{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T06:04:54Z","timestamp":1784009094275,"version":"3.55.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Purpose<\/jats:title>\n HPV vaccine hesitancy is prevalent among female college students in China, yet how trust interacts with cost concerns remains unclear. This study, grounded in the 3C model, examined whether trust in healthcare professionals buffers price-related barriers and identified high-risk subgroups.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cross-sectional survey recruited 4,326 female college students from 12 Chinese provinces. Trust, price perception, and vaccination intention were measured. Interaction effects were tested using the Breslow-Day test; a decision tree model (CART) identified high-risk profiles.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Trust in healthcare professionals showed the strongest positive correlation with vaccination intention (\n r<\/jats:italic>\n s<\/jats:sub>\n \u202f=\u202f0.610,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), with a clear dose\u2013response pattern. A significant trust-by-price interaction emerged (\n p<\/jats:italic>\n \u202f=\u202f0.008): among low-trust respondents, high price was associated with substantially higher hesitancy (78.5% vs. 54.3%,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001); among high-trust respondents, the price effect was negligible (35.6% vs. 30.1%,\n p<\/jats:italic>\n \u202f=\u202f0.12). The most frequently cited reasons for hesitancy were high cost (53.5%), fear of side effects (52.7%), and limited vaccine knowledge (46.3%). Decision tree analysis identified \u201clow trust and high price\u201d as the dominant high-risk profile, accounting for 32.4% of all hesitant individuals.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Trust can buffer price-related barriers to HPV vaccination. Stratified interventions should prioritize the \u201clow trust and high price\u201d group through combined trust-building and financial support.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1848085","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:38:35Z","timestamp":1784007515000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Trust buffers price-related barriers to HPV vaccination among female college students: a cross-sectional study in China based on the 3C model"],"prefix":"10.3389","volume":"14","author":[{"given":"Yiyi","family":"Zhuang","sequence":"first","affiliation":[{"name":"Health Industry Department, College of Health Industry, Xiamen Donghai Vocational and Technical College","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianye","family":"Zhao","sequence":"additional","affiliation":[{"name":"Health Industry Department, College of Health Industry, Xiamen Donghai Vocational and Technical College","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Pingshan District Central Hospital of Shenzhen","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Liu","sequence":"additional","affiliation":[{"name":"Changle People\u2019s Hospital","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Pingshan District Central Hospital of Shenzhen","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanping","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Pingshan District Central Hospital of Shenzhen","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuimei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Changle People\u2019s Hospital","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxia","family":"Wang","sequence":"additional","affiliation":[{"name":"Changle People\u2019s Hospital","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baojun","family":"Pan","sequence":"additional","affiliation":[{"name":"Changle People\u2019s Hospital","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenming","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Pingshan District Central Hospital of Shenzhen","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e197","DOI":"10.1016\/S2214-109X(22)00501-0","article-title":"Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO global cervical Cancer elimination initiative","volume":"11","author":"Singh","year":"2023","journal-title":"Lancet Glob Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e35712","DOI":"10.1002\/cncr.35712","article-title":"Burden of female-specific cancers in China from 1990 to 2021: a systematic analysis for the global burden of disease study 2021","volume":"131","author":"Ren","year":"2025","journal-title":"Cancer"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"58","DOI":"10.36303\/sapj.1164","article-title":"Human papillomavirus (HPV) as the main cause of cervical and other related cancers: a 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