Girls’ preferences for HPV vaccination: A discrete choice experiment

A discrete choice experiment was developed to investigate if girls aged 12–16 years make trade-offs between various aspects of human papillomavirus (HPV) vaccination, and to elicit the relative weight that girls’ place on these characteristics. Degree of protection against cervical cancer, protection duration, risk of side-effects, and age of vaccination, all proved to influence girls’ preferences for HPV vaccination. We found that girls were willing to trade-off 38% protection against cervical cancer to obtain a lifetime protection instead of a protection duration of 6 years, or 17% to obtain an HPV vaccination with a 1 per 750,000 instead of 1 per 150,000 risk of serious side-effects. We conclude that girls indeed made a trade-off between degree of protection and other vaccine characteristics, and that uptake of HPV vaccination may change considerably if girls are supplied with new evidence-based information about the degree of protection against cervical cancer, the protection duration, and the risk of serious side-effects.     

Parental preferences for rotavirus vaccination in young children: A discrete choice experiment

Objective

This study aimed to identify characteristics that affect parental decisions about rotavirus vaccination, to determine the relative importance of those characteristics and subsequently to estimate vaccination coverage for different implementation strategies.

Methods

A Discrete choice experiment (DCE) questionnaire was sent to the parents of 1250 newborns aged 6 weeks (response rate 37.3%). Mixed-logit models were used to estimate the relative importance of the five included rotavirus vaccine and implementation characteristics; vaccine effectiveness, frequency of severe side effects, protection duration, the healthcare facility that administrates vaccination and out-of-pocket costs. Based on the utility functions of the mixed-logit model, the potential vaccination coverage was estimated for different vaccine scenarios and implementation strategies.

Results

All characteristics, except for healthcare facility that administrates vaccination, influenced parental willingness to vaccinate their newborn against rotavirus. Parents were willing to trade 20.2 percentage points vaccine effectiveness for the lowest frequency of severe side effects (i.e., 1 in 1,000,000) or 20.8 percentage points for a higher protection duration. Potential vaccination coverage ranged between 22.7 and 86.2%, depending on vaccine scenario (i.e., vaccine effectiveness and protection duration) and implementation strategy (i.e., out-of-pocket costs and healthcare facility that administrates vaccination).

Conclusions

When deciding about vaccination against rotavirus, parents are mostly driven by the out-of-pocket costs, vaccine effectiveness, protection duration, and frequency of severe side effects. The highest vaccination coverage is expected for a vaccine with high effectiveness and protection duration that is implemented within the current National Immunization Program context. Implementation of the same rotavirus vaccine in the free market will result in lowest coverage.     

The effects of convenience and quality on the demand for vaccination: Results from a discrete choice experiment

BackgroundVaccination is an effective way to prevent infectious diseases. Most studies analysed people's vaccine decisions, but few studies have analysed the effects of convenience such as immunisation schedule and distance and the quality of vaccination service on vaccination uptake.ObjectiveThe aim of this paper was to investigate adults’ preferences for convenience and quality of vaccination service, calculate the private economic benefit from convenience (vaccination schedule and distance) and quality, and predict the uptake rate for different vaccine scenarios.MethodsIn our study, we interviewed 266 adults in 2 counties of Shandong province in China. The discrete choice experiment (DCE) was employed to analyse the preference for hepatitis B virus (HBV) vaccination, and a mixed logit model was used to estimate respondent preferences for vaccination attributes included in the DCE.ResultsThe protection rate against hepatitis B (HB), duration of protection, risk of side effects, vaccination cost, schedule, and vaccination sites were proved to influence adults’ preferences for HBV vaccination. The estimated willingness to pay (WTP) for 1 dose schedule instead of 3 doses and for a third-level vaccination site instead of a first-level site was almost equal (19 RMB). However, if the protection duration of the vaccination programme changed from 5 years to 20 years, the adults were willing to pay 35.05 RMB, and WTP for a 99% protection rate instead of a 79% rate was 67.71 RMB. The predicted uptake rate is almost 43% for the base case of HBV vaccination.ConclusionsAdults made trade-offs between vaccination schedules, vaccination sites, and other characteristics of HBV vaccine. The impact of attributes of the vaccine itself, especially protection rate against HB, duration of protection, and risk of side-effects, is more dramatic than convenience and quality of vaccination service.     

