The impact of exposure to HPV related information and injunctive norms on young women's intentions to receive the HPV vaccine in China: A structural equation model based on KAP theory

Wang, Yi; Chen, Yubing; Bao, Sheng

doi:10.3389/fpubh.2022.1102590

Cited by 3 publications

(1 citation statement)

References 77 publications

(75 reference statements)

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“…On Weibo, the prevalence of misinformation and perceived barriers to accepting vaccines decreased throughout the study period, while social norms became more prevalently discussed than misinformation since March 2020. Social norms not only exert a positive influence on intentions of receiving the HPV vaccine, 32 but also serve as a measure to raise perceived benefits of vaccination and counter misinformation and perceived barriers. 33,34 Although HPV vaccine-related perceived barriers and misinformation declined in China and were lower than those on platforms like Instagram and X, 35,36 the importance of managing misinformation should not be ignored.…”

Section: Discussionmentioning

confidence: 99%

Trajectories of and spatial variations in HPV vaccine discussions on Weibo, 2018-2023: a deep learning analysis

Wang,

Yang,

Ding

et al. 2023

Preprint

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SummaryResearch in contextEvidence before this studyWe first searched PubMed for articles published until November 2023 with the keywords “(“HPV”) AND (“Vaccine” or “Vaccination”) AND (“Social Media”)”. We identified about 390 studies, most of which were discussions on the potentials or feasibility of social media in HPV vaccination advocacy or research, or manual coding-driven analyses on text (eg., tweets) about HPV vaccines emerged on social media platforms. When we added keyword “Machine Learning”, we identified only 12 studies, with several of them using AI-driven approach, such as deep learning, machine learning, and natural language process, to analyze extensive text data about public perceptions of HPV vaccination and perform monitor on social media platforms, X (Twitter) and Reddit. All these studies are from English-language social media platforms in developed countries. No study to date has monitored public perceptions of HPV vaccination on social media platforms from the developing countries including China.Added value of this studyThis is the first deep-learning study monitoring public perceptions of HPV vaccination expressed on Chinese social media platforms (Weibo in our case), revealing key temporal and geographic variations. We found a sustained high level of positive attitude towards HPV vaccination and exposure to social norms facilitating HPV vaccination among Weibo users, with a lower national prevalence of negative attitude, perceived barriers to accepting vaccination, misinformation about HPV or HPV vaccination, indicating the achievement of relevant health communication. High prevalence practical barriers to HPV vaccination expressed on Weibo was associated with relatively insufficient of HPV vaccine accessibility in China, suggesting the health systems should prioritize on addressing issues about vaccine supply. Lower positive perception of HPV vaccination among male users, higher vaccine hesitancy towards 2-valent vaccine, and provincial-level spatial cluster of higher negative attitude towards HPV vaccination indicate that tailored strategies need to be formed targeting specific population, areas, and vaccine type. Our monitor practice on public perceptions of HPV vaccine from Weibo shows the feasibility of realizing public health surveillance potential of social media listening in Chinese context. Leveraging recent advances in deep learning, our approach could be a cost-effective supplement to existing surveillance techniques.Implications of all the available evidenceThis national surveillance study highlights the value of deep learning-driven social media listening as a convenient and effective approach for identifying emerging trends in public perceptions of HPV vaccination to inform interventions. As a supplement to existing public health surveillance techniques, it is particularly helpful to inform tailored and timely strategies in health communication and resource allocation at multiple levels. Key stakeholders and officials should maintain focus on health education highlighting the risks and consequences of HPV infections, and benefits and safety of all types of HPV vaccines; health systems should aim to resolve issues of vaccine accessibility. A proposed research area is the further development of deep learning models to monitor public perceptions of vaccines and analyzing misinformation about and barriers to HPV vaccination expressed on Chinese social media platforms.BackgroundHPV vaccination rate is low in China. Understanding the multidimensional barriers and impetuses perceived by individuals to vaccination is essential. We aim to assess the public perceptions, perceived barriers, and facilitators towards HPV vaccination expressed on Chinese social media platform Weibo.MethodsWe collected Weibo posts regarding HPV vaccines between 2018 to 2023. We annotated 6,600 posts manually according to behavior change theories, and subsequently fine-tuned deep learning models to annotate all posts collected. Based on the annotated results of deep learning models, temporal and geographic analyses were conducted for public attitudes towards HPV vaccination and its determinants.FindingsTotally 1,972,495 Weibo posts were identified as relevant to HPV vaccines. Deep learning models reached predictive accuracy of 0.78 to 0.96 in classifying posts. During 2018 to 2023, 1,314,510 (66.6%) posts were classified as positive attitudes. And 224,130 posts (11.4%) were classified as misinformation, 328,442 posts (16.7%) as perceived barriers to accepting vaccines, and 580,590 posts (29.4%) as practical barriers to vaccination. The prevalence of positive attitude increased from 15.8% in March 2018 to 79.1% in mid-2023 (p < 0.001), and misinformation declined from 36.6% in mid-2018 to 10.7% in mid-2023 (P < .001). Central regions exhibited higher prevalence of positive attitudes and social norms, whereas Shanghai, Beijing megacities and northeastern regions showed higher prevalence of negative attitudes and misinformation. Positive attitudes were significantly lower for 2-valent vaccines (65.7%), than 4-valent or 9-valent vaccines (79.6% and 74.1%).InterpretationSocial media listening represents a promising surveillance approach for monitoring public perceptions on health issues and can enable the development of health communication strategies.

