ArticleFrontiers in public health2026
Limited discriminant validity of health belief and 3C models in high HPV vaccine coverage settings: the moderating role of
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
Background: Whether traditional health belief models (HBM) and 3C models can distinguish residual non-vaccinators in settings with >70% HPV vaccine coverage is unknown. The moderating role of China's household registration ( Methods: From April 2025 to February 2026, we surveyed 1,257 women aged 18-65 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 months), self-reported vaccination history, reasons for non-vaccination, and information channel preferences. Analyses included t-tests (Cohen's d), observed-variable multi-group path analysis, and cross-sectional comparisons of vaccination proportions among women with high intention. Results: 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 = 0.13, self-efficacy d = 0.13). HPV vaccination intention did not differ significantly between vaccinated (M = 3.72, SD = 0.83) and unvaccinated women (M = 3.67, SD = 0.80), t = 0.81, Conclusion: 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.
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