Determinants of parental demand of human papillomavirus vaccination for adolescent daughters in China: Contingent valuation survey

Background Several types of human papillomavirus (HPV) vaccines have been approved for use in adolescent girls in China. These vaccines are regulated as non‐National Immunisation Program vaccines and are optional and generally fully self‐paid by vaccinees. Objective To assess parents' demand fo...

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Veröffentlicht in:The International journal of health planning and management 2024-09, Vol.39 (5), p.1456-1481
Hauptverfasser: Chang, Jie, Zhu, Shan, Zhang, Yuting, Carvalho, Natalie, Xu, Sen, Lu, Yunshu, Liu, Xin, Fang, Yu, Meng, Qingyue
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container_issue 5
container_start_page 1456
container_title The International journal of health planning and management
container_volume 39
creator Chang, Jie
Zhu, Shan
Zhang, Yuting
Carvalho, Natalie
Xu, Sen
Lu, Yunshu
Liu, Xin
Fang, Yu
Meng, Qingyue
description Background Several types of human papillomavirus (HPV) vaccines have been approved for use in adolescent girls in China. These vaccines are regulated as non‐National Immunisation Program vaccines and are optional and generally fully self‐paid by vaccinees. Objective To assess parents' demand for HPV vaccination by eliciting their willingness‐to‐pay for their adolescent daughters to be vaccinated against HPV and to examine the determinants of demand for HPV vaccination in China. Methods A contingent valuation survey was conducted across three cities in Shandong Province in eastern China. We selected 11 junior middle schools with different socioeconomic features and randomly selected 6 classes in each school, and questionnaires were distributed to all girls aged 12–16 in the 66 classes for their parents to complete. A payment card approach was used to elicit parental willingness‐to‐pay for HPV vaccination for their daughters. We also collected a wide array of socioeconomic and psychological variables and interval regressions were applied to examine the determinants of parental willingness‐to‐pay. Results A total of 1074 eligible parents who completed valid questions were included in analyses. Over 85% of parents believed HPV vaccines were, in general, necessary and beneficiary. However, only around 10% believed that their daughters would be infected by HPV. About 8% of parents would not accept HPV vaccine even if the vaccine were free mainly due to concerns about the potential side effects and vaccine safety and quality issues, and 27.37% would only accept the vaccine if it were free. The median willingness‐to‐pay was 300 CNY (42 USD). Several factors were positively correlated with higher willingness‐to‐pay: income, urban residence (relative to rural residence), mothers (relative to fathers), parents' beliefs about vaccine benefits, whether they should make decisions for their daughters, and whether their daughters would be susceptible to HPV. Though education‐level was not significantly correlated with willingness‐to‐pay in the main regressions, a subgroup analysis revealed interesting dynamics in the relation between education and willingness‐to‐pay across different income‐levels. Conclusions There is a large gap between parents' willingness‐to‐pay and the market price of HPV vaccine for girls in China. Parents generally believed the HPV vaccines were beneficial and necessary but when asked for their daughters, most parents did not believe their daughters
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These vaccines are regulated as non‐National Immunisation Program vaccines and are optional and generally fully self‐paid by vaccinees. Objective To assess parents' demand for HPV vaccination by eliciting their willingness‐to‐pay for their adolescent daughters to be vaccinated against HPV and to examine the determinants of demand for HPV vaccination in China. Methods A contingent valuation survey was conducted across three cities in Shandong Province in eastern China. We selected 11 junior middle schools with different socioeconomic features and randomly selected 6 classes in each school, and questionnaires were distributed to all girls aged 12–16 in the 66 classes for their parents to complete. A payment card approach was used to elicit parental willingness‐to‐pay for HPV vaccination for their daughters. We also collected a wide array of socioeconomic and psychological variables and interval regressions were applied to examine the determinants of parental willingness‐to‐pay. Results A total of 1074 eligible