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Analysis of hepatitis B vaccination behavior and vaccination willingness among migrant workers from rural China based on protection motivation theory.
Hum Vaccin Immunother. 2016 05 03; 12(5):1155-63.HV

Abstract

INTRODUCTION

With China's accelerating urbanization, migrant workers comprise up to 40% of the urban population of China's largest cities. More mobile than non-migrant urban dwellers, migrants are more likely to contract and spread hepatitis B (HB) than non-migrants. Due to the mandatory system of household registration (hukou), migrants are less likely to be covered by national HB immunization programs and also to have more limited access to public health services where they work than non-migrants. Migrants form a significant sub-group in all Chinese cities posing unique public policy vaccination challenges.

OBJECTIVE

Using protection motivation theory (PMT), we developed and measured HB cognitive variables and analyze the factors affecting HB vaccination behavior and willingness to vaccinate by migrant workers. We propose public policy interventions to increase HB vaccination rates of migrant workers.

METHODS

We developed a questionnaire to collect information on the HB vaccination characteristics of 1684 respondents from 6 provinces and Beijing. Exploratory factor analysis was used to create PMT variables and a binary logistic regression model was used to analyze the factors affecting migrant workers' HB vaccination behavior and willingness to vaccinate.

RESULTS

Vulnerability and response-efficacy were significant PMT cognition factors determining HB vaccination behavior. The HB vaccination rate for migrants decreased with increasing age and was smaller for the primary education than the high education group. The vaccination rate of the medical insurance group was significantly greater than the non-insured group, and the vaccination probability was significantly higher for the self-rated good health compared to the self-rated poor health group. Geographical birth location mattered: the vaccination rate for Beijing city and Ningxia province migrants were higher than for Hebei province and the vaccination rate was lower for migrants born far from health facilities compared to those located middle-near distances from health facilities. We also studied vaccination willingness for the unvaccinated group. For this group, vulnerability and self-efficacy cognition factors were significant factors determining HB vaccination willingness. The probability of willingness to vaccinate for the 46+ age group was significantly smaller than the 16-25 age group and the willingness to vaccinate was lower in Jiangsu and Hainan province than in Hebei province.

CONCLUSION

Increased knowledge of HB cognition is an effective way for improving HB vaccination behavior and HB vaccination willingness of migrant workers. We also found that health intervention policies should focus on older migrants (age 46+), without medical insurance, with poorer self-reported health status and poor health services accessibility.

Authors+Show Affiliations

a Institute of Social Medicine and Health Management and Center for Health Economic Experiment and Public Policy, School of Public Health, Shandong University , Jinan , Shandong , China.b Academy of Human Civilization and Social Science, Shandong Traditional Chinese Medicine University , Jinan , Shandong , China.c University of Oslo , Oslo , Norway.d Australian School of Business, University of New South Wales , Sydney , NSW , Australia.e Tianjin Normal University, Beijing Foreign Studies University, University of Newcastle , Newcastle , NSW , Australia.f Institute of Social Medicine and Health Management and Center for Health Economic Experiment and Public Policy, School of Public Health, Shandong University , Jinan , Shandong , China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27078191

Citation

Liu, Rugang, et al. "Analysis of Hepatitis B Vaccination Behavior and Vaccination Willingness Among Migrant Workers From Rural China Based On Protection Motivation Theory." Human Vaccines & Immunotherapeutics, vol. 12, no. 5, 2016, pp. 1155-63.
Liu R, Li Y, Wangen KR, et al. Analysis of hepatitis B vaccination behavior and vaccination willingness among migrant workers from rural China based on protection motivation theory. Hum Vaccin Immunother. 2016;12(5):1155-63.
Liu, R., Li, Y., Wangen, K. R., Maitland, E., Nicholas, S., & Wang, J. (2016). Analysis of hepatitis B vaccination behavior and vaccination willingness among migrant workers from rural China based on protection motivation theory. Human Vaccines & Immunotherapeutics, 12(5), 1155-63. https://doi.org/10.1080/21645515.2015.1123358
Liu R, et al. Analysis of Hepatitis B Vaccination Behavior and Vaccination Willingness Among Migrant Workers From Rural China Based On Protection Motivation Theory. Hum Vaccin Immunother. 2016 05 3;12(5):1155-63. PubMed PMID: 27078191.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Analysis of hepatitis B vaccination behavior and vaccination willingness among migrant workers from rural China based on protection motivation theory. AU - Liu,Rugang, AU - Li,Youwei, AU - Wangen,Knut R, AU - Maitland,Elizabeth, AU - Nicholas,Stephen, AU - Wang,Jian, Y1 - 2016/04/14/ PY - 2016/4/15/entrez PY - 2016/4/15/pubmed PY - 2017/10/27/medline KW - behavior KW - hepatitis B vaccination KW - migrant workers KW - protection motivation theory KW - willingness SP - 1155 EP - 63 JF - Human vaccines & immunotherapeutics JO - Hum Vaccin Immunother VL - 12 IS - 5 N2 - INTRODUCTION: With China's accelerating urbanization, migrant workers comprise up to 40% of the urban population of China's largest cities. More mobile than non-migrant urban dwellers, migrants are more likely to contract and spread hepatitis B (HB) than non-migrants. Due to the mandatory system of household registration (hukou), migrants are less likely to be covered by national HB immunization programs and also to have more limited access to public health services where they work than non-migrants. Migrants form a significant sub-group in all Chinese cities posing unique public policy vaccination challenges. OBJECTIVE: Using protection motivation theory (PMT), we developed and measured HB cognitive variables and analyze the factors affecting HB vaccination behavior and willingness to vaccinate by migrant workers. We propose public policy interventions to increase HB vaccination rates of migrant workers. METHODS: We developed a questionnaire to collect information on the HB vaccination characteristics of 1684 respondents from 6 provinces and Beijing. Exploratory factor analysis was used to create PMT variables and a binary logistic regression model was used to analyze the factors affecting migrant workers' HB vaccination behavior and willingness to vaccinate. RESULTS: Vulnerability and response-efficacy were significant PMT cognition factors determining HB vaccination behavior. The HB vaccination rate for migrants decreased with increasing age and was smaller for the primary education than the high education group. The vaccination rate of the medical insurance group was significantly greater than the non-insured group, and the vaccination probability was significantly higher for the self-rated good health compared to the self-rated poor health group. Geographical birth location mattered: the vaccination rate for Beijing city and Ningxia province migrants were higher than for Hebei province and the vaccination rate was lower for migrants born far from health facilities compared to those located middle-near distances from health facilities. We also studied vaccination willingness for the unvaccinated group. For this group, vulnerability and self-efficacy cognition factors were significant factors determining HB vaccination willingness. The probability of willingness to vaccinate for the 46+ age group was significantly smaller than the 16-25 age group and the willingness to vaccinate was lower in Jiangsu and Hainan province than in Hebei province. CONCLUSION: Increased knowledge of HB cognition is an effective way for improving HB vaccination behavior and HB vaccination willingness of migrant workers. We also found that health intervention policies should focus on older migrants (age 46+), without medical insurance, with poorer self-reported health status and poor health services accessibility. SN - 2164-554X UR - https://www.unboundmedicine.com/medline/citation/27078191/Analysis_of_hepatitis_B_vaccination_behavior_and_vaccination_willingness_among_migrant_workers_from_rural_China_based_on_protection_motivation_theory_ L2 - http://www.tandfonline.com/doi/full/10.1080/21645515.2015.1123358 DB - PRIME DP - Unbound Medicine ER -