Optimising HPV vaccination communication to adolescents: A discrete choice experiment

BackgroundHuman Papillomavirus (HPV) vaccine coverage in France is below 30%, despite proven effectiveness against HPV infections and (pre-)cancerous cervical lesions. To optimise vaccine promotion among adolescents, we used a discrete choice experiment (DCE) to identify optimal statements regarding a vaccination programme, including vaccine characteristics.MethodsGirls and boys enrolled in the last two years of five middle schools in three French regions (aged 13–15 years) participated in an in-class cross-sectional self-administered internet-based study. In ten hypothetical scenarios, participants decided for or against signing up for a school-based vaccination campaign against an unnamed disease. Scenarios included different levels of four attributes: the type of vaccine-preventable disease, communication on vaccine safety, potential for indirect protection, and information on vaccine uptake among peers. One scenario was repeated with an added mention of sexual transmission.ResultsThe 1,458 participating adolescents (estimated response rate: 89.4%) theoretically accepted vaccination in 80.1% of scenarios. All attributes significantly impacted theoretical vaccine acceptance. Compared to a febrile respiratory disease, protection against cancer was motivating (odds ratio (OR) 1.29 [95%-CI 1.09–1.52]), but not against genital warts (OR 0.91 [0.78–1.06]). Compared to risk negation (“vaccine does not provoke serious side effects”), a reference to a positive benefit-risk balance despite a confirmed side effect was strongly dissuasive (OR 0.30 [0.24–0.36]), while reference to ongoing international pharmacovigilance without any scientifically confirmed effect was not significantly dissuasive (OR 0.86 [0.71–1.04]). The potential for indirect protection motivated acceptance among girls but not boys (potential for eliminating the disease compared to no indirect protection, OR 1.57 [1.25–1.96]). Compared to mentioning “insufficient coverage”, reporting that “>80% of young people in other countries got vaccinated” motivated vaccine acceptance (OR 1.94 [1.61–2.35]). The notion of sexual transmission did not influence acceptance.ConclusionHPV vaccine communication to adolescents can be tailored to optimise the impact of promotion efforts.     

Parent,provider and vaccinee preferences for HPV vaccination: A systematic review of discrete choice experiments

ObjectivesTo systematically review, appraise and evaluate available evidence regarding discrete-choice experiments (DCEs) for the human papilloma virus (HPV) vaccination in order to support policymakers in making reasonable and effective vaccination program implementation decisions.MethodsA systematic literature review was conducted using the databases PubMed and Embase for DCEs in HPV up to May 2019. Extracted data was tabulated and two checklists were used for the quality appraisal of the included studies. All attributes were categorized in outcome, process or costs attributes and the relative importance of attributes was calculated using the range method.ResultsOut of 164 identified studies, 12 met the inclusion criteria. Eight were from high income countries (HICs) and four from low and middle-income countries (LMICs). Five studies each examined vaccinee and parent preferences, while only two assessed the providers’ preferences. The studies were rather heterogenous in terms of the populations investigated, the attributes included and the methodologic approach. Overall, outcome measures were the most prominent attributes and effectiveness consistently yielded high relative importance scores. But also process factors, such as the age at vaccination, played an important role for decision making. Discrepancies between HICs and LMICs were most prominent for cost attributes.ConclusionThe heterogenous preferences this review elicited highlight the importance of context when making decisions grounded on consumer preferences. Especially the lack of evidence from LMICs, where the burden of cervical cancer is highest, is worrisome. In order to increase uptake, close vaccination gaps and reduce current inequities in (reproductive) healthcare, policy makers need to understand the features that drive individual vaccination decisions and adapt national and clinical guidelines accordingly. Future research therefore needs to focus on LMICs in order to elicit preferences of those most vulnerable populations.     