parents who completed valid questions were included in analyses. Over 85% of parents believed HPV vaccines were, in general, necessary and beneficiary. However, only around 10% believed that their daughters would be infected by HPV. About 8% of parents would not accept HPV vaccine even if the vaccine were free mainly due to concerns about the potential side effects and vaccine safety and quality issues, and 27.37% would only accept the vaccine if it were free. The median willingness‐to‐pay was 300 CNY (42 USD). Several factors were positively correlated with higher willingness‐to‐pay: income, urban residence (relative to rural residence), mothers (relative to fathers), parents' beliefs about vaccine benefits, whether they should make decisions for their daughters, and whether their daughters would be susceptible to HPV. Though education‐level was not significantly correlated with willingness‐to‐pay in the main regressions, a subgroup analysis revealed interesting dynamics in the relation between education and willingness‐to‐pay across different income‐levels. Conclusions There is a large gap between parents' willingness‐to‐pay and the market price of HPV vaccine for girls in China. Parents generally believed the HPV vaccines were beneficial and necessary but when asked for their daughters, most parents did not believe their daughters would be infected by HPV despite the high prevalence in China. Future focus should be on ensuring the provision of accurate health information about HPV prevalence, vaccine quality, and safety to promote vaccine uptake, and promotional efforts tailored to different income groups might yield better effects. Government involvement in negotiating more widely acceptable and affordable prices or subsidising may be necessary for protecting high‐risk population groups. Highlights There is a large gap between parents' willingness‐to‐pay and market price of the human papillomavirus (HPV) vaccines for girls in China. Given the current lower bound of the price spectrum of HPV vaccines and the financing strategy in China, only about 35% of respondents would pay to get their daughters vaccinated against HPV. Government involvement in negotiating more widely acceptable prices among stakeholders or subsidising vaccines may be necessary for protecting high‐risk populations. Several correlations between socioeconomic and psychological factors and willingness‐to‐pay were revealed, which might provide some clues to promote HPV vaccination.</description><identifier>ISSN: 0749-6753</identifier><identifier>ISSN: 1099-1751</identifier><identifier>EISSN: 1099-1751</identifier><identifier>DOI: 10.1002/hpm.3818</identifier><identifier>PMID: 39014911</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adolescent girls ; Adolescents ; Bargaining ; behavioural psychological factors ; Classes ; Contingent valuation ; Correlation ; Daughters ; Demand ; Education ; Girls ; Government ; Health education ; Health information ; Health initiatives ; Health surveys ; HPV vaccines ; Human papillomavirus ; Immunization ; Income ; Lower bounds ; Market prices ; Middle schools ; Parents ; Parents &amp; parenting ; Polls &amp; surveys ; Prices ; Psychological aspects ; Psychological factors ; Residence ; Safety ; Schools ; Side effects ; Social factors ; Socioeconomic factors ; Socioeconomics ; Subgroups ; Surveys ; Teenagers ; Uptake ; Vaccines ; Valuation ; Willingness ; willingness to pay</subject><ispartof>The International journal of health planning and management, 2024-09, Vol.39 (5), p.1456-1481</ispartof><rights>2024 John Wiley &amp; Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2408-35eb1663d41f79ef958690e800ffe395f4a37e28de2a7b61320e4595ff211b503</cites><orcidid>0000-0001-7296-8641</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhpm.3818$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhpm.3818$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,30976,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39014911$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chang, Jie</creatorcontrib><creatorcontrib>Zhu, Shan</creatorcontrib><creatorcontrib>Zhang, Yuting</creatorcontrib><creatorcontrib>Carvalho, Natalie</creatorcontrib><creatorcontrib>Xu, Sen</creatorcontrib><creatorcontrib>Lu, Yunshu</creatorcontrib><creatorcontrib>Liu, Xin</creatorcontrib><creatorcontrib>Fang, Yu</creatorcontrib><creatorcontrib>Meng, Qingyue</creatorcontrib><title>Determinants of parental demand of human papillomavirus vaccination for adolescent daughters in China: Contingent valuation survey</title><title>The International journal of health