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Zhang S, Zhu W, Chen B, Tang T, Tao Z, Li X, Hua T, Ju N, Zheng S. Relationship between demographic factors, health education, breast cancer-related knowledge, attitudes, and breast self-examination behavior among Chinese female college student: A structural equation analysis. J Obstet Gynaecol Res 2021; 47:4440-4449. [PMID: 34643014 DOI: 10.1111/jog.15064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/08/2021] [Accepted: 10/03/2021] [Indexed: 12/09/2022]
Abstract
AIMS This study aimed to create a structural equation model to evaluate the associations among demographic factors, health education, breast cancer-related knowledge, attitudes, and breast self-examination behavior among Chinese female college students. METHODS A survey was undertaken using a self-administered questionnaire and targeting 2233 students from Eastern China. Structural equation modeling with the bootstrap approach was utilized to estimate the interrelationships and the strength of the associations among measured variables based on the hypothetical model. RESULTS Among the total participants, 14.7% of the female college students reported having performed breast self-examination. The final structural equation model showed highly satisfactory fitness on indices. Breast self-examination behavior was significantly linked to demographic factors, breast cancer related-knowledge, attitudes, and health education. Health education had the greatest influence on breast self-examination behavior. In addition, breast cancer related-knowledge was significantly associated with demographic factors and health education. Health education and knowledge all significantly affected attitudes towards breast cancer. CONCLUSION Breast self-examination behavior was influenced by demographic factors, breast cancer related-knowledge, attitudes towards breast cancer, and health education in a sample of female college students in China. Health education was the most important predictor of breast self-examination behavior.
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Affiliation(s)
- Shunhua Zhang
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Weihao Zhu
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Baole Chen
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Ting Tang
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Zhaoyu Tao
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Xiang Li
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Tiantian Hua
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Nianting Ju
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Suge Zheng
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
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You D, Han L, Li L, Hu J, D. Zimet G, Alias H, Danaee M, Cai L, Zeng F, Wong LP. Human Papillomavirus (HPV) Vaccine Uptake and the Willingness to Receive the HPV Vaccination among Female College Students in China: A Multicenter Study. Vaccines (Basel) 2020; 8:E31. [PMID: 31963370 PMCID: PMC7157221 DOI: 10.3390/vaccines8010031] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 12/30/2019] [Accepted: 01/14/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study aimed to determine human papillomavirus (HPV) vaccine uptake and willingness to receive HPV vaccination among female college students, in China, and its associated factors. METHODS An online cross-sectional survey of female college students across the eastern, central, and western regions of China was undertaken between April and September 2019. Partial least squares structural equation modeling (PLS-SEM) was used to examine factors associated with the HPV vaccine uptake and willingness to receive the HPV vaccine. RESULTS Among the total 4220 students who participated in this study, 11.0% reported having been vaccinated against HPV. There are direct effects of indicators of higher socioeconomic status, older age (β = 0.084 and p = 0.006), and geographical region (residing in Eastern China, β = 0.033, and p = 0.024) on HPV vaccine uptake. Higher knowledge (β = 0.062 and p < 0.000) and perceived susceptibility (β = 0.043 and p = 0.002) were also predictors of HPV vaccine uptake. Of those who had not received the HPV vaccine, 53.5% expressed a willingness to do so. Likewise, social economic status indicators were associated with the willingness to receive the HPV vaccine. Total knowledge score (β = 0.138 and p < 0.001), both perceived susceptibility (β = 0.092 and p < 0.001) and perceived benefit (β = 0.088 and p < 0.001), and sexual experience (β = 0.041 and p = 0.007) had a positive and significant direct effect on the willingness to receive the HPV vaccine, while perceived barriers (β = -0.071 and p < 0.001) had a negative effect on the willingness to receive the HPV vaccine. CONCLUSIONS Geographical region and socioeconomic disparities in the HPV vaccination uptake rate and willingness to receive the HPV vaccine provide valuable information for public health planning that aims to improve vaccination rates in underserved areas in China. The influence of knowledge and perceptions of HPV vaccination suggests the importance of communication for HPV immunization.
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Affiliation(s)
- Dingyun You
- Department of Epidemiology, School of Public Health, Kunming Medical University, Kunming 650500, China;
| | - Liyuan Han
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315200, China; (L.H.); (L.L.); (J.H.)
| | - Lian Li
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315200, China; (L.H.); (L.L.); (J.H.)
| | - Jingcen Hu
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315200, China; (L.H.); (L.L.); (J.H.)
| | - Gregory D. Zimet
- Department of Pediatrics, School of Medicine, Indiana University, 410 W, 10th St., HS 1001, Indianapolis, IN 46202, USA;
| | - Haridah Alias
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; (H.A.); (M.D.)
| | - Mahmoud Danaee
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; (H.A.); (M.D.)
| | - Le Cai
- Department of Epidemiology, School of Public Health, Kunming Medical University, Kunming 650500, China;
| | - Fangfang Zeng
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou 510632, China;
| | - Li Ping Wong
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo 315200, China; (L.H.); (L.L.); (J.H.)
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; (H.A.); (M.D.)
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