Information source use versus trust as drivers of HPV vaccination among Belgrade University students

Background

The information environment shapes vaccination decisions, but research rarely distinguishes between source use (frequency of consultation) and trust (perceived credibility). Frequently used but distrusted sources could affect behaviour differently from trusted but rarely consulted ones. We compared the independent contributions of information source use and trust to HPV vaccination drivers among university students.

Methods

A cross-sectional study enrolled 2,079 university students in Belgrade, Serbia (75.8% female; 52.0% vaccinated). Twelve information sources were assessed for both use frequency and trust level, categorized as formal (scientific literature, physicians, health authorities) or informal (social media, television, family, friends). SEM with WLSMV estimation tested four pathways (formal/informal × use/trust) to vaccination, mediated through vaccine confidence, knowledge, and perceived information lack.

Results

Trust had stronger effects than use. Formal source trust boosted confidence (β = 0.60, p < 0.001), knowledge (β = 0.36, p < 0.001), and reduced perceived information lack (β=−0.31, p < 0.001). Informal source trust had opposing effects: reducing confidence (β=−0.22, p < 0.001) and knowledge (β=−0.28, p < 0.001). Informal source use modestly enhanced confidence (β = 0.12, p < 0.001). The model explained 70.5% of vaccination variance. A complementary per-source use-trust composite approach achieved comparable power (R²=70.4%).

Conclusions

Trust in information sources matters more than use frequency for HPV vaccination. Opposing effects of formal versus informal source trust suggest interventions should strengthen trust in evidence-based sources while building critical appraisal skills for informal channels. Public health communication should prioritize credibility-building through physicians and scientific institutions over mere exposure.

Key messages

• Trust in information sources has stronger effects on vaccination drivers than frequency of use, with formal source trust boosting vaccine confidence (β = 0.60) and knowledge (β = 0.36).

• Trust in informal sources (social media, family, peers) undermines vaccine confidence (β=−0.22) and knowledge (β=−0.28), revealing opposing effects of formal vs informal information trust.