HPV knowledge, attitudes, and intentions: the impact of information sources on Israeli young adults

Abstract Background Human papillomavirus (HPV) is the leading cause of cervical cancer globally. Despite inclusion in Israel's national immunization program, HPV vaccine uptake among young adults (18-26) remains suboptimal. Understanding how different information sources shape HPV vaccination knowledge, attitudes, and intentions may aid the design of effective public health interventions. Methods This cross-sectional study (Dec 2023-Feb 2024) surveyed unvaccinated Israeli adults to assess HPV vaccine knowledge, attitudes, intentions, and information sources. Sources were categorized as formal interpersonal (e.g health worker), informal interpersonal (e.g. family), formal online/media (e.g. government website), and informal online/media (e.g. social media). Multivariable linear regression models examined associations between source types and knowledge, attitudes, and intentions, adjusting for demographics. Results Of 1972 respondents, 39% had no prior HPV vaccine awareness. Formal interpersonal sources were most cited (58.4%), while informal online/media were least used (25.3%). Participants using multiple source categories had significantly higher knowledge (β = 0.45, P=.001), attitudes (β = 1.33, P=.002), and intentions (β = 0.77, P<.001) compared to those who used one source. Lack of prior awareness was associated with lower scores across all outcomes (knowledge: β=-0.81, P<.001; attitudes: β=-2.72, P<.001; intentions: β=-0.96, P<.001). Using online/media sources was associated with less positive attitudes (β=-1.14, P=.006) compared to using at least one formal interpersonal source. Conclusions A high proportion of young adults in Israel lack awareness of the HPV vaccine. Exposure to multiple information sources positively influences HPV vaccination outcomes, underscoring the need for multi-channel communication strategies. As the main source of information about HPV vaccination, healthcare workers must be equipped with the skills to address patient concerns. Key messages • Exposure to multiple information sources improves HPV vaccination knowledge, attitudes, and intentions, highlighting the importance of multi-channel communication strategies to increase vaccine uptake. • Formal interpersonal sources are most effective in fostering positive attitudes towards HPV vaccination, while using online/media sources may hinder attitudes, thus targeted communication is crucial.