Convergent validity between a discrete choice experiment and a direct, open-ended method: comparison of preferred attribute levels and willingness to pay estimates

The Discrete Choice Experiment (DCE) has become increasingly popular as a method for eliciting patient or population preferences. If DCE estimates are to inform health policy, it is crucial that the answers they provide are valid. Convergent validity is tested in this paper by comparing the results of a DCE exercise with the answers obtained from direct, open-ended questions. The two methods are compared in terms of preferred attribute levels and willingness to pay (WTP) values. Face-to-face interviews were held with 292 women in Calgary, Canada. Similar values were found between the two methods with respect to preferred levels for two out of three of the attributes examined. The DCE predicted less well for levels outside the range than for levels inside the range reaffirming the importance of extensive piloting to ensure appropriate level range in DCEs. The mean WTP derived from the open-ended question was substantially lower than the mean derived from the DCE. However, the two sets of willingness to pay estimates were consistent with each other in that individuals who were willing to pay more in the open-ended question were also willing to pay more in the DCE. The difference in mean WTP values between the two approaches (direct versus DCE) demonstrates the importance of continuing research into the different biases present across elicitation methods.     

Patient preferences for managing asthma: results from a discrete choice experiment

Effective control of asthma requires regular preventive medication. Poor medication adherence suggests that patient preferences for medications may differ from the concerns of the prescribing clinicians. This study investigated patient preferences for preventive medications across symptom control, daily activities, medication side-effects, convenience and costs, using a discrete choice experiment embedded in a randomized clinical trial involving patients with mild-moderate persistent asthma. The present data were collected after patients had received 6 weeks' treatment with one of two drugs. Three choice options were presented, to continue with the current drug, to change to an alternative, hypothetical drug, or to take no preventive medication. Analysis used random parameter multinomial logit. Most respondents chose to continue with their current drug in most choice situations but this tendency differed depending on which medication they had been allocated. Respondents valued their ability to participate in usual daily activities and sport, preferred minimal symptoms, and were less likely to choose drugs with side-effects. Cost was also significant, but other convenience attributes were not. Demographic characteristics did not improve the model fit. This study illustrates how discrete choice experiments may be embedded in a clinical trial to provide insights into patient preferences.     

Parental acceptance of human papillomavirus (HPV) vaccination in Indonesia: a cross-sectional study

Background

Cervical cancer ranks the second most frequent cancer in Indonesian women. In Indonesia, human papillomavirus (HPV) vaccine acceptance has not been studied before.

Objective

To determine parental HPV vaccine acceptance in Indonesia, and factors that influence their decision. Factors include sociodemographic factors, knowledge of HPV, HPV vaccination and cervical cancer, health beliefs about cervical cancer, and attitudes towards vaccination in general.

Methods

746 parents, with at least 1 daughter aged 0-14, were interviewed using questionnaires based on published and adjusted interviews. Interviews were done in sub district public health centers, general governmental hospitals, and via house-visits, in 5 Indonesian provinces.

Results

Parental HPV vaccine acceptance was 96.1%. Logistic regression revealed that age, beliefs regarding cervical cancer, and attitudes towards vaccination in general were significantly associated with HPV vaccine acceptance. Of the participants, 66.0%, 16.6%, and 15.8% had heard about cervical cancer, HPV, and HPV vaccination respectively. The mean total knowledge score was 1.91(Standard Deviation 2.31) on a 0-8 scale. Health beliefs about cervical cancer and attitudes towards vaccination in general were positive. Participants named the high cost of the vaccine, fear for side-effects, and chosen vaccination locations as possible barriers towards HPV vaccine implementation.

Discussion

Parental HPV vaccine acceptance is high, but knowledge about HPV and cervical cancer is low. During HPV vaccination programs, focus should not only be on providing information, but also on existing beliefs and attitudes towards cervical cancer and vaccination in general. If HPV vaccination programs were to be implemented in Indonesia, the indicated barriers should be taken into account.     

