{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T22:02:49Z","timestamp":1789596169975,"version":"build-2803163510"},"reference-count":53,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"\n Background<\/jats:title>\n Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. Despite the availability of effective vaccines, uptake remains suboptimal in many settings, including Saudi Arabia, where cultural sensitivities, limited awareness, and vaccine hesitancy have been documented. Educational interventions grounded in behavioral theory, such as the information-motivation-behavioral skills (IMB) model, can help address informational and motivational barriers to HPV vaccination.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate the impact of an educational intervention in improving HPV vaccination decision-making among women in Northern Saudi Arabia.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A quasi-experimental design (pretest-posttest with a control group) was used among women attending primary health care centers in the Northern Border Region of Saudi Arabia. A total of 380 participants, 190 in the control group and 190 in the intervention group, completed surveys at baseline (T1), 1-week post intervention (T2), and a 3-month follow-up (T3), assessing HPV-related knowledge, health awareness, attitudes, and vaccination intentions. The educational intervention consisted of a culturally adapted, evidence-based, 45-minute interactive group session delivered in primary health care centers.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Study retention was excellent (380\/389, 97.7%). At the 3-month follow-up, intervention participants demonstrated medium to large effect size improvements compared with controls: knowledge (adjusted \u03b2=0.84, 95% CI 0.53-1.15; P<.001; Cohen d=0.45, medium effect), health awareness (\u03b2=0.88, 95% CI 0.53-1.23; P<.001; d=0.44, medium effect), attitude (\u03b2=0.70, 95% CI 0.42-0.98; P<.001; d=0.38, medium effect), and vaccination intentions (\u03b2=0.86, 95% CI 0.60-1.12; P<.001; d=0.82, large effect). Exploratory subgroup analyses found no significant effect modification by age, education, or health literacy (all interaction P>.10), suggesting consistent intervention effects across demographic characteristics.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This culturally tailored educational intervention was effective in improving HPV-related knowledge, attitudes, health awareness, and vaccination intentions among women in Northern Saudi Arabia. Given the well-documented intention-behavior gap in vaccination uptake, future research should incorporate verified vaccine initiation and completion outcomes, along with longer follow-up, to assess whether enhanced intentions translate into actual vaccine uptake.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/104529","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:10:06Z","timestamp":1789593006000},"page":"e104529","source":"Crossref","is-referenced-by-count":0,"title":["Impact of a Culturally Tailored Educational Intervention on Human Papillomavirus Knowledge and Vaccination Intentions Among Women in Saudi Arabia: Quasi-Experimental Study"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6425-6724","authenticated-orcid":false,"given":"Ebtesam A","family":"Elsayed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6450-5097","authenticated-orcid":false,"given":"Fathia Ahmed","family":"Mersal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8264-3074","authenticated-orcid":false,"given":"Heba Ahmed Osman","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3581-7123","authenticated-orcid":false,"given":"Ala M","family":"Aljehani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0890-0698","authenticated-orcid":false,"given":"Najla M","family":"Aljehani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000193"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines11061060"},{"key":"ref3","unstructured":"Human papillomavirus and cancerWorld Health Organization202403052026-09-01https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/human-papilloma-virus-and-cancer"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2014.00065"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1405044"},{"issue":"11","key":"ref6","first-page":"300","volume":"64","author":"Petrosky, E","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2025.107851"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6832a3"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines13101003"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2022.2055422"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2014.01.091"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2013.08.091"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1111\/spc3.12265"},{"key":"ref14","unstructured":"Saudi Arabia: human papillomavirus and related cancers, fact sheet 2023ICO\/IARC Information Centre on HPV and Cancer2026-09-01https:\/\/hpvcentre.net\/statistics\/reports\/SAU_FS.pdf"},{"key":"ref15","unstructured":"Cancer incidence report: Saudi ArabiaSaudi Health Council2026-09-01https:\/\/shc.gov.sa\/Arabic\/NewNCC\/Activities\/AnnualReports\/Cancer%20Incidence%20Report%202022.pdf"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2026.103505"},{"key":"ref17","unstructured":"Saudi Cancer Registry Annual ReportsSaudi Health Council20262026-09-01https:\/\/shc.gov.sa\/en\/Centers\/NCC\/Pages\/AnnualReports.aspx"},{"key":"ref18","unstructured":"Women\u2019s health: human papillomavirus (HPV)Ministry of Health, Kingdom of Saudi Arabia2026-09-01https:\/\/www.moh.gov.sa\/en\/healthawareness\/educationalcontent\/wh\/pages\/human-papillomavirus.aspx"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2024.2395086"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines11071188"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2024.1470048"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare13192408"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-27814-z"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2025.2513708"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1501358"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.5334\/aogh.4866"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1111\/dewb.12355"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/s0277-9536(96)00221-3"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2015.06.022"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-012-2077-6"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2008.07.018"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.3390\/medicina60091550"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.5993\/ajhb.27.1.s3.6"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-15876-5"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-2-201107190-00005"},{"issue":"8","key":"ref36","first-page":"588","volume":"36","author":"Chew, LD","year":"2004","journal-title":"Fam Med"},{"key":"ref37","unstructured":"National action plan to improve health literacyOffice of Disease Prevention and Health Promotion20102026-09-01https:\/\/odphp.health.gov\/our-work\/national-health-initiatives\/health-literacy\/national-action-plan-improve-health-literacy"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.111.3.455"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.2147\/PRBM.S112504"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.3389\/ijph.2023.1605596"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.2147\/JMDH.S438633"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1446-2"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1037\/a0033309"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11121766"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-020-00837-5"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2012.712615"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.2105\/ajph.94.3.361"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.54905\/disssi\/v26i128\/ms404e2411"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.15167\/2421-4248\/jpmh2025.66.3.3607"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.2196\/37848"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1177\/10732748211070719"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2023.2225994"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.7416\/ai.2024.2630"}],"container-title":["JMIR Public Health and Surveillance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publichealth.jmir.org\/2026\/1\/e104529","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:10:09Z","timestamp":1789593009000},"score":1,"resource":{"primary":{"URL":"https:\/\/publichealth.jmir.org\/2026\/1\/e104529"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,16]]},"references-count":53,"URL":"https:\/\/doi.org\/10.2196\/104529","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.104529","asserted-by":"object"}]},"ISSN":["2369-2960"],"issn-type":[{"value":"2369-2960","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,16]]}}}