Study On Influencing Factors Of HPV Vaccination Behavior In Gynecological Outpatients Based On Structural Equation Model

Objective:In this study,the Structural Equation Model(SEM)of Human Papilloma Virus(HPV)vaccination Behavioral Utility was constructed to analyze the influencing factors of HPV vaccination Behavioral Utility in women in gynecological outpatient clinics,and the multi-group structural equation model was used to explore whether general population has a moderating effect in the model,so as to provide a reference for HPV vaccination behavior intervention.Methods:Using the convenient sampling method,450 patients aged 18～45 in the gynecology outpatient clinic of Shanxi Provincial People’s Hospital from October 2021 to August2022 were selected as the research subjects,and the questionnaire was designed by themselves based on UTAUT2,and the electronic questionnaire was distributed by professional investigators on the spot,collecting information on the general demographic characteristics of respondents and the influencing factors of HPV vaccination behavior,and using the SPSS26.0 statistical software package to describe the general demographic characteristics of respondents and exploratory factor analysis.The AMOS24.0 statistical software package was used to construct the structural equation model of the influencing factors of HPV vaccination behavior,as well as the multi-group structural equation model analysis,and the maximum likelihood method was used to estimate the parameters of the model,and the fit of χ2/df,RMSEA,GFI and other models was evaluated.The mediation effect test adopts the bootstrap method in the structural equation model,and the sampling number is 1000,P<0.05,indicating that there is an intermediate effect.Results:In this study,there were 139 people aged 18～26,accounting for 32.3%,129 people aged 27～35,accounting for 29.9%,and 163 people aged 36～45,accounting for 37.8%,and the number of people in all ages was basically balanced;There are 205undergraduate/university students with different education levels,accounting for the largest proportion of 47.6%,87 students in junior high school and below,accounting for20.2%,72 students in high school/technical secondary school,accounting for 16.7%,and67 graduate students,accounting for 15.5%,and the number of people is basically balanced.Among the different occupational categories,there were 95 people in medicine and health,accounting for 22.0%,and 336 in non-medical and health categories,accounting for the most 78.0%.Among the per capita monthly income of different families,there were 33 people <1000 yuan,accounting for 7.8% less,145 people<1000～3000 yuan,accounting for 33.6%,and 163 people with 3000～<5000 yuan,accounting for 37.8%,>5,000 yuan for a total of 90 people,accounting for 20.8%.There were 105 cases of HPV vaccine,accounting for 24.36%.The scores of efficacy expectation,social impact,price value,enabling conditions,effort expectation and vaccination intention were 4.15±0.79,3.86±0.89,3.66±0.94,4.12±0.76,3.51±0.95 and4.02±0.94,respectively.The exploratory factor analysis results show that the question items of each element are set reasonably,and the reliability and validity of the measurement model meet the standard.The fitting index of structural equation model χ2/df=3.457,RMSEA=0.076,RMR=0.059,GFI=0.887,NFI=0.905,IFI=0.930,CFI=0.930,PGFI=0.649,PNFI=0.733,PCFI=0.756,all reached the standard.in the pathway analysis,the Performance Expectancy(β=0.229,P<0.05),Social Influence(β=0.275,P<0.05),Price Value(β=0.383,P<0.05)positively affected the Behavioral Intention,the Facilitating Conditions had no positive effect on the Behavioral Intention,the Behavioral Intention directly positively affected the Behavioral Utility(β=0.304,P<0.05),the vaccination intention also indirectly affected the Behavioral Intention through the mediating effect of Effort Expectancy(β=0.280,P<0.05),the mediating effect accounted for the total effect(47.94%),age,education level and occupational category in demographic characteristics had a moderating effect in the influencing factor model of HPV vaccination behavior,and there was no moderating effect on the per capita monthly income of households.Conclusions:1.Among the factors related to HPV vaccination,Performance Expectancy,Social Influence,Price Value,Effort Expectancy,and Behavioral Intention are all influencing factors of Behavioral Utility,and Effort Expectancy is the mediating variable between Behavioral Intention and Behavioral Utility,The Facilitating Conditions had no positive effect on vaccination behavior.2.In the multi-group analysis,age,education level,and occupational category were used as the moderating variables in the model.