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Khorasheh T, AbuAyyash CB, Mallakin M, Sellen K, Corace K, Pauly B, Buchman D, Hamilton M, Boyce N, Ng K, Strike C, Taha S, Manson H, Leece P. Supporting community overdose response planning in Ontario, Canada: Findings from a situational assessment. BMC Public Health 2022; 22:1390. [PMID: 35854231 PMCID: PMC9296108 DOI: 10.1186/s12889-022-13762-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background Many communities across North America are coming together to develop comprehensive plans to address and respond to the escalating overdose crisis, largely driven by an increasingly toxic unregulated drug supply. As there is a need to build capacity for successful implementation, the objective of our mixed methods study was to identify the current planning and implementation practices, needs, and priority areas of support for community overdose response plans in Ontario, Canada. Methods We used a situational assessment methodology to collect data on current planning and implementation practices, needs, and challenges related to community overdose response plans in Ontario, consisting of three components. Between November 2019 to February 2020, we conducted ten semi-structured key informant interviews, three focus groups with 25 participants, and administered an online survey (N = 66). Purposeful sampling was used to identify professionals involved in coordinating, supporting, or partnering on community overdose response plans in jurisdictions with relevant information for Ontario including other Canadian provinces and American states. Key informants included evaluators, representatives involved in centralised supports, as well as coordinators and partners on community overdose response plans. Focus group participants were coordinators or leads of community overdose response plans in Ontario. Results Sixty-six professionals participated in the study. The current planning and implementation practices of community overdose response plans varied in Ontario. Our analysis generated four overarching areas for needs and support for the planning and implementation of community overdose response plans: 1) data and information; 2) evidence and practice; 3) implementation/operational factors; and 4) partnership, engagement, and collaboration. Addressing stigma and equity within planning and implementation of community overdose response plans was a cross-cutting theme that included meaningful engagement of people with living and lived expertise and meeting the service needs of different populations and communities. Conclusions Through exploring the needs and related supports for community overdose response plans in Ontario, we have identified key priority areas for building local capacity building to address overdose-related harms. Ongoing development and refinement, community partnership, and evaluation of our project will highlight the influence of our supports to advance the capacity, motivation, and opportunities of community overdose response plans. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13762-0.
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Affiliation(s)
- Triti Khorasheh
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, M5G 1V2, Canada
| | - Caroline Bennett AbuAyyash
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, M5G 1V2, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, M5T 3M7, Canada
| | - Maryam Mallakin
- Health Design Studio, Ontario College of Arts and Design (OCAD) University, Toronto, M5T 1W1, Canada
| | - Kate Sellen
- Health Design Studio, Ontario College of Arts and Design (OCAD) University, Toronto, M5T 1W1, Canada
| | - Kim Corace
- Department of Psychiatry, University of Ottawa, Ottawa, K1N 6N5, Canada.,University of Ottawa Institute of Mental Health Research, Ottawa, K1Z 7K4, Canada
| | - Bernadette Pauly
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, V8N 5M8, Canada.,School of Nursing, University of Victoria, Victoria, V8P 5C2, Canada
| | - Daniel Buchman
- Dalla Lana School of Public Health, University of Toronto, Toronto, M5T 3M7, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, M5G 2C1, Canada.,Joint Centre for Bioethics, University of Toronto, University of Toronto, Toronto, M5T 1P8, Canada
| | - Michael Hamilton
- Institute for Safe Medication Practices Canada, North York, M2N 6K8, Canada
| | - Nick Boyce
- Ontario Harm Reduction Network, Toronto, M4X 1K9, Canada
| | - Karen Ng
- Toronto Academic Pain Medicine Institute (TAPMI), Women's College Hospital, Toronto, M5S 1B2, Canada
| | - Carol Strike
- Dalla Lana School of Public Health, University of Toronto, Toronto, M5T 3M7, Canada
| | - Sheena Taha
- Canadian Centre on Substance Use and Addiction, Ottawa, K1P 5E7, Canada
| | - Heather Manson
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, M5G 1V2, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, M5T 3M7, Canada
| | - Pamela Leece
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, M5G 1V2, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, M5T 3M7, Canada. .,Department of Family and Community Medicine, University of Toronto, Toronto, M5G 1V7, Canada.
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Li C, Sun M, Wang Y, Luo L, Yu M, Zhang Y, Wang H, Shi P, Chen Z, Wang J, Lu Y, Li Q, Wang X, Bi Z, Fan M, Fu L, Yu J, Hao M. The Centers for Disease Control and Prevention System in China: Trends From 2002-2012. Am J Public Health 2017; 106:2093-2102. [PMID: 27831781 DOI: 10.2105/ajph.2016.303508] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess the improvements of the Chinese Centers for Disease Control and Prevention (CDCs) system between 2002 and 2012, and problems the system has encountered. METHODS We obtained data from 2 national cross-sectional surveys in 2006 and 2013, including 32 provincial, 139 municipal, and 489 county-level CDCs throughout China. We performed a pre-post comparative analysis to determine trends in resource allocation and service delivery. RESULTS The overall completeness of public health services significantly increased from 47.4% to 76.6%. Furthermore, the proportion of CDC staff with bachelor's or higher degrees increased from 14.6% to 32.6%, and governmental funding per CDC increased 5.3-fold (1.283-8.098 million yuan). The working area per CDC staff increased from 37.9 square meters to 63.3 square meters, and configuration rate of type A devices increased from 28.1% to 65.0%. Remaining problems included an 11.9% reduction in staff and the fact that financial investments covered only 71.1% of actual expenditures. CONCLUSIONS China's CDC system has progressed remarkably, enabling quicker responses to emergent epidemics. Future challenges include establishing a sustainable financing mechanism and retaining a well-educated, adequately sized public health workforce.
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Affiliation(s)
- Chengyue Li
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Mei Sun
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Ying Wang
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Li Luo
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Mingzhu Yu
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Yu Zhang
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Hua Wang
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Peiwu Shi
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Zheng Chen
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Jian Wang
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Yueliang Lu
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Qi Li
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Xinhua Wang
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Zhenqiang Bi
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Ming Fan
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Liping Fu
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Jingjin Yu
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Mo Hao
- Chengyue Li, Mei Sun, Ying Wang, Li Luo, and Mo Hao are with the Research Institute of Health Development Strategies and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China. Mingzhu Yu and Jingjin Yu are with the Department of the Bureau of Disease Control and Prevention of National Health and Family Planning Commission, Beijing, China. Yu Zhang is with the Department of Health and Family Planning Commission of Hubei Province, Wuhan, Hubei, China. Hua Wang is with the Department of Health and Family Planning Commission of Jiangsu Province, Nanjing, Jiangsu, China. Peiwu Shi is with Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China. Zheng Chen is with the Department of National Grassroots Health Prevention Group, Shanghai. Jian Wang is with Chinese Center for Disease Control and Prevention, Beijing. Yueliang Lu is with Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu. Qi Li is with Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, Hubei. Xinhua Wang is with Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China. Zhenqiang Bi is with Shandong Provincial Center for Disease Control and Prevention, Jinan, Shandong, China. Ming Fan is with Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin, China. Liping Fu is with Xinjiang Provincial Center for Disease Control and Prevention, Urumqi, Xinjiang, China
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