Preferences for physician services in Ukraine: a discrete choice experiment

Evidence on preferences of Ukrainian consumers for healthcare improvements can help to design reforms that correspond to societal priorities. This study aims to elicit and to place monetary values on public preferences for out‐patient physician services in Ukraine. The method of discrete choice experiment is used on a sample of 303 respondents, representative of the adult Ukrainian population. The random effect logit model with interactions provides the best fit for the data and is used to calculate the marginal willingness to pay (MWTP) for quality and access improvements. At a sample level, there is no clear preference to pay formally rather than informally or vice versa. We also do not find that visiting a general practitioner is preferred over direct access to a medical specialist. However, there are differences between population groups. Quality‐related attributes of physician services appear important to respondents, especially the attitude of medical staff. Thus, interpersonal aspects of out‐patient care should be given priority in decisions about investments in quality improvements. Other aspects, that is social quality and access, are important as well but their improvement brings fewer social gains. Measures should be taken to eradicate the informal payment channels and to strengthen the gate‐keeping role of primary care. Copyright © 2014 John Wiley & Sons, Ltd.     

Mothers' preferences and willingness to pay for HPV vaccines in Vinh Long Province, Vietnam

About 530,000 women develop cervical cancer worldwide and 275,000 die from the disease each year. Eighty percent of these deaths occur in developing countries. In Vietnam, cervical cancer has recently emerged as the most common type of cancer in women, and there are no national screening programs for cervical cancer. Since 2009, two different human papillomavirus (HPV) vaccines have been licensed for use in Vietnam, but access to these vaccines is generally limited to people who live in urban areas. Studies have shown that HPV vaccination may be cost-effective in cervical cancer prevention in Vietnam, depending on vaccination costs. Given that current HPV vaccines are expensive and public health funding for supporting a rapid introduction of the vaccine is limited, expanding and sustaining access to the HPV vaccine may require alternative financing mechanisms, such as fees-based immunization services. A conjoint analysis study was conducted with mothers of girls 9-17 years of age in Vinh Long Province in Vietnam to estimate the mothers' demand for HPV vaccines for their daughters and to measure the tradeoffs between vaccine fees and vaccine uptake. The results suggest that the demand for HPV vaccines was high, increased with vaccine effectiveness and duration of effectiveness, and decreased with vaccine cost. Vaccine effectiveness was the most important vaccine attribute to these mothers, followed by duration of effectiveness. The predicted probability of respondents buying an HPV vaccine that was 70% effective for 10 years varied by the price, ranging from 30% when the vaccine price was $353 per course, to 68% when the vaccine cost $6 per course. As expected, demand and predicted purchase probability were higher among groups with higher socioeconomic status.     

Eliciting preferences for medical devices in South Korea: A discrete choice experiment

This study aims to identify the attributes that contribute to the value of medical devices and quantify the relative importance of them using a discrete choice experiment. Based on a literature review and expert consultation, seven attributes and their levels were identified—severity of disease (2), availability of substitutes (2), improvement in procedure (3), improvement in clinical outcomes (2), increase in survival (2), improvement in quality of life (3), and cost (4). Among 576 hypothetical profiles, optimal choice sets with 20 choices were developed and experts experienced in health technology assessment and reimbursement decision making in South Korea were surveyed. A total of 102 respondents participated in the survey. The results of the random-effect probit model showed that among the seven attributes, six, except for improvement in procedure, had a significant impact on respondents’ choices on medical devices. Respondents were willing to pay the highest amount for devices that provided substantial improvements in quality of life, followed by increased survival, improved clinical outcome, treatment without substitutes, and technology for treating severe diseases. The findings of this experiment will inform decision-makers of the relative importance of the criteria and help them in reimbursement decision making of medical devices.     