planning and management</title><addtitle>Int J Health Plann Manage</addtitle><description>Background Several types of human papillomavirus (HPV) vaccines have been approved for use in adolescent girls in China. These vaccines are regulated as non‐National Immunisation Program vaccines and are optional and generally fully self‐paid by vaccinees. Objective To assess parents' demand for HPV vaccination by eliciting their willingness‐to‐pay for their adolescent daughters to be vaccinated against HPV and to examine the determinants of demand for HPV vaccination in China. Methods A contingent valuation survey was conducted across three cities in Shandong Province in eastern China. We selected 11 junior middle schools with different socioeconomic features and randomly selected 6 classes in each school, and questionnaires were distributed to all girls aged 12–16 in the 66 classes for their parents to complete. A payment card approach was used to elicit parental willingness‐to‐pay for HPV vaccination for their daughters. We also collected a wide array of socioeconomic and psychological variables and interval regressions were applied to examine the determinants of parental willingness‐to‐pay. Results A total of 1074 eligible parents who completed valid questions were included in analyses. Over 85% of parents believed HPV vaccines were, in general, necessary and beneficiary. However, only around 10% believed that their daughters would be infected by HPV. About 8% of parents would not accept HPV vaccine even if the vaccine were free mainly due to concerns about the potential side effects and vaccine safety and quality issues, and 27.37% would only accept the vaccine if it were free. The median willingness‐to‐pay was 300 CNY (42 USD). Several factors were positively correlated with higher willingness‐to‐pay: income, urban residence (relative to rural residence), mothers (relative to fathers), parents' beliefs about vaccine benefits, whether they should make decisions for their daughters, and whether their daughters would be susceptible to HPV. Though education‐level was not significantly correlated with willingness‐to‐pay in the main regressions, a subgroup analysis revealed interesting dynamics in the relation between education and willingness‐to‐pay across different income‐levels. Conclusions There is a large gap between parents' willingness‐to‐pay and the market price of HPV vaccine for girls in China. Parents generally believed the HPV vaccines were beneficial and necessary but when asked for their daughters, most parents did not believe their daughters would be infected by HPV despite the high prevalence in China. Future focus should be on ensuring the provision of accurate health information about HPV prevalence, vaccine quality, and safety to promote vaccine uptake, and promotional efforts tailored to different income groups might yield better effects. Government involvement in negotiating more widely acceptable and affordable prices or subsidising may be necessary for protecting high‐risk population groups. Highlights There is a large gap between parents' willingness‐to‐pay and market price of the human papillomavirus (HPV) vaccines for girls in China. Given the current lower bound of the price spectrum of HPV vaccines and the financing strategy in China, only about 35% of respondents would pay to get their daughters vaccinated against HPV. Government involvement in negotiating more widely acceptable prices among stakeholders or subsidising vaccines may be necessary for protecting high‐risk populations. Several correlations between socioeconomic and psychological factors and willingness‐to‐pay were revealed, which might provide some clues to promote HPV vaccination.</description><subject>Adolescent girls</subject><subject>Adolescents</subject><subject>Bargaining</subject><subject>behavioural psychological factors</subject><subject>Classes</subject><subject>Contingent valuation</subject><subject>Correlation</subject><subject>Daughters</subject><subject>Demand</subject><subject>Education</subject><subject>Girls</subject><subject>Government</subject><subject>Health education</subject><subject>Health information</subject><subject>Health initiatives</subject><subject>Health surveys</subject><subject>HPV vaccines</subject><subject>Human papillomavirus</subject><subject>Immunization</subject><subject>Income</subject><subject>Lower bounds</subject><subject>Market prices</subject><subject>Middle schools</subject><subject>Parents</subject><subject>Parents &amp; parenting</subject><subject>Polls &amp; surveys</subject><subject>Prices</subject><subject>Psychological