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Mao Y, Zhao Y, Zhang L, Li J, Abdullah AS, Zheng P, Wang F. Frequency of health care provider recommendations for HPV vaccination: a survey in three large cities in China. Front Public Health 2023; 11:1203610. [PMID: 37497028 PMCID: PMC10366465 DOI: 10.3389/fpubh.2023.1203610] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/21/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction Human papillomavirus (HPV) infection, an important pathogenic factor for cervical cancer, can be prevented by the HPV vaccine. Health care provider (HCP) recommendations contribute to improve HPV vaccination coverage. The aim of this study was to assess the frequency of HCP recommendations for HPV vaccination and associated factors. Methods From Nov 8 to Dec 6 in 2018, a cross-sectional study was conducted through online questionnaires among HCPs (n = 1,371) from hospitals in three large cities in China (Shanghai, Guangzhou, and Shenzhen). Data on demographic characteristics, the frequency of HPV vaccination recommendations, HPV knowledge and related attitudes were collected through the questionnaires. Results Among 1,371 participants, only 30.2% reported that they frequently recommended HPV vaccination. Multivariate analyses indicated that female sex, being employed in obstetrics or gynecology departments and community health service centers, and having higher self-reported and actual knowledge of HPV were factors associated with a higher recommendation frequency. Factors including a self-perceived non-obligation to provide recommendations and difficulties in discussing sexual topics were significantly correlated with less frequent recommendations. Employment in a community health service center (OR = 2.068, 95% CI: 1.070-3.999) was the strongest factor associated with the frequency of HCPs' recommendations for HPV vaccination. Discussion The frequency of HCPs' recommendations for HPV vaccination in China was much lower than that in many developed countries. To enhance the recommendation frequency, medical institutions should help HCPs gain more knowledge of HPV and master communication skills. At the same time, the government should take measures to enhance the accessibility of HPV vaccines. The media should help to alleviate people's concerns and encourage them to face up sexual health.
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Affiliation(s)
- Yimeng Mao
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian, China
- Department of Preventive Medicine and Health Education, School of Public Health, Institute of Health Communication, Key Lab of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Yuchen Zhao
- Department of Preventive Medicine and Health Education, School of Public Health, Institute of Health Communication, Key Lab of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Lingyun Zhang
- Department of Preventive Medicine and Health Education, School of Public Health, Institute of Health Communication, Key Lab of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jie Li
- School of Journalism and Communication/National Media and Experimental Teaching Center, Jinan University, Guangzhou, China
| | - Abu S Abdullah
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Pinpin Zheng
- Department of Preventive Medicine and Health Education, School of Public Health, Institute of Health Communication, Key Lab of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Fan Wang
- Fudan Development Institute, Fudan University, Shanghai, China
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Fang H, Chen C, Fang Y, He X, Hou Z, Jiang M, Jiang Y, Li S, Liu Y, Sui B, Sun Q, Wu J, Xu T, Yang J, Yin Z, Ying X, Yuan B, Zheng H, Zheng Y. A guideline for economic evaluations of vaccines and immunization programs in China. Hum Vaccin Immunother 2022; 18:2132802. [PMID: 36287462 PMCID: PMC9746533 DOI: 10.1080/21645515.2022.2132802] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
This study aimed to develop a consensus framework for economic evaluations of vaccines as a national guideline in China. Some unique and important aspects were particularly emphasized. Nineteen Chinese experts in the field of health economics and immunization decision-making were nominated to select and discuss relevant aspects of vaccine economic evaluations in China. A workshop attended by external experts was held to summarize unique and important aspects and formulate consensus recommendations. There were ten unique and/or important aspects identified for economic evaluations of vaccines in China, including study perspectives, comparator strategies, analysis types, model choices, costing approaches, utility measures, discounting, uncertainty, equity, and evaluation purposes. Background information and expert recommendations were provided for each aspect. Economic evaluations of vaccines should play an important role in China's immunization policy-making. This guideline can help improve the quality of economic evaluations as a good practice consensus.
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Affiliation(s)
- Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China,Institute for Global Health and Development, Peking University, Beijing, China,CONTACT Hai Fang China Center for Health Development Studies, Peking University, Beijing, China
| | - Chen Chen
- School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shaanxi Province, China
| | - Xiaoning He
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Zhiyuan Hou
- School of Public Health, Fudan University, Shanghai, China
| | - Minghuan Jiang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shaanxi Province, China
| | - Yawen Jiang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong Province, China
| | - Shunping Li
- School of Public Health, Shandong University, Jinan, Shandong Province, China
| | - Yang Liu
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK,Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Binyan Sui
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Qiang Sun
- School of Public Health, Shandong University, Jinan, Shandong Province, China
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Tingting Xu
- School of Public Health, Capital Medical University, Beijing, China
| | - Juan Yang
- School of Public Health, Fudan University, Shanghai, China
| | - Zundong Yin
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaohua Ying
- School of Public Health, Fudan University, Shanghai, China
| | - Beibei Yuan
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Hui Zheng
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yaming Zheng
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
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Shi W, Cheng X, Wang H, Zang X, Chen T. Cost-effectiveness of human papillomavirus vaccine in China: a systematic review of modelling studies. BMJ Open 2021; 11:e052682. [PMID: 34880019 PMCID: PMC8655525 DOI: 10.1136/bmjopen-2021-052682] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES China suffers from high burdens of human papillomavirus (HPV) and cervical cancer, whereas the uptake of HPV vaccine remains low. The first Chinese domestic HPV vaccine was released in 2019. However, collective evidence on cost-effectiveness of HPV vaccination in China has yet to be established. We summarised evidence on the cost-effectiveness of HPV vaccine in China. DESIGN Systematic review and narrative synthesis DATA SOURCES: PubMed, EMBASE, China National Knowledge Infrastructure and Wanfang Data were searched through 2 January 2021 ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Cost-effectiveness studies using a modelling approach focusing on HPV vaccination interventions in the setting of China were included for review. DATA EXTRACTION AND SYNTHESIS We extracted information from the selected studies focusing on cost-effectiveness results of various vaccination programmes, key contextual and methodological factors influencing cost-effectiveness estimates and an assessment of study quality. RESULTS A total of 14 studies were included for review. Considerable heterogeneity was found in terms of the methodologies used, HPV vaccination strategies evaluated and study quality. The reviewed studies generally supported the cost-effectiveness of HPV vaccine in China, although some reached alternative conclusions, particularly when assessed incremental to cervical cancer screening. Cost of vaccination was consistently identified as a key determinant for the cost-effectiveness of HPV vaccination programmes. CONCLUSIONS Implementing HPV vaccination programmes should be complemented with expanded cervical cancer screening, while the release of lower-priced domestic vaccine offers more promising potential for initiating public HPV vaccination programmes. Findings of this study contributes important evidence for policies for cervical cancer prevention in China and methodological implications for future modelling efforts.
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Affiliation(s)
- Wenchuan Shi
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Xiaoli Cheng
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Haitao Wang
- Office of Financial Affairs, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China, Chongqing, China
| | - Xiao Zang
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Tingting Chen
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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