{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T06:23:41Z","timestamp":1787639021971,"version":"build-2736575974"},"reference-count":74,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"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":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Whether traditional health belief models (HBM) and 3C models can distinguish residual non-vaccinators in settings with &amp;gt;70% HPV vaccine coverage is unknown. The moderating role of China\u2019s household registration (\n                      <jats:italic>hukou<\/jats:italic>\n                      ) on psychological factors and behavior has rarely been quantified.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From April 2025 to February 2026, we surveyed 1,257 women aged 18\u201365 from six Shenzhen communities. We collected demographics, HBM (15 items), 3C (12 items), social support, HPV vaccination intention (measured by a single item: willingness to receive the HPV vaccine within the next 6\u202fmonths), self-reported vaccination history, reasons for non-vaccination, and information channel preferences. Analyses included t-tests (Cohen\u2019s d), observed-variable multi-group path analysis, and cross-sectional comparisons of vaccination proportions among women with high intention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      HPV vaccination rate was 70.0% (880\/1,257); cervical cancer screening rate 58.3%. Vaccinated and unvaccinated groups differed on only two of ten psychological constructs (trivial effect sizes: perceived susceptibility d\u202f=\u202f0.13, self-efficacy d\u202f=\u202f0.13). HPV vaccination intention did not differ significantly between vaccinated (M\u202f=\u202f3.72, SD\u202f=\u202f0.83) and unvaccinated women (M\u202f=\u202f3.67, SD\u202f=\u202f0.80), t\u202f=\u202f0.81,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.417. Main reasons for non-vaccination were high cost (42.3%) and safety concerns (33.8%). Observed-variable multi-group path analysis showed good fit (CFI\u202f=\u202f0.968, RMSEA\u202f=\u202f0.051). Perceived barriers were significantly negatively associated with HPV vaccination intention among non-Shenzhen\n                      <jats:italic>hukou<\/jats:italic>\n                      women (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      =\u202f\u22120.247,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001), but not among Shenzhen\n                      <jats:italic>hukou<\/jats:italic>\n                      women (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      =\u202f\u22120.102,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.128). The formal test of\n                      <jats:italic>hukou<\/jats:italic>\n                      moderation was not statistically significant (\u0394\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      =\u202f2.358, \u0394df\u202f=\u202f8,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.968). Most preferred information channels: WeChat official accounts (91.5%), face-to-face doctor consultations (85.1%), short video platforms (76.5%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      At 70% coverage, HBM and 3C scales show limited discriminant validity between vaccinated and unvaccinated individuals. Residual non-vaccination is associated with cost and safety barriers.\n                      <jats:italic>Hukou<\/jats:italic>\n                      showed a suggestive but not statistically significant moderating effect on the perceived barriers-intention association. Interventions may need to target structural barriers and tailor information channels.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1903410","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T05:36:18Z","timestamp":1787636178000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Limited discriminant validity of health belief and 3C models in high HPV vaccine coverage settings: the moderating role of hukou and structural barriers"],"prefix":"10.3389","volume":"14","author":[{"given":"Ya","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Gynecology, Shandong First Medical University Affiliated Heze Hospital (Heze Municipal Hospital)","place":["Heze, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Qingdao Public Health Clinical Center","place":["Qingdao, 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":"Nan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Shandong First Medical University Affiliated Heze Hospital (Heze Municipal Hospital)","place":["Heze, Shandong, 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":"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":"Yang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gynecology, The Third People's Hospital of Shenzhen","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutao","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Gynecology, The Third People's Hospital of Shenzhen","place":["Shenzhen, Guangdong, 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":[[2026,8,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e333","DOI":"10.1016\/s2214-109x(26)00004-5","article-title":"Understanding the WHO global strategy to accelerate cervical cancer elimination","volume":"14","author":"Defo","year":"2026","journal-title":"Lancet Glob Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.32687\/0869-866X-2021-29-6-1547-1555","article-title":"The condition and tendencies of cervical carcinoma diagnostic in the Russian Federation","volume":"29","author":"Tatarinova","year":"2021","journal-title":"Probl Sotsialnoi Gig Zdravookhranenniiai 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