Parental Preferences of Influenza Vaccination for Children in China: A National Survey with a Discrete Choice Experiment.
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SUBMITTER: Jiang M
PROVIDER: S-EPMC8871809 | biostudies-literature | 2022 Feb
REPOSITORIES: biostudies-literature
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Parental Preferences of Influenza Vaccination for Children in China: A National Survey with a Discrete Choice Experiment.
Jiang Minghuan M Gong Yilin Y Fang Yu Y Yao Xuelin X Feng Liuxin L Zhu Shan S Peng Jin J Shi Xinke X
International journal of environmental research and public health 20220214 4
The influenza vaccination coverage among children is low in China. We aimed to conduct a nationwide survey to quantify parental preferences and willingness to pay (WTP) for influenza vaccination for their children. Parents with children aged six months to 18 years from six provinces in China were investigated by a discrete choice experiment regarding six influenza vaccination attributes. Mixed logit models were used to estimate the relative importance of vaccine attributes and parents' WTP. Inte ...[more]
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Project description:BackgroundMandatory vaccination has been mooted to combat falling childhood vaccine uptake rates in England. This study investigated parental preferences for a mandatory vaccination scheme.MethodsDiscrete choice experiment. Six attributes were investigated: vaccine, child age group, incentive, penalty, ability to opt out, and compensation scheme. Mixed effects conditional logit regression models were used to investigate parental preferences and relative importance of attributes.FindingsParticipants were 1,001 parents of children aged 5 years and under in England (53% female; mean age=33·6 years, SD=7·1; 84% white). Parental preferences were mostly based on incentives (30·7% relative importance; 80·9% [95% confidence interval 76·3-85·0%] preference for parent and 74·8% [71·0-78·3%] for child incentive; reference: no incentive) and penalties (25·4% relative importance; 69·5% [65·7-73·1%] preference for schemes where unvaccinated children cannot attend school or day care and 67·6% [63·6-71·4%] for those withholding financial benefits for parents of unvaccinated children; reference: £450 fine). Parents also preferred schemes that: offered a compensation scheme (18·1% relative importance; 66·4% [62·7-69·8%] preference; reference: not offered), mandated vaccination in children aged 2 years (versus 5 years; 11·4% relative importance; 42·6% [39·4-45·9%] preference; reference: 2 years), mandated the 6-in-1 vaccine (10·5% relative importance; 58·2% [54·6-61·7%] preference; reference: MMR), and that offered only medical exemptions (versus medical and religious belief exemptions; 4·0% relative importance; 45·5% [41·1-50·0%] preference; reference: medical exemptions).InterpretationThese findings can inform policymakers' decisions about how best to implement a mandatory childhood vaccination scheme in England.FundingData collection was funded by a British Academy/Leverhulme Small Research Grants (SRG1920\101118).
| S-EPMC9097614 | biostudies-literature
Project description:ObjectivesTo investigate what factors affect parents' influenza vaccination preference for their children and whether there exists preference heterogeneity among respondents in China.DesignCross-sectional study. A discrete choice experiment was conducted. Five attributes were identified based on literature review and qualitative interviews, including protection rate, duration of vaccine-induced protection, risk of serious side effects, location of manufacturer and out-of-pocket cost.SettingMultistage sampling design was used. According to geographical location and the level of economic development, 10 provinces in China were selected, and the survey was conducted at community healthcare centres or stations.ParticipantsParents with at least one child aged between 6 months and 5 years old were recruited and the survey was conducted via a face-to-face interview in 2019. In total, 600 parents completed the survey, and 449 who passed the internal consistency test were included in the main analysis.Main outcomes and measuresA mixed logit model was used to estimate factors affecting parents' preference to vaccinate their children. In addition, sociodemographic characteristics were included to explore the preference heterogeneity.ResultsIn general, respondents preferred to vaccinate their children. All attributes were statistically significant and among them, the risk of severe side effects was the most important attribute, followed by the protection rate and duration of vaccine-induced protection. Contrary to our initial expectation, respondents have a stronger preference for the domestic than the imported vaccine. Some preference heterogeneity among parents was also found and in particular, parents who were older, or highly educated placed a higher weight on a higher protection rate.ConclusionVaccination safety and vaccine effectiveness are the two most important characteristics that influenced parents' decision to vaccinate against influenza for their children in China. Results from this study will facilitate future policy implementations to improve vaccination uptake rates.
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Project description:BackgroundChina is the only country in the world that has not included the Haemophilus influenzae type b (Hib) vaccine in its National Immunization Program, making it more difficult to eliminate Hib-related diseases through Hib vaccination. It is necessary to study parental preferences for Hib vaccination to optimize vaccine promotion strategies in China.ObjectiveThis study aimed to investigate Chinese parental preference for five attributes of Hib vaccination, i.e., the place of origin, effectiveness, adverse event, doctors' recommendation, and the price of full vaccination when making a decision to vaccinate their children under 2 years old.MethodsA cross-sectional survey was conducted in two cities in Zhejiang Province from November to December in 2020 using a discrete choice experiment (DCE). A mixed logit model was used to estimate participating parents' preference for Hib vaccination attributes included in the DCE. Subgroup analysis and probability analysis were also conducted to capture the heterogeneity and trade-off of parental preference for Hib vaccination.ResultsData from 6,168 observations were included in the analyses. Parents of children are, on average, more likely to voice a positive preference for Hib vaccination. Such attributes of Hib vaccination as effectiveness and doctor's recommendation have a significant positive influence on parents' preference for Hib vaccination, while imported vaccines, adverse events, and the price of full vaccination have a significant negative influence on parents' preference. Parents with different demographic characteristics also existed heterogeneities in preference for Hib vaccination. Parents will make a trade-off on price if the Hib vaccine has a good performance on effectiveness and safety.ConclusionThe study found that, regardless of the place of origin of the Hib vaccine, parents with children under 2 years old prefer to compromise on price if the vaccine has a better effectiveness and safety profile. A proactive recommendation from doctors would strengthen their willingness for Hib vaccination. These findings help aid the development of communication strategies with parents for Hib vaccination in China.
