Knowledge about human papillomavirus (HPV), and health beliefs and intention to recommend HPV vaccination for girls and boys among Korean health teachers

Abstract

The human papillomavirus (HPV) vaccination rate in Korea is very low because a school-based HPV vaccination program has not yet been introduced. This study was designed to assess HPV knowledge, compare the health beliefs toward HPV vaccination and intention to recommend HPV vaccination for girls and boys, and identify the factors influencing the intention to recommend HPV vaccination for girls and boys among Korean health teachers. A descriptive cross-sectional study design was employed, in which 757 health teachers who worked at elementary, middle, high, and special schools in Korea participated via an online survey. A self-administered, structured questionnaire was applied, which included items on sociodemographics, HPV awareness, HPV knowledge, perceived benefits, susceptibility, severity, and barriers toward HPV vaccination for girls and boys, and intention to recommend HPV vaccination for girls and boys. The rate of correct HPV knowledge items ranged from 5.2% to 89.2%; 23.4% of the health teachers answered that they had ever taught about HPV, 97% answered that both boys and girls should receive HPV vaccination, and 47.6% answered that the best time for HPV vaccination is when students are at middle school. There were differences regarding the perceived benefits (Z=−7.69, p<0.001), perceived susceptibility (Z=−3.37, p=0.001), perceived severity (Z=−4.13, p<0.001), and perceived barriers (Z=−4.90, p<0.001) toward HPV vaccination, and regarding intention to recommend HPV vaccination (Z=−15.21, p<0.001) for girls and boys. Factors associated with the intention to recommend HPV vaccination for girls were the HPV vaccination status of the health teachers’ children [odds ratio (OR)=4.24, 95% confidence interval (95% CI)=1.14–15.72], and the teachers’ Pap-test experience (OR=2.50, 95% CI=1.05–5.91), perceived benefits (OR=3.30, 95% CI=1.26–7.40), perceived susceptibility (OR=3.25, 95% CI=1.58–6.68), and perceived barriers (OR=0.51, 95% CI=0.30–0.99); these factors for boys were the health teachers’ career duration (OR=1.61, 95% CI=1.12–2.32), HPV knowledge (OR=1.45, 95% CI=1.01–2.09), perceived benefits (OR=3.46, 95% CI=2.27–5.26), perceived susceptibility (OR=1.55, 95% CI=1.04–2.29), and perceived severity (OR=1.71, 95% CI=1.15–2.56). General awareness of HPV should be increased and more specific information about HPV—including that related to vaccination of boys and men—should be provided for health teachers. Although a school-based HPV vaccine program has yet to be introduced in Korea, health teachers should possess general knowledge about HPV and HPV vaccination, and differences in attitudes and intentions related to HPV vaccination between girls and boys should be reduced.