Hepatitis B Vaccination Intention and Influencing Factors among College Students in Huanggang, Hubei, China: A Protection Motivation Theory-Based Cross-Sectional Study

Abstract

Objective: This study assessed the intention to receive the hepatitis B vaccine and identified influencing factors among college students in Huanggang, China, using the Protection Motivation Theory (PMT).Material and Methods: A cross-sectional study was conducted between April and May 2025. Data were collected via PMT-based questionnaire measuring knowledge, preventive behaviors, perceived severity, perceived susceptibility, response efficacy, self-efficacy, and response cost. Statistical analyses were performed using Statistical Package for the Social Sciences (SPSS) v27.0 to examine associations between variables and vaccination intention.Results: Among the 1,130 participants, 58.9% intended to receive the hepatitis B vaccine. In bivariate analyses, higher hepatitis B knowledge, vaccine knowledge, preventive behaviors, and favorable PMT constructs were positively associated with intention. Multivariate logistic regression confirmed independent associations: hepatitis B knowledge (odds ratio [OR]=1.41, 95% confidence interval [CI]: 1.02-1.95), vaccine knowledge (OR=1.49, 95% CI: 1.11-2.00), preventive behaviors (OR=1.60, 95% CI: 1.15-2.23), perceived severity (OR=1.05, 95% CI: 1.01-1.10), self-efficacy (OR=1.10, 95% CI: 1.02-1.18), and response efficacy (OR=1.16, 95% CI: 1.04-1.29) were positive predictors, whereas perceived response cost (OR=0.85, 95% CI: 0.79-0.91) was a negative predictor. Sociodemographic factors were not significant after adjustment.Conclusion: The findings offer insights into hepatitis B vaccination behavior among college students. This evidence-based information could inform the future direction for improving hepatitis B vaccination rates in university settings by focusing health education on the severity of the hepatitis B consequences and the efficacy and safety of the vaccination, all of which could reduce the psychological and practical barriers.