基于计划行为理论的HPV疫苗支付意愿与需求预测研究

The prevalence of human papillomavirus (HPV) is high in China. In recent years, the cervical cancer incidence rate and mortality rate increased rapidly in China. The prevention and control of cervical cancer has been a major challenge for the country. HPV vaccines are a kind of effective vaccines to prevent HPV infection, has been utilized in most countries and regions worldwide. The licensure and utilization of HPV vaccines in China is an inevitable trend. Based on China’s reality, HPV vaccine will be firstly treated as self-paid vaccines which the full price of the vaccine would be charged. However, our previous studies have found that the monetary cost is the paramount impediment for the promotion of self-paid vaccines in China, limiting individual utilization of vaccination services and the vaccination coverage. To this end, the project will carry out following research: 1) to measure the willingness-to-pay for HPV vaccines of the target population applying contingent valuation method; 2) to combine social psychology theory into the analytical framework to explore the psychological factors and decision-making process behind willingness-to-pay; 3) to estimate the target population’s HPV vaccine demand function based on willingness-to-pay data, which could predict the level of demand under different prices. The study will provide evidences for feasible and effective vaccination promotion strategies design and reasonable pricing and financing mechanisms design in China, to optimize the utilization of self-paid vaccines. By providing scientific evidence for HPV vaccines promotion, the study will contribute to reducing the prevalence of HPV, cervical cancer prevention and control, as well as improvements in women's health of China.

我国是人类乳头瘤病毒（HPV）高感染率国家，妇女宫颈癌发病率与死亡率逐年增高，宫颈癌防控面临重大挑战。HPV疫苗能有效预防HPV感染，已在大多数国家和地区得到应用，在我国上市也已成为必然趋势。基于我国现实，HPV疫苗将首先作为自费疫苗提供。然而，我们在前期研究中发现：价格因素严重阻碍了我国自费疫苗推广，极大地限制了个体接种服务利用和人群接种率提高。为此，本课题进行以下深入研究：1）前瞻性的应用条件价值法测量目标人群HPV疫苗的支付意愿；2）将社会心理学理论引入分析框架，探索HPV疫苗支付意愿的心理因素和个体决策过程；3）构建我国目标人群HPV疫苗需求函数，预测价格与需求对应关系。本研究将为探索有效可行的HPV疫苗促进接种策略和合理的定价筹资机制提供循证支持，促进自费疫苗接种服务得到最大程度的有效利用。为HPV疫苗推广提供科学证据，贡献于我国HPV感染率降低、宫颈癌防控，乃至女性健康的改善。

本研究以实施科学视角为出发点，通过理论分析与实证研究，旨在为更优的HPV疫苗接种策略设计提供实证数据参考。在对国内外目标领域文献的收集、复习、归纳与系统评价与综合专家意见的基础上，构建了基于计划行为理论的HPV疫苗接种行为影响因素理论模型。在此基础上设计调查工具，并采用条件价值法对3地市的11所初级中学的66个班级的1132名13-15岁女性青少年家长进行了现场调查。数据分析中，把支付意愿作为分析的核心，基于所构建理论框架分析了计划行为理论变量、健康信念模型变量、中国文化特征变量对HPV疫苗支付意愿的影响，检验了理论假设；并基于支付意愿数据预测了HPV疫苗的潜在需求与实际需求。基于这些实证发现，探讨了能够提高HPV疫苗接种率的促进接种策略和定价筹资机制。此外，我们还利用离散选择试验对目标群体HPV疫苗的接种偏好与支付意愿进行了测量，以进一步补充与互证条件价值法的测量结果。同时，我们利用二手数据分析发现了供方接种服务质量对需方二类疫苗接种行为影响效应的实证证据。另外，还利用翻译与文化调试后的PACV量表对在中国儿童家长中日益凸显的疫苗迟疑状况进行了测量分析。整体研究在综合了理论总结与实证分析的基础之上，较为系统的分析探讨了，在目前中国自费自愿与公众对疫苗安全性与质量疑虑不断提升的背景环境下，实施二类疫苗接种并提高接种率所面临的挑战与应对策略。