Knowledge, attitude, and behavior of human papillomavirus vaccination among undergraduate students in Shanghai, China

Factors predicting willingness to receive and promote HPV vaccine in the future_

Factors	B	SE	β	t	P
Constant	15.403	1.962		7.851	0
Age (years)	0.097	0.111	0.036	0.872	0.383
Gender	–0.334	0.240	–0.036	–1.395	0.163
Year of study	0.014	0.140	0.004	0.098	0.922
Heard of cervical cancer	0.902	0.199	0.123	4.526	0
Heard of HPV	0.505	0.260	0.051	1.945	0.052
Worried about the risk of cervical cancer	1.511	0.181	0.221	8.332	0
Heard of HPV vaccine	0.130	0.309	0.011	0.422	0.673
Friends or families received HPV vaccine	0.456	0.255	0.047	1.787	0.074
Knowledge	0.021	0.051	0.011	0.404	0.687

Correct responses to knowledge of HPV among health science and non-health science undergraduates (N = 1448)_

Questions	Overall(n = 1448), n (%)	Health science(n = 712), n (%)	Non-health science(n = 712), n (%)	χ2 (P value)
Q1	438 (30.2)	269 (37.8)	169 (23.0)	37.667 (0.000)
Q2	853 (58.9)	469 (65.9)	384 (52.2)	28.048 (0.000)
Q3	418 (28.9)	230 (32.3)	188 (25.5)	8.054 (0.005)
Q4	351 (24.2)	261 (36.7)	90 (12.2)	117.605 (0.000)
Q5	337 (23.3)	167 (23.5)	195 (26.5)	1.783 (0.183)
Q6	1115 (77.0)	611 (85.8)	504 (68.5)	61.422 (0.000)
Q7	1139 (78.7)	587 (82.4)	552 (75.0)	11.946 (0.001)
Q8	474 (32.7)	231 (32.4)	243 (33.3)	0.054 (0.816)
Q9	1111 (76.7)	567 (79.6)	544 (73.9)	6.635 (0.010)
Q10	1043 (72.0)	539 (75.7)	504 (68.5)	9.374 (0.002)
Total knowledge score (M ± SD)	5.027 ± 1.670	5.486 ± 1.631	4.583 ± 1.647

Factors influencing undergraduates’ attitude toward HPV vaccination_

Factors	M ± SD	d.f.	F	P
Gender		286.799	7.613	0.13
Male	14.770 ± 2.553
Female	14.455 ± 2.891
Age group (years)		1446	0.033	0.119
>18	14.674 ± 2.609
≤18	14.962 ± 2.560
Major		1446	2.848	0.241
Health science	14.803 ± 2.602
Non-health science	14.643 ± 2.615
Year of study		3/1444	4.484	0.004
Year 1	15.048 ± 2.667
Year 2	14.740 ± 2.600
Year 3	14.411 ± 2.527
Year 4	14.497 ± 2.575
Heard of cervical cancer		1446	0.023	0
Yes	14.816 ± 2.607
No	14.095 ± 2.541
Heard of HPV		732.834	4.4	0.028
Yes	14.965 ± 2.771
No	14.621 ± 2.522
Worried about the risk of cervical cancer		1446	0.283	0.247
Yes	14.819 ± 2.608
No	14.657 ± 2.609
Heard of HPV vaccine		1446	1.228	0.913
Yes	14.746 ± 2.851
No	14.719 ± 2.586
Received pay-by-self vaccine before		1446	0.015	0.505
Yes	14.791 ± 2.586
No	14.691 ± 2.620
Friends or families received HPV vaccine		240.934	6.24	0.059
Yes	15.092 ± 2.994
No	14.664 ± 2.540
Yourself received HPV vaccine		1446	2.38	0.16
Yes	14.091 ± 3.126
No	14.736 ± 2.595

Spearman’s correlation coefficient for demographic characteristics, HPV vaccine knowledge, attitude, and behavior_

