Perceived knowledge, attitudes, and practices toward genital warts and HPV vaccination among college students in Shandong Province, China.
- 1Department of Obstetrics and Gynecology, Weifang People's Hospital, Weifang, Shandong, China.
- 2Department of Infectious Disease Prevention and Control, Huantai Center for Disease Control and Prevention, Zibo, Shandong, China.
Abstract
Objective
This study aimed to investigate the perceived knowledge, attitudes, and practices regarding genital warts and HPV vaccination among college students in Shandong Province, China.Methods
A cross-sectional study was conducted on Chinese college students from March 13 to April 2, 2026, in four universities in Shandong Province, China. Data were collected using a self-administered questionnaire in Chinese that was newly developed for this study and covered demographic characteristics and the three dimensions of the knowledge-attitude-practice (KAP) framework: perceived knowledge (14 items, score range 0-28), attitude (9 items, score range 9-45), and practice (10 items, score range 10-50). Bloom's cut-off criteria were applied to the attainable range of each scale, calculated as (observed score - minimum possible score) / (maximum possible score - minimum possible score) × 100%, and scores were classified as poor (< 60%), moderate (60%-79%), or good (≥80%). Structural equation modeling (SEM) was used to examine the associations among perceived knowledge, attitude, and practice.Results
A total of 959 participants were included, with 58.39% of participants being male. The mean perceived knowledge, attitude, and practice scores were 15.34 ± 7.64, 35.92 ± 7.42, and 36.84 ± 11.71, corresponding to 54.79%, 74.78%, and 67.10% of the attainable range of each scale, and therefore to poor perceived knowledge and moderate attitude and practice. In the SEM, perceived knowledge was directly associated with attitude (β = 0.119, P = 0.012) and with practice (β = 0.461, P = 0.014), and attitude was directly associated with practice (β = 0.118, P = 0.007). An indirect association between perceived knowledge and practice through attitude was also observed (β = 0.014, P = 0.003). Perceived knowledge, attitude, and practice scores were positively correlated with each other (all P < 0.001).Conclusion
College students in Shandong Province, China had poor perceived knowledge and moderate attitudes and practices regarding genital warts and HPV vaccination. Perceived knowledge showed the strongest association with the practice construct in the specified SEM, with attitude acting as a modest indirect association through attitude. Because the design was cross-sectional; these findings represent associations rather than causal effects. Campus-based sexual health education should prioritize accurate HPV-related knowledge, male vaccination awareness, and accessible referral pathways for STI examination and HPV vaccination.
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BibTeX
@article{zhu2026perceived,
title = {{Perceived knowledge, attitudes, and practices toward genital warts and HPV vaccination among college students in Shandong Province, China.}},
author = {Min Zhu and Guilin Xu and Ningfeng Li and Xinli Tian},
journal = {Frontiers in public health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1931591},
url = {https://europepmc.org/article/MED/42909026},
note = {CC BY},
}
RIS
TY - JOUR
TI - Perceived knowledge, attitudes, and practices toward genital warts and HPV vaccination among college students in Shandong Province, China.
AU - Min Zhu
AU - Guilin Xu
AU - Ningfeng Li
AU - Xinli Tian
PY - 2026
DA - 2026/10/07
JO - Frontiers in public health
DO - 10.3389/fpubh.2026.1931591
UR - https://europepmc.org/article/MED/42909026
AB - Objective This study aimed to investigate the perceived knowledge, attitudes, and practices regarding genital warts and HPV vaccination among college students in Shandong Province, China.Methods A cross-sectional study was conducted on Chinese college students from March 13 to April 2, 2026, in four universities in Shandong Province, China. Data were collected using a self-administered questionnaire in Chinese that was newly developed for this study and covered demographic characteristics and the three dimensions of the knowledge-attitude-practice (KAP) framework: perceived knowledge (14 items, score range 0-28), attitude (9 items, score range 9-45), and practice (10 items, score range 10-50). Bloom's cut-off criteria were applied to the attainable range of each scale, calculated as (observed score - minimum possible score) / (maximum possible score - minimum possible score) × 100%, and scores were classified as poor (< 60%), moderate (60%-79%), or good (≥80%). Structural equation modeling (SEM) was used to examine the associations among perceived knowledge, attitude, and practice.Results A total of 959 participants were included, with 58.39% of participants being male. The mean perceived knowledge, attitude, and practice scores were 15.34 ± 7.64, 35.92 ± 7.42, and 36.84 ± 11.71, corresponding to 54.79%, 74.78%, and 67.10% of the attainable range of each scale, and therefore to poor perceived knowledge and moderate attitude and practice. In the SEM, perceived knowledge was directly associated with attitude (β = 0.119, P = 0.012) and with practice (β = 0.461, P = 0.014), and attitude was directly associated with practice (β = 0.118, P = 0.007). An indirect association between perceived knowledge and practice through attitude was also observed (β = 0.014, P = 0.003). Perceived knowledge, attitude, and practice scores were positively correlated with each other (all P < 0.001).Conclusion College students in Shandong Province, China had poor perceived knowledge and moderate attitudes and practices regarding genital warts and HPV vaccination. Perceived knowledge showed the strongest association with the practice construct in the specified SEM, with attitude acting as a modest indirect association through attitude. Because the design was cross-sectional; these findings represent associations rather than causal effects. Campus-based sexual health education should prioritize accurate HPV-related knowledge, male vaccination awareness, and accessible referral pathways for STI examination and HPV vaccination.
SN - 2296-2565
ER -