Awareness, Preference, and Acceptance of HPV Vaccine and Related Influencing Factors Among Guardians of Adolescent Girls in China: A Health Belief Model-Based Cross-Sectional Study.

Background: Cervical cancer poses a threat to the health of women globally. Adolescent girls are the primary target population for HPV vaccination, and guardians' attitude towards the HPV vaccine plays a significant role in determining the vaccination status among adolescent girls.

Objectives: This study aimed to explore the factors influencing guardians' HPV vaccine acceptance for their girls and provide clues for the development of health intervention strategies.

Methods: Combining the health belief model as a theoretical framework, a questionnaire-based survey was conducted. A total of 2157 adolescent girls and their guardians were recruited. The multivariable logistic model was applied to explore associated factors.

Results: The guardians had a high HPV vaccine acceptance rate (86.7%) for their girls, and they demonstrated a relatively good level of awareness regarding HPV and HPV vaccines. Factors influencing guardians' HPV vaccine acceptance for girls included guardians' education background (OR = 0.57, 95%CI = 0.37-0.87), family income (OR = 1.94, 95%CI = 1.14-3.32), risk of HPV infection (OR = 3.15, 95%CI = 1.40-7.10) or importance of the HPV vaccine for their girls (OR = 6.70, 95%CI = 1.61-27.83), vaccination status surrounding them (OR = 2.03, 95%CI = 1.41-2.92), awareness of negative information about HPV vaccines (OR = 0.59, 95%CI = 0.43-0.82), and recommendations from medical staff (OR = 2.32, 95%CI = 1.65-3.25). Also, guardians preferred to get digital information on vaccines via government or CDC platforms, WeChat platforms, and medical knowledge platforms.

Conclusions: Though HPV vaccine willingness was high among Chinese guardians, they preferred to vaccinate their daughters at the age of 17-18 years, later than WHO's recommended optimal age period (9-14 years old), coupled with safety concerns. Future work should be conducted based on these findings to explore digital intervention effects on girls' vaccination compliance.