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Project description:Although the number of medical workers has increased rapidly, its scarcity in rural areas remains a serious problem in China. This study aimed to investigate medical students' stated preferences when choosing a job, so as to assist policy makers with designing alternative interventions to address the unbalanced distribution of the health workforce in China.A discrete choice experiment (DCE) was conducted to elicit the job preferences of final year medical students. Attributes include work location, hospital type, monthly income, bianzhi (which can be loosely regarded as state administrative staffing), work environment, Training and career development opportunity. This study was carried out during April to June 2017 in 4 medical universities in Shandong Province, China. Mixed logit models were used to analyze the relative importance of job attributes.A total of 519 medical students participated in the survey. All 6 attributes were statistically significant with the expected sign and demonstrated the existence of preference heterogeneity. In the main effects mixed logit model, working in the city and a superior working environment were most strongly associated with job preference. A relatively unexpected finding was the relatively lower utility of offering bianzhi in job preferences. Subgroup analysis showed that females and those who have an urban background were significantly willing to pay more for working in the city. The most preferred scenario for medical students was to select a better work environment job in a tertiary hospital in the city, which could offer 9000 CNY monthly, with sufficient training and career development opportunities and bianzhi.Both monetary and nonmonetary intervention could be considered by policy makers to attract medical students to work in rural areas in China. There exists preference heterogeneity on medical students' job preferences, which should also be taken into account in developing more effective policy incentive packages.
| S-EPMC6160052 | biostudies-literature
Project description:BackgroundPharmacists are a crucial part of the health workforce and play an important role in achieving universal health coverage. In China, pharmaceutical human resources are in short supply, and the distribution is unequal. This study aimed to identify the key job characteristics that influence the job preferences of undergraduate pharmacy students and to elicit the relative importance of different job characteristics to shed light on future policy interventions.MethodsA discrete choice experiment was conducted to assess the job preferences of undergraduate pharmacy students from 6 provinces in mainland China. A face-to-face interview was used to collect data. Conditional logit and mixed logit models were used to analyse data, and the final model was chosen according to the model fit statistics. A series of policy simulations was also conducted.ResultsIn total, 581 respondents completed the questionnaire, and 500 respondents who passed the internal consistency test were analysed. All attributes were statistically significant except for open management. Monthly income and work location were most important to respondents, followed by work unit (which refers to the nature of the workplace) and years to promotion. There was preference heterogeneity among respondents, e.g., male students preferred open management, and female students preferred jobs in public institutions. Furthermore, students with an urban background or from a single-child family placed higher value on a job in the city compared to their counterparts.ConclusionThe heterogeneity of attributes showed the complexity of job preferences. Both monetary and nonmonetary job characteristics significantly influenced the job preferences of pharmacy students in China. A more effective policy intervention to attract graduates to work in rural areas should consider both incentives on the job itself and the background of pharmacy school graduates.
| S-EPMC8259344 | biostudies-literature
Project description:Background: Generic substitution policies have been widely implemented worldwide to enhance the accessibility of medications. Nevertheless, certain patients have voiced discontent with these policies. This study aimed to evaluate the patient preferences for generic substitution policies and explore the potential for optimization to enhance patient acceptance. Methods: A discrete choice experiment (DCE) was conducted to estimate the relative importance (RI) of five attributes, including generic consistency evaluation (GCE), reimbursement rate, medication use control, information disclosure, and post-marketing surveillance. Respondents were recruited among inpatients and outpatients in three cities and surveys were conducted face-to-face. Preference coefficients, RI of attributes, and the uptake rate of various policies were computed using a mixed logit model. The interaction effects were also included to examine preference heterogeneity. Results: A total of 302 patients completed the survey. All five attributes significantly impacted policy acceptance. GCE held the highest RI value at 56.64%, followed by reimbursement rate (RI = 12.62%), information disclosure (RI = 12.41%), post-marketing surveillance (RI = 9.54%), and medication use control (RI = 8.80%). Patient preferences varied depending on their gender and income. The patient uptake rate of China's current policy was only 68.56%. If all generics were to pass GCE without altering the other attributes, the uptake rate of policies would rise to 82.63%. Similarly, implementing information disclosure without changing other attributes would result in a 78.67% uptake rate, which is comparable to the effect of a 10% increase in reimbursement rate for generics (78.81%). Combining these policies could mitigate the adverse effects of mandatory substitution on patient. Conclusion: Chinese patient preferences for generic substitution policies were mainly influenced by GCE. China's current generic substitution policy has room for further optimization to enhance patient acceptance.
| S-EPMC11250648 | biostudies-literature