aspects</subject><subject>Psychological factors</subject><subject>Residence</subject><subject>Safety</subject><subject>Schools</subject><subject>Side effects</subject><subject>Social factors</subject><subject>Socioeconomic factors</subject><subject>Socioeconomics</subject><subject>Subgroups</subject><subject>Surveys</subject><subject>Teenagers</subject><subject>Uptake</subject><subject>Vaccines</subject><subject>Valuation</subject><subject>Willingness</subject><subject>willingness to pay</subject><issn>0749-6753</issn><issn>1099-1751</issn><issn>1099-1751</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNp1kUFrFDEUx4NY7LYKfgIJePEyNW8ymUy8yWqt0NIe9DxkZ166KZlkTCYre_WTm3WriOAp4f1_78eDPyEvgV0AY_Xb7Txd8A66J2QFTKkKpICnZMVko6pWCn5KzlJ6YKxkoJ6RU64YNApgRX58wAXjZL32S6LB0FlH9It2dMRJ-_Ew2ubyK8FsnQuT3tmYE93pYShbiw2emhCpHoPDNJRdOup8vy3WRK2n622h3tF18Iv194d4p10-7qUcd7h_Tk6MdglfPL7n5Ovlxy_rq-r69tPn9fvraqgb1lVc4Abalo8NGKnQKNG1imHHmDHIlTCN5hLrbsRay00LvGbYiDI3NcBGMH5O3hy9cwzfMqaln2w52DntMeTUc9aBlFxJVdDX_6APIUdfriuUUpwLwf8SDjGkFNH0c7STjvseWH_opS-99IdeCvrqUZg3E45_wN9FFKA6At-tw_1_Rf3V3c0v4U-o3ZhC</recordid><startdate>202409</startdate><enddate>202409</enddate><creator>Chang, Jie</creator><creator>Zhu, Shan</creator><creator>Zhang, Yuting</creator><creator>Carvalho, Natalie</creator><creator>Xu, Sen</creator><creator>Lu, Yunshu</creator><creator>Liu, Xin</creator><creator>Fang, Yu</creator><creator>Meng, Qingyue</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7296-8641</orcidid></search><sort><creationdate>202409</creationdate><title>Determinants of parental demand of human papillomavirus vaccination for adolescent daughters in China: Contingent valuation survey</title><author>Chang, Jie ; Zhu, Shan ; Zhang, Yuting ; Carvalho, Natalie ; Xu, Sen ; Lu, Yunshu ; Liu, Xin ; Fang, Yu ; Meng, Qingyue</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2408-35eb1663d41f79ef958690e800ffe395f4a37e28de2a7b61320e4595ff211b503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent girls</topic><topic>Adolescents</topic><topic>Bargaining</topic><topic>behavioural psychological factors</topic><topic>Classes</topic><topic>Contingent valuation</topic><topic>Correlation</topic><topic>Daughters</topic><topic>Demand</topic><topic>Education</topic><topic>Girls</topic><topic>Government</topic><topic>Health education</topic><topic>Health information</topic><topic>Health initiatives</topic><topic>Health surveys</topic><topic>HPV vaccines</topic><topic>Human papillomavirus</topic><topic>Immunization</topic><topic>Income</topic><topic>Lower bounds</topic><topic>Market prices</topic><topic>Middle schools</topic><topic>Parents</topic><topic>Parents &amp; parenting</topic><topic>Polls &amp; surveys</topic><topic>Prices</topic><topic>Psychological aspects</topic><topic>Psychological factors</topic><topic>Residence</topic><topic>Safety</topic><topic>Schools</topic><topic>Side effects</topic><topic>Social factors</topic><topic>Socioeconomic factors</topic><topic>Socioeconomics</topic><topic>Subgroups</topic><topic>Surveys</topic><topic>Teenagers</topic><topic>Uptake</topic><topic>Vaccines</topic><topic>Valuation</topic><topic>Willingness</topic><topic>willingness to pay</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chang, Jie</creatorcontrib><creatorcontrib>Zhu, Shan</creatorcontrib><creatorcontrib>Zhang, Yuting</creatorcontrib><creatorcontrib>Carvalho, Natalie</creatorcontrib><creatorcontrib>Xu, Sen</creatorcontrib><creatorcontrib>Lu, Yunshu</creatorcontrib><creatorcontrib>Liu, Xin</creatorcontrib><creatorcontrib>Fang, Yu</creatorcontrib><creatorcontrib>Meng, Qingyue</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index &amp; Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><jtitle>The International journal of health planning and management</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chang, Jie</au><au>Zhu, Shan</au><au>Zhang, Yuting</au><au>Carvalho, Natalie</au><au>Xu, Sen</au><au>Lu, Yunshu</au><au>Liu, Xin</au><au>Fang, Yu</au><au>Meng, Qingyue</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Determinants of parental demand of human papillomavirus vaccination for adolescent daughters in China: Contingent valuation survey</atitle><jtitle>The International journal of health planning and management</jtitle><addtitle>Int J Health Plann Manage</addtitle><date>2024-09</date><risdate>2024</risdate><volume>39</volume><issue>5</issue><spage>1456</spage><epage>1481</epage><pages>1456-1481</pages><issn>0749-6753</issn><issn>1099-1751</issn><eissn>1099-1751</eissn><abstract>Background Several types of human papillomavirus (HPV) vaccines