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Effect of Cervical Cancer Prevention Education on HPV Vaccination Awareness among Female University Students in Nigeria

Abstract

Cervical cancer remains an important public health concern in Nigeria and is largely associated with persistent infection with high-risk types of human papillomavirus (HPV). HPV vaccination is an effective primary prevention strategy that can substantially reduce the risk of HPV-related cervical disease when administered appropriately. Female university students represent an important population for cervical cancer prevention education because they are within an age group in which awareness and understanding of HPV infection and vaccination can influence future preventive health decisions. Cervical cancer prevention education provides students with information about cervical cancer, HPV infection, routes of transmission, risk factors, the relationship between HPV and cervical cancer, HPV vaccination, vaccine safety and effectiveness, recommended vaccination schedules, and sources of vaccination services. HPV vaccination awareness refers to the extent to which individuals understand the purpose, benefits, availability, eligibility, safety, and importance of HPV vaccination for preventing HPV infection and cervical cancer. In Nigeria, limited awareness, misconceptions about HPV and vaccination, concerns about vaccine safety, stigma, misinformation, cost, and inadequate access to reliable vaccination information may affect HPV vaccination awareness among female university students. Effective cervical cancer prevention education may improve students' understanding of HPV vaccination and strengthen their awareness of its role in cervical cancer prevention. Against this background, this study investigates the effect of cervical cancer prevention education on HPV vaccination awareness among female university students in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding students' awareness and perceptions of HPV vaccination. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping preventive health behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from cervical cancer prevention education may influence HPV vaccination awareness. Collectively, these theoretical perspectives provide a suitable framework for explaining how cervical cancer prevention education may influence HPV vaccination awareness among female university students in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from female undergraduate students in selected universities in Nigeria using a structured anonymous self-administered questionnaire. A multistage sampling technique will be employed to select states, universities, faculties or departments, academic levels, and eligible female students. Where feasible, selected student groups will be assigned to intervention and comparison groups. Students in the intervention group will receive structured cervical cancer prevention education covering cervical cancer, HPV infection, risk factors, transmission, the relationship between HPV and cervical cancer, HPV vaccination, vaccine safety and effectiveness, recommended vaccination schedules, eligibility, sources of vaccination services, and other cervical cancer prevention measures. HPV vaccination awareness will be assessed using indicators such as knowledge of HPV, understanding of the relationship between HPV and cervical cancer, awareness of HPV vaccine availability, knowledge of vaccine benefits, awareness of recommended vaccination schedules, understanding of vaccine safety, awareness of eligibility, and knowledge of where vaccination services can be obtained. Descriptive statistics will be used to summarize students' sociodemographic characteristics, baseline HPV knowledge, exposure to education, and HPV vaccination awareness. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be used to determine the effect of cervical cancer prevention education on HPV vaccination awareness. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that cervical cancer prevention education has a significant positive effect on HPV vaccination awareness among female university students in Nigeria. Students exposed to structured cervical cancer prevention education are expected to demonstrate improved knowledge of HPV infection, cervical cancer, and HPV vaccination. Education may increase awareness of the relationship between HPV and cervical cancer, improve understanding of vaccine benefits and safety, reduce misconceptions and misinformation, and increase awareness of where and when HPV vaccination can be obtained. However, education alone may not guarantee access to or uptake of HPV vaccination because students may continue to face barriers such as vaccine cost, limited availability, concerns about vaccine safety, inadequate access to vaccination services, social influences, and misinformation. Consequently, cervical cancer prevention education is expected to be most effective when supported by accessible and affordable HPV vaccination services, reliable health communication, trained healthcare providers, vaccination campaigns, and appropriate university-based preventive health programmes. The study is expected to contribute to the literature on cervical cancer prevention, HPV vaccination, health education, adolescent and young adult health, reproductive health, cancer prevention, and public health in Nigeria by providing empirical evidence on the effect of cervical cancer prevention education on HPV vaccination awareness among female university students. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), Nigeria Centre for Disease Control and Prevention (NCDC), National Cancer Control Programme, National Universities Commission, university health services, state ministries of health, healthcare providers, public health practitioners, development partners, and policymakers regarding strategies for strengthening HPV vaccination awareness and cervical cancer prevention among young women. The study will also provide evidence-based recommendations for strengthening university-based cervical cancer education, improving HPV vaccination communication, addressing vaccine misinformation and misconceptions, expanding access to HPV vaccination services, and promoting informed HPV vaccination decisions among female university students across Nigeria.

Keywords: Cervical cancer prevention education, HPV vaccination awareness, female university students, human papillomavirus, HPV vaccination, cervical cancer prevention, cancer education, health education, reproductive health, vaccination awareness, public health, Nigeria.