我国西部地区城市和农村中学生对人乳头瘤病毒及其预防性疫苗的认知及态度调查

目的 调查我国西部地区城市和农村中学生对人乳头瘤病毒(human papillomavirus, HPV)及其预防性疫苗的认知及态度,为今后在西部地区适龄接种人群中推广HPV疫苗提供参考依据。方法 采取以人群为基础的横断面调查。采用便利抽样,分别于 2015年、2016 年在四川成都市和新疆乌鲁木齐市各抽取一所城市中学和一所农村中学,对所选学校的初一学生进行问卷调查。结果 本研究共纳入2062名学生,有61.3%的学生接触过性教育或性知识,仅7.8%的学生对青春期知识非常了解。有34.6%的学生听说过宫颈癌,城市学生的知晓率高于农村学生(37.7% vs 31.7%,P＜0.05)。分别有13.7%和17.7%的学生听说过HPV和HPV疫苗。有50.0%的城市学生和59.6%的农村学生表示愿意接种HPV疫苗,接种意愿存在城乡差异(P＜0.05)。来自乌鲁木齐市农村地区且相关认知合格的女学生更愿意接种 HPV 疫苗。结论 我国西部地区城乡中学生对青春期健康、宫颈癌、HPV 及 HPV 疫苗的认知水平较低且存在差异。应将HPV相关知识纳入以学校为基础的健康教育,并根据城乡学生的差异进行有针对性的教育,从而提高城乡适龄接种人群对HPV及其疫苗的正确认知,为将来提高HPV疫苗在青少年人群中的接种率提供基础。     

不同生源地医学生就业偏好及异质性研究——基于北京市6家医院的离散选择实验

目的：分析不同生源地医学生就业偏好及异质性,为优化基层卫生人力管理提供参考。方法：采用整群抽样方法,对北京市6家教学医院的925名医学生开展离散选择实验的线上问卷调查,获得有效问卷741份,有效回收率为80.1%。运用混合logit模型对6个工作属性进行回归分析并估计支付意愿。结果：不同生源地医学生对工作地点的选择具有显著差异。亚组分析结果表明,相比于来自城市的医学生,来自农村和县城的医学生更重视充足的职业发展机会;本科生亚组结果显示,相比于其他生源地的本科生,来自农村的本科生更偏好良好的工作环境。结论：不同生源地的医学生就业偏好存在异质性;政策制定者应关注医学生生源地,兼顾教育程度优化多元工作要素,分类制定针对性的基层卫生人才吸引措施。     

Public preference for COVID‐19 vaccines in China: A discrete choice experiment

BackgroundAs the coronavirus disease 2019 (COVID‐19) pandemic is sweeping across the globe, there is an urgent need to develop effective vaccines as the most powerful strategy to end the pandemic. This study aimed to examine how factors related to vaccine characteristics, their social normative influence and convenience of vaccination can affect the public''s preference for the uptake of the COVID‐19 vaccine in China.MethodsAn online discrete choice experiment (DCE) survey was administered to a sample of China''s general population. Participants were asked to make a series of hypothetical choices and estimate their preference for different attributes of the vaccine. A mixed logit regression model was used to analyse the DCE data. Willingness to pay for each attribute was also calculated.ResultsData of 1236 participants who provided valid responses were included in the analysis. There was strong public preference for high effectiveness of the vaccine, followed by long protective duration, very few adverse events and being manufactured overseas. Price was the least important attribute affecting the public preference in selecting the COVID‐19 vaccine.ConclusionsThe strong public preferences detected in this study should be considered when developing COVID‐19 vaccination programme in China. The results provide useful information for policymakers to identify the individual and social values for a good vaccination strategy.Patient or Public ContributionThe design of the experimental choices was fully based on interviews and focus group discussions participated by 26 Chinese people with diverse socio‐economic backgrounds. Without their participation, the study would not be possible.     

