Chinese Evidence-based Medicine Center and CREAT Group, West China Hospital, Sichuan University , Chengdu, Sichuan, 610041, People's Republic of China.
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
BMC Public Health. 2019 May 2;19(1):488. doi: 10.1186/s12889-019-6823-0.
Little is known about the knowledge and attitudes towards human papillomavirus (HPV) and its vaccines among adolescents in mainland China. Also, limited information has been available on how to improve their knowledge and willingness towards HPV and its vaccines to ensure a successful vaccination program in the future.
This was a school-based interventional follow-up study. One urban and one rural junior middle school in Chengdu were selected by convenience sampling. At baseline, half of the grade one students were randomly selected as controls and the rest were interventions. A set of self-administered questionnaires on HPV and its vaccines were completed by both groups at baseline. After that, only the intervention group received a PowerPoint-oriented health education and finished the post-education questionnaires. One year later, both groups completed the same questionnaires as the follow-up survey.
In total, 1675 students finished the pre-intervention questionnaires; 751 were from the control group and 924 were from the intervention group. Among them, only 34.3% had heard of cervical cancer/genital warts, while only 15.1% of them had ever heard of HPV. However, 55.2% of students showed their willingness to be vaccinated even before any intervention. Seven variables were found to be associated with the willingness to be vaccinated at baseline. Immediately after the intervention, 88.4% of students were willing to vaccinate themselves. After 1 year, the effectiveness of intervention remained but decreased. Compared with the control group, the intervention group was more aware about cervical cancer, HPV and its vaccines with statistical significance. However, the level of HPV knowledge and willingness to be vaccinated among the intervention group had significantly decreased compared with that immediately after the intervention (P < 0.001).
The baseline level of knowledge on HPV, its vaccines, and cervical cancer was very low among junior middle school students in Chengdu, China. However, the willingness to be vaccinated seemed positive. School-based health education is effective and appropriate in increasing the awareness of HPV and willingness towards its vaccines. Regular health education on HPV and cervical cancer prevention at a shorter interval should be guaranteed to ensure continuous effectiveness.
在中国内地，青少年对人乳头瘤病毒（HPV）及其疫苗的了解和态度知之甚少。此外，关于如何提高他们对 HPV 及其疫苗的认识和意愿，以确保未来疫苗接种计划取得成功的信息也很有限。
这是一项基于学校的干预性随访研究。采用便利抽样法选择了成都市的一所城市初中和一所农村初中。在基线时，随机选择一半一年级学生作为对照组，其余学生作为干预组。两组学生均填写了一份关于 HPV 及其疫苗的自我管理问卷。之后，只有干预组接受了以幻灯片为导向的健康教育，并完成了教育后问卷。一年后，两组学生均完成了相同的问卷作为随访调查。
共有 1675 名学生完成了预干预问卷；对照组 751 人，干预组 924 人。其中，仅有 34.3%的学生听说过宫颈癌/生殖器疣，而仅有 15.1%的学生听说过 HPV。然而，55.2%的学生在未接受任何干预的情况下表示愿意接种疫苗。有 7 个变量与接种意愿相关。干预后立即，88.4%的学生愿意接种疫苗。1 年后，干预效果仍然存在，但有所下降。与对照组相比，干预组对宫颈癌、HPV 及其疫苗的认识更为显著。然而，与干预后立即相比，干预组的 HPV 知识水平和接种意愿均显著下降（P<0.001）。
成都市初中生对 HPV、其疫苗和宫颈癌的了解程度非常低，但接种意愿似乎很积极。基于学校的健康教育在提高 HPV 认识和接种意愿方面是有效且合适的。应保证定期进行 HPV 和宫颈癌预防的健康教育，以确保持续的有效性。