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Section: Discussionmentioning

confidence: 99%

Trajectories of and spatial variations in HPV vaccine discussions on Weibo, 2018-2023: a deep learning analysis

Wang,

Yang,

Ding

et al. 2023

Preprint

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Understanding hepatitis E vaccination intention among women of childbearing-age: A theory-based cross-sectional study

Dong,

Luo,

Shao

et al. 2024

Vaccine

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Risk perception and trust in the relationship between knowledge and HPV vaccine hesitancy among female university students in China: a cross-sectional study

Chen,

Wang,

Huang

et al. 2024

BMC Public Health

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Background Cervical cancer poses a heavy health burden in China, with the second highest incidence and mortality rate among female tumors, yet human papillomavirus (HPV) vaccination rate among female university students remain remains low. This study conducted a cross-sectional survey to assess the degree of HPV vaccine hesitancy among female university students and to explore the potential association between knowledge, risk perception, trust, and HPV vaccine hesitancy. Methods A total of 1,438 female university students from four Chinese cities were recruited through stratified, multistage, cluster sampling method. The mediation model was constructed using the Bootstrap method, introducing trust and risk perception as mediating variables to examine the effect of knowledge on HPV vaccine hesitancy. Results The study found that 8.9% (95%CI:7.4%∼10.4%) of the female university students exhibited HPV vaccine hesitancy. Pearson’s correlation analysis revealed a negative association between vaccine hesitancy and knowledge, risk perception, and trust. The mediation model showed that knowledge had significant indirect effects on HPV vaccine hesitancy through trust (indirect effect: -0.224, 95% CI: -0.293 ∼ -0.167) and risk perception (indirect effect: -0.013, 95% CI: -0.033 ∼ -0.002). Conclusion HPV vaccine hesitancy among female university students has mitigated, but still needs to be addressed. In addition, trust and risk perception are mediators mediating the relationship between knowledge with HPV vaccine hesitancy. Therefore, there is a need to strengthen public health education to improve knowledge, with a particular focus on providing information about trust and risk perception to reduce HPV vaccine hesitancy.

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The impact of exposure to HPV related information and injunctive norms on young women's intentions to receive the HPV vaccine in China: A structural equation model based on KAP theory

Cited by 3 publications

References 77 publications

Trajectories of and spatial variations in HPV vaccine discussions on Weibo, 2018-2023: a deep learning analysis

Trajectories of and spatial variations in HPV vaccine discussions on Weibo, 2018-2023: a deep learning analysis

Understanding hepatitis E vaccination intention among women of childbearing-age: A theory-based cross-sectional study

Risk perception and trust in the relationship between knowledge and HPV vaccine hesitancy among female university students in China: a cross-sectional study

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