Cheung Doug, Xie Luyao, Wang Lijuan, Chen Siyu, Li Xinge, Zhang Zheng, Chen Xinyue, Ge Shen, Yu Fuk-Yuen, Fang Yuan, Chen Zihuang, Li Zhennan, Sun Fenghua, Mo Phoenix, Liu Yingjie, Wang Zixin
Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong).
Beijing Chaoyang District Center for Disease Control and Prevention, Beijing, China.
JMIR Public Health Surveill. 2025 Jun 18;11:e70635. doi: 10.2196/70635.
Exposure to information about mpox may shape distinct perceptual processes that influence vaccination intent. Understanding how such information impacts perceived risk and vaccination intention is crucial for designing effective risk communication and public health messaging, particularly among populations at high risk such as gay, bisexual, and other men who have sex with men (GBMSM).
This study examined the specific pathways through which mpox information exposure and associated perceptual processes influence vaccination intent. Differences between GBMSM in Beijing and Hong Kong were also examined to explore potential contextual influences.
We conducted a cross-sectional survey of mpox-unvaccinated GBMSM in Hong Kong (n=470) and Beijing (n=519) between November 2023 and March 2024. Structural equation modeling was conducted to estimate the direct and indirect effects of information exposure, perceptual processes (eg, perceived control and threat perceptions), and perceived risk on vaccination intent. Multigroup structural equation modeling was used to estimate the effect measure modification by city.
Exposure to positive mpox information significantly enhanced perceived control (β=0.33; P=.001) and increased vaccination intention through heightened perceived risk of contracting mpox (β=0.27; P<.001) in the following 6 months. The indirect effect of positive information exposure on vaccination intent via perceived control and risk was significant in Hong Kong (B=0.01; Wald test: Z=3.05 and P=.002) but not in Beijing (B=-0.01; P=.25). Conversely, negative information exposure primarily increased threat perceptions (Hong Kong: B=0.33 and P=.001; Beijing: B=0.93 and P<.001) but did not consistently translate to increased perceived risk of contracting mpox (Hong Kong: B=-0.10 and P=.31; Beijing: B=0.20 and P=.11). Notable contextual differences emerged between Beijing and Hong Kong-participants in Beijing reported higher levels of information exposure (eg, international mpox statistics; mean score 2.17, SD 0.97 vs 1.79, SD 0.89; P<.001) and more nonregular sex partners (mean 2.20, SD 6.73 vs 1.65, SD 3.37; P=.02), but the associations among information exposure, perceived risk, and vaccination intent were weaker than in Hong Kong participants.
Positive mpox-related information strongly promotes vaccination intent by enhancing perceived control and amplifying perceived risk, particularly in settings with accessible vaccination programs such as Hong Kong. Conversely, negative information appears less effective in driving vaccination intention. Tailored, stigma-free communication is crucial for improving vaccination uptake, especially in mainland China, where subsidized vaccines are scarce and perceptual pathways linking information exposure to vaccination intent are relatively weak. Enhancing access to vaccines and addressing contextual barriers can further optimize the impact of such interventions.
接触猴痘信息可能会形成不同的认知过程，进而影响疫苗接种意愿。了解此类信息如何影响感知风险和疫苗接种意愿，对于设计有效的风险沟通和公共卫生信息至关重要，尤其是在男同性恋、双性恋和其他与男性发生性行为的男性（GBMSM）等高风险人群中。
本研究探讨了接触猴痘信息及相关认知过程影响疫苗接种意愿的具体途径。同时还研究了北京和香港的GBMSM之间的差异，以探索潜在的背景影响因素。
2023年11月至2024年3月期间，我们对香港（n = 470）和北京（n = 519）未接种猴痘疫苗的GBMSM进行了横断面调查。采用结构方程模型来估计信息接触、认知过程（如感知控制和威胁认知）以及感知风险对疫苗接种意愿的直接和间接影响。多组结构方程模型用于估计城市对效应量的修正作用。
接触正面猴痘信息显著增强了感知控制（β = 0.33；P = 0.001），并通过提高未来6个月感染猴痘的感知风险（β = 0.27；P < 0.001）增加了疫苗接种意愿。正面信息接触通过感知控制和风险对疫苗接种意愿的间接影响在香港显著（B = 0.01；Wald检验：Z = 3.05，P = 0.002），但在北京不显著（B = -0.01；P = 0.25）。相反，负面信息接触主要增加了威胁认知（香港：B = 0.33，P = 0.001；北京：B = 0.93，P < 0.001），但并没有始终转化为感染猴痘的感知风险增加（香港：B = -0.10，P = 0.31；北京：B = 0.20，P = 0.11）。北京和香港之间出现了显著的背景差异——北京的参与者报告了更高的信息接触水平（如国际猴痘统计数据；平均得分2.17，标准差0.97 vs 1.79，标准差0.89；P < 0.001）和更多的非固定性伴侣（平均2.20，标准差6.73 vs 1.65，标准差3.37；P = 0.02），但信息接触、感知风险和疫苗接种意愿之间的关联比香港参与者弱。
与猴痘相关的正面信息通过增强感知控制和放大感知风险，有力地促进了疫苗接种意愿，特别是在像香港这样有可及疫苗接种项目的地区。相反，负面信息在推动疫苗接种意愿方面似乎效果较差。量身定制、无污名化的沟通对于提高疫苗接种率至关重要，尤其是在中国大陆，那里补贴疫苗稀缺，且信息接触与疫苗接种意愿之间的认知途径相对较弱。增加疫苗可及性和解决背景障碍可以进一步优化此类干预措施的效果。