Parent's preferences for unscheduled paediatric healthcare: A discrete choice experiment

Background

Unscheduled healthcare is a key component of healthcare delivery and makes up a significant proportion of healthcare access, with children being particularly high users of unscheduled healthcare. Understanding the relative importance of factors that influence this behaviour and decision-making is fundamental to ensuring the system is best designed to meet the needs of users and foster appropriate cost-effective usage of health system resources.

Objective

The aim of the study was to identify the parent's preferences for unscheduled healthcare for a common mild childhood illness.

Design

A discrete choice experiment (DCE) was developed to identify the preferences of parents accessing unscheduled healthcare for their children.

Setting and Participants

Data were collected from parents in Ireland (N = 458) to elicit preferences across five attributes: timeliness, appointment type, healthcare professional attended, telephone guidance before attending and cost.

Results

Using a random parameters logit model, all attributes were statistically significant, cost (β = −5.064, 95% confidence interval, CI [−5.60, −4.53]), same-day (β = 1.386, 95% CI [1.19, 1.58]) or next-day access (β = 0.857, 95% CI [0.73, 0.98]), coupled with care by their own general practitioner (β = 0.748, 95% CI [0.61, 0.89]), identified as the strongest preferences of parents accessing unscheduled healthcare for their children.

Discussion

The results have implications for policy development and implementation initiatives that seek to improve unscheduled health services as understanding how parents use these services can maximise their effectiveness.

Patient or Public Contribution

The development of the DCE included a qualitative research component to ensure that the content accurately reflected parents experiences when seeking healthcare. Before data collection, a pilot test was carried out with the target population to gather their views on the survey.     

Using discrete choice experiments to understand preferences for quality of life. Variance-scale heterogeneity matters

Health services researchers are increasingly using discrete choice experiments (DCEs) to model a latent variable, be it health, health-related quality of life or utility. Unfortunately it is not widely recognised that failure to model variance heterogeneity correctly leads to bias in the point estimates. This paper compares variance heterogeneity latent class models with traditional multinomial logistic (MNL) regression models. Using the ICECAP-O quality of life instrument which was designed to provide a set of preference-based general quality of life tariffs for the UK population aged 65+, it demonstrates that there is both mean and variance heterogeneity in preferences for quality of life, which covariate-adjusted MNL is incapable of separating. Two policy-relevant mean groups were found: one group that particularly disliked impairments to independence was dominated by females living alone (typically widows). Males who live alone (often widowers) did not display a preference for independence, but instead showed a strong aversion to social isolation, as did older people (of either sex) who lived with a spouse. Approximately 6–10% of respondents can be classified into a third group that often misunderstood the task. Having a qualification of any type and higher quality of life was associated with smaller random component variances. This illustrates how better understanding of random utility theory enables richer inferences to be drawn from discrete choice experiments. The methods have relevance for all health studies using discrete choice tasks to make inferences about a latent scale, particular QALY valuation exercises that use DCEs, best-worst scaling and ranking tasks.     

Willingness to pay and financing preferences for COVID-19 vaccination in China

BackgroundThe COVID-19 pandemic has caused significant diseases and economic burdens in the world. Vaccines are often considered as a cost-effective way to prevent and control infectious diseases, and the research and development of COVID-19 vaccines have been progressing unprecedently. It is needed to understand individuals’ willingness to pay (WTP) among general population, which provides information about social demand, access and financing for future COVID-19 vaccination.ObjectiveTo investigate individuals’ WTP and financing mechanism preference for COVID-19 vaccination during the pandemic period in China.MethodsDuring March 1–18, 2020, we conducted a network stratified random sampling survey with 2058 respondents in China. The survey questionnaires included out-of-pocket WTP, financing mechanism preference as well as basic characteristics of the respondents; risk perception and impact of the COVID-19 pandemic; attitude for future COVID-19 vaccination. Multivariable Tobit regression was used to determine impact factors for respondents’ out-of-pocket WTP.ResultsThe individuals’ mean WTP for full COVID-19 vaccination was CNY 254 (USD 36.8) with median of CNY 100 (USD 14.5). Most respondents believed that governments (90.9%) and health insurance (78.0%) needed to pay for some or full portions of COVID-19 vaccination, although 84.3% stated that individuals needed to pay. Annual family income, employee size in the workplace, and whether considering the COVID-19 pandemic in China in a declining trend affected respondents’ WTP significantly.ConclusionThe findings demonstrated the individuals’ WTP for COVID-19 vaccination in China and their preferences for financing sources from individuals, governments and health insurance. And to suggest an effective and optimal financing strategy, the public health perspective with equal access to COVID-19 vaccination should be prioritized to ensure a high vaccination rate.     

