HPV Education and Its Impact on Vaccination Willingness and Recommendation Intentions Among Unvaccinated Japanese University Students: A Cross-Sectional Study.

Although Japan resumed proactive HPV vaccination in 2022 and introduced catch-up initiatives, vaccination rates remain low, partly due to insufficient cancer education during school years. Moreover, male vaccination remains underrecognized despite its cancer prevention benefits. This study evaluated the effect of a planned educational intervention on HPV-related knowledge, willingness to receive vaccination, and recommendation intent among unvaccinated male and female university students. A total of 285 unvaccinated students participated in a planned educational intervention between October 29 and November 3, 2023. As part of a planned educational intervention conducted in a university setting, participants watched an educational YouTube video on HPV and cervical cancer and completed pre- and post-intervention surveys assessing their knowledge, vaccination willingness, and recommendation intent. Data were analyzed using McNemar's test and stepwise multiple regression analysis. Participants' knowledge about HPV and the vaccine significantly improved after the intervention (P < 0.001). Willingness to receive vaccination increased in both male and female participants, with a greater change observed among males (β = 0.79, P < 0.001). Improved knowledge was significantly associated with increased willingness to receive vaccination (β = 0.09, P = 0.001) and recommendation intent (β = 0.05, P = 0.038). These findings demonstrate that a brief, planned educational intervention can enhance vaccine-related knowledge and positively influence attitudes. Future efforts should incorporate such approaches across educational settings, including universities and earlier stages, to strengthen HPV vaccination awareness among both males and females and advance cancer-prevention education.