have been approved for use in adolescent girls in China. These vaccines are regulated as non‐National Immunisation Program vaccines and are optional and generally fully self‐paid by vaccinees. Objective To assess parents' demand for HPV vaccination by eliciting their willingness‐to‐pay for their adolescent daughters to be vaccinated against HPV and to examine the determinants of demand for HPV vaccination in China. Methods A contingent valuation survey was conducted across three cities in Shandong Province in eastern China. We selected 11 junior middle schools with different socioeconomic features and randomly selected 6 classes in each school, and questionnaires were distributed to all girls aged 12–16 in the 66 classes for their parents to complete. A payment card approach was used to elicit parental willingness‐to‐pay for HPV vaccination for their daughters. We also collected a wide array of socioeconomic and psychological variables and interval regressions were applied to examine the determinants of parental willingness‐to‐pay. Results A total of 1074 eligible parents who completed valid questions were included in analyses. Over 85% of parents believed HPV vaccines were, in general, necessary and beneficiary. However, only around 10% believed that their daughters would be infected by HPV. About 8% of parents would not accept HPV vaccine even if the vaccine were free mainly due to concerns about the potential side effects and vaccine safety and quality issues, and 27.37% would only accept the vaccine if it were free. The median willingness‐to‐pay was 300 CNY (42 USD). Several factors were positively correlated with higher willingness‐to‐pay: income, urban residence (relative to rural residence), mothers (relative to fathers), parents' beliefs about vaccine benefits, whether they should make decisions for their daughters, and whether their daughters would be susceptible to HPV. Though education‐level was not significantly correlated with willingness‐to‐pay in the main regressions, a subgroup analysis revealed interesting dynamics in the relation between education and willingness‐to‐pay across different income‐levels. Conclusions There is a large gap between parents' willingness‐to‐pay and the market price of HPV vaccine for girls in China. Parents generally believed the HPV vaccines were beneficial and necessary but when asked for their daughters, most parents did not believe their daughters would be infected by HPV despite the high prevalence in China. Future focus should be on ensuring the provision of accurate health information about HPV prevalence, vaccine quality, and safety to promote vaccine uptake, and promotional efforts tailored to different income groups might yield better effects. Government involvement in negotiating more widely acceptable and affordable prices or subsidising may be necessary for protecting high‐risk population groups. Highlights There is a large gap between parents' willingness‐to‐pay and market price of the human papillomavirus (HPV) vaccines for girls in China. Given the current lower bound of the price spectrum of HPV vaccines and the financing strategy in China, only about 35% of respondents would pay to get their daughters vaccinated against HPV. Government involvement in negotiating more widely acceptable prices among stakeholders or subsidising vaccines may be necessary for protecting high‐risk populations. Several correlations between socioeconomic and psychological factors and willingness‐to‐pay were revealed, which might provide some clues to promote HPV vaccination.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>39014911</pmid><doi>10.1002/hpm.3818</doi><tpages>26</tpages><orcidid>https://orcid.org/0000-0001-7296-8641</orcidid></addata></record>
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subjects Adolescent girls
Adolescents
Bargaining
behavioural psychological factors
Classes
Contingent valuation
Correlation
Daughters
Demand
Education
Girls
Government
Health education
Health information
Health initiatives
Health surveys
HPV vaccines
Human papillomavirus
Immunization
Income
Lower bounds
Market prices
Middle schools
Parents
Parents & parenting
Polls & surveys
Prices
Psychological aspects
Psychological factors
Residence
Safety
Schools
Side effects
Social factors
Socioeconomic factors
Socioeconomics
Subgroups
Surveys
Teenagers
Uptake
Vaccines
Valuation
Willingness
willingness to pay
title Determinants of parental demand of human papillomavirus vaccination for adolescent daughters in China: Contingent valuation survey
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