深圳地区女性流动人群HPV预防性疫苗接种意愿调查及影响因素分析

目的 了解深圳地区女性流动人群对HPV及其疫苗的认知情况及疫苗接种意愿和相关影响因素。方法 于2015年1-6月在深圳市10个行政区各社康中心对21～60岁女性流动人群进行问卷调查,采用非条件logistic回归模型分析HPV疫苗接种意愿的影响因素。结果 本次调查的969名女性流动人群平均年龄为（35.34±8.21）岁,仅有283人（29.2%）听说过人乳头瘤病毒,但548人（56.6%）愿意接种HPV预防性疫苗。不愿意接种的主要原因有:“担心疫苗的安全性”（34.7%）、“疫苗还没有大面积推广”（17.8%）、“疫苗的价格问题”（11.4%）、“对疫苗的效果不信任”（9.7%）、“认为没有患子宫颈癌的危险”（9.7%）及“已经有性生活,接种与否没有什么不同”（8.3%）。多因素logistic回归分析显示,中部地区（OR = 1.537,95%CI:1.034～2.286）和东部地区（OR = 2.252,95%CI:1.641～3.091）、汉族（OR = 1.698,95%CI:1.018～2.832）、高中及以上学历（OR = 2.150,95%CI:1.345～3.437)、近6个月性伴数为2个及以上（OR = 2.019,95%CI:1.105～3.689)的妇女对HPV疫苗接种意愿更高。结论 深圳地区女性流动人群HPV及其疫苗知晓率较低,接种意愿相对较高。地区、民族、受教育程度、性伴数量是影响女性流动人群HPV疫苗接种意愿的相关因素。     

Acceptability of human papillomavirus vaccine among parents of junior middle school students in Jinan,China

ObjectiveTo determine the level of awareness on human papillomavirus (HPV) vaccine and acceptance of HPV vaccination among parents of junior middle school students.MethodsA cross sectional survey employing cluster sampling was conducted in Jinan, Shandong Province of China in January of 2013.ResultsA total of 400 parents of junior middle school students participated in the questionnaire survey, among whom 360 (90%) completed valid questionnaires. About 88 (22.63%) parents had ever heard of HPV. Only one in ten (10.2%) knew about HPV vaccine. Parents willing to accept HPV vaccination for children accounted for 40.8%. Factors associated willing to accept HPV vaccination for children among parents were: female parent (AOR: 0.38, 95%CI: 0.21–0.67), having ever heard of HPV vaccine (AOR: 2.38, 95%CI: 1.01–5.61), thinking HPV vaccination should commence before sexual debut(AOR: 2.16, 95%CI: 1.21–3.85), thinking HPV vaccination should commence before 12 years old (AOR: 2.76, 95%CI: 1.02–7.46) or 13–15 years old (AOR: 4.75, 95%CI: 1.79–12.61), concern about suffering from cervical cancer and/or genital warts (AOR: 2.43, 95%CI: 1.31–4.50). About 60% of parents were in favor of future HPV vaccination promoting in China believing that HPV vaccine could efficiently prevent cervical cancer, anal cancer or genital warts, 37.4% of parents with expectation of governmental subsidy and price regulation.ConclusionParental awareness level of HPV vaccine and willingness to accept HPV vaccination for children was low. However, the general attitude of many participants toward future promoting of HPV vaccination in China was encouraging, particularly if certain expectations were met.