Items	1	2	3	4	5	6	7	8	9	10	11	12	13	14
1. Age (years)	1
2. Gender	0.043	1
3. Major	0.021	–0.218**	1
4. Year of study	0.809**	–0.126**	0.123**	1
5. Heard of cervical cancer	–0.081**	–0.158**	–0.096**	0.145**	1
6. Heard of HPV	–0.095**	0.008	–0.012	0.190**	0.197**	1
7. Worried about cervical cancer	–0.126**	–0.205**	0.071**	0.212**	0.186**	0.167**	1
8. Heard of HPV vaccine	–0.058*	–0.057*	0.063*	0.103**	0.055*	0.221**	0.150**	1
9. Received pay-by-self vaccine before	0.054*	–0.023	0.037	–0.086**	0.026	–0.086**	–0.003	0.073**	1
10. Friends or families received the HPV vaccine	–0.013	0.005	0.094*	0.088**	0.064*	0.250**	0.124**	0.186**	0.077**	1
11. Received HPV vaccine	–0.013	0.025	0.048	–0.057*	–0.037	0.064*	0.056*	0.150**	0.141**	0.264**	1
12. HPV knowledge	–0.003	–0.038	–0.031	–0.100**	0.164**	0.122**	0.081**	–0.022	–0.014	–0.005	0.008	1
13. HPV attitude	0.041	–0.044	–0.266**	0.212**	0.093**	0.060*	0.03	0.003	0.018	0.056*	–0.037	0.058*	1
14. HPV behavior	0.102*	–0.093**	0.032	0.121**	0.132**	0.190**	0.274**	0.087**	0.022	0.112**	0.031	0.062*	–0.047	1

Awareness rate of HPV and related questions among health science and non-health science undergraduates (N = 1448)_

Questions	Overall (n = 1448), n (%)	Health science (n = 712), n (%)	Non-health science (n = 712), n (%)	χ2 (P value)
Heard about cervical cancer
Yes	1258 (86.9)	642 (90.2)	616 (83.7)	13.301 (0.000)
No	190 (13.1)	70 (9.8)	120 (16.3)
Worried about the risk of cervical cancer
Yes	425 (29.4)	258 (36.2)	318 (43.2)	7.340 (0.007)
No	1023 (70.6)	454 (63.8)	418 (56.8)
Heard about HPV
Yes	576 (39.8)	213 (29.9)	212 (28.8)	0.216 (0.642)
No	872 (60.2)	499 (70.1)	524 (71.2)
Heard about HPV vaccines
Yes	126 (8.7)	49 (6.9)	77 (10.5)	5.838 (0.016)
No	1322 (91.3)	663 (93.1)	659 (89.5)
Yourself received HPV vaccine
Yes	33 (2.3)	11 (1.5)	22 (3.0)	3.389 (0.066)
No	1415 (97.7)	701 (98.5)	714 (97.0)

Sample characteristics (N = 1448)_

Social and demographic characteristics	N (%)
Gender
Female	1226 (84.7)
Male	222 (15.3)
Age (year), mean ± SD: 19.76 ± 1.25
Major
Health science	712 (49.2)
Non-health science	736 (50.8)
Study year
Freshman	442 (30.5)
Sophomore	465 (32.1)
Junior	360 (24.9)
Senior	181 (12.5)
Heard about cervical cancer
Yes	1258 (86.9)
No	190 (13.1)
Worried about the risk of cervical cancer
Yes	425 (29.4)
No	1023 (70.6)
Heard about HPV
Yes	576 (39.8)
No	872 (60.2)
Heard about HPV vaccine
Yes	126 (8.7)
No	1322 (91.3)
Receive pay-by-self vaccine before
Yes	440 (30.4)
No	1008 (69.6)
Friends or families received HPV vaccines
Yes	196 (13.5)
No	1252 (86.5)
Yourself received HPV vaccine
Yes	33 (2.3)
No	1415 (97.7)