Factors Related to Satisfaction with Decision-making Regarding Human Papillomavirus Vaccination Behavior among Female University Students in Japan.

Introduction: Cervical cancer is the fourth most common cancer among women worldwide. Most cervical cancers are caused by persistent infection with human papillomavirus (HPV) acquired through sexual contact. Decision-making is the process of choosing among several options, and a better decision is one that the people engaged in the decision-making process express satisfaction with. Despite that HPV infection is associated with sexual behavior, no studies in Japan on HPV vaccination decision-making that include perspectives on sexuality exist. This study aimed to determine the factors that influence satisfaction with decision-making concerning HPV vaccination among female university students in Japan. Methods: The cross-sectional study was carried out by an anonymous self-administered questionnaire mail survey of 1988 female university students in Japan between April and July 2021. Of them, 301 agreed to participate in the survey. After the exclusion of those with missing data, the analysis included 252 (12.7%) students. We summarized descriptive statistics in terms of characteristics, satisfaction with decision-making regarding HPV vaccination, HPV vaccination behavior, knowledge, attitude about HPV vaccination, influencing factors, and perceptions and behaviors related to sexuality. Furthermore, we conducted multivariate analyses to investigate factors that influence satisfaction with decision-making regarding HPV vaccination. Results: Of the 252 participants, 102 (40.5%) were satisfied with their decisions regarding HPV vaccination. After adjustment for confounding factors, the multivariable-adjusted odds ratios (95% confidence intervals) for factors associated with satisfaction in decision-making regarding HPV vaccination were as follows: being vaccinated (vs. non-vaccinated) 5.46 (2.51-11.89), having high knowledge scores (vs. per 1 point) 1.09 (1.01-1.17), and having awareness about the risk of contracting sexually transmitted infections (STIs) via sexual intercourse (vs. per 1 point) 0.83 (0.72-0.96). Conclusions: Being vaccinated, having higher knowledge scores, and having lower awareness regarding the risk of STIs were associated with satisfied decision-making concerning HPV vaccination. Providing younger people with correct information about cervical cancer, HPV vaccines, and STI prevention contributes to increased satisfaction with their HPV vaccination decisions.

Relationship between communicative and critical health literacy, health information sources, and participation in health checkups among middle-aged Japanese community residents.

We assessed the relationship between health literacy and participation in health checkups among middle-aged Japanese community residents. Additionally, we explored the health information sources related to participation in health checkups among those with low, medium, and high health literacy. This mail survey using a self-administered questionnaire was conducted in 2020 and included 33,902 community residents with National Health Insurance (NHI), aged 40-64 years from five cities in Osaka Prefecture, Japan. Of these, 12,446 (36.7%) agreed to participate in the survey. After exclusion of those with regular visits to medical institutions and those with missing data, the analysis included 3582 participants. Health literacy was measured by the Communicative and Critical Health Literacy (CCHL) scale, and participants were classified into three groups (low, medium, and high health literacy groups) by the tertiles of CCHL scale score. After adjusting for confounding factors, the multivariable-adjusted odds ratios for non-participation in health checkups were 1.20 (95% CI 1.01-1.43, p = 0.039) in the medium health literacy group and 1.47 (95% CI 1.20-1.80, p < 0.001) in the low health literacy group compared with the high health literacy group. Additionally, some health information sources were associated with participation in health checkups in the medium and high health literacy groups, whereas none of the health information sources were associated with participation in health checkups in the low health literacy group. We believe that it is important to develop materials and interventions aimed at low health literacy populations to promote participation in health checkups.

Association between Recommendations from Public Health Nurses, Medical Professionals, and Family Members and Participation in Health Checkups among Middle-aged Community Residents with National Health Insurance.

Introduction: Participation in specific health checkups is low in Japan, especially among middle-aged community residents with municipal National Health Insurance (NHI). This study explored associations between recommendations from public health nurses, medical professionals, and family members and participation in specific health checkups among middle-aged Japanese community residents with NHI. Methods: This mail survey was conducted in 2020, and it included 33,902 community residents with NHI aged 40-64 years from five cities in Osaka Prefecture, Japan. Of these, 12,446 (36.7%) community residents agreed to participate in the survey. After excluding those with missing data, 11,180 participants were included in the analyses. Participants were classified into a participation group and a nonparticipation group. Those who selected "I underwent a specific health checkup in the past year" were classified as the participation group. Results: Of the 11,180 community residents with NHI, 4,384 (39.2%) were classified in the participation group. After adjusting for confounding factors, the presence (vs. absence) of recommendations from public health nurses (multivariable-adjusted odds ratio [OR], 1.81; 95% confidence interval [CI], 1.47-2.24), primary care physicians (multivariable-adjusted OR, 2.79; 95% CI, 2.49-3.13), nurses (multivariable-adjusted OR, 2.06; 95% CI, 1.57-2.69), and family members (multivariable-adjusted OR, 1.22; 95% CI, 1.12-1.32) was positively associated with participation in specific health checkups. Conclusions: Our findings suggest that recommendations from public health nurses, medical professionals (primary care physicians and nurses), and family members may be important to promote participation in specific health checkups among middle-aged Japanese community residents with NHI.