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Parental willingness to participate in supplementary insurance for adverse events following immunization for children in Anshun city and its influencing factors: a cross-sectional study
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Wenxia LI1, Ziyun WANG1, Yinggang WANG2, Zhengyong SUN2, Fei ZENG2, Xu PENG2, Yongting ZHANG2, Qin WAN2, Yang LI1, 2
Chinese Journal of Public Health | 2025, 41(6) : 673 - 680
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Chinese Journal of Public Health | 2025, 41(6): 673-680
• Special Report – Focusing on Child Health and Development •
Parental willingness to participate in supplementary insurance for adverse events following immunization for children in Anshun city and its influencing factors: a cross-sectional study
Full
Wenxia LI1, Ziyun WANG1, Yinggang WANG2, Zhengyong SUN2, Fei ZENG2, Xu PENG2, Yongting ZHANG2, Qin WAN2, Yang LI1, 2
Affiliations
  • 1Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang 561113, China
  • 2Anshun Municipal Center for Disease Control and Prevention, Anshun 561000, China
Published: 2025-06-10 doi: 10.11847/zgggws1146352
Outline
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Objective

To investigate the willingness of parents of children in Anshun city, Guizhou province, to participate in supplementary insurance for adverse events following immunization (AEFI) (hereinafter referred to as supplementary insurance) and its influencing factors.

Methods

From March to June 2024, a stratified random sampling method was used to select 14 vaccination clinics from seven counties (districts) in Anshun city. Questionnaires were administered to 1 634 parents of children aged 0-1 year and 14 medical staff. A two-level logistic regression model and random forest analysis were used to analyze the factors influencing parents′ willingness to participate in the insurance.

Results

The willingness of parents to participate in supplementary insurance was 56.90%. Two-level logistic regression analysis showed that parents′ willingness to participate in the insurance was clustered at the vaccination clinic level. The length of time vaccination clinic staff were responsible for education work (1 year - < 2: OR = 1.697, 95%CI: 1.241 - 2.320; ≥ 2 years: OR = 2.061, 95%CI: 1.328 - 3.198), and the presence of insurance company staff on-site to assist with education (OR = 1.443, 95%CI: 1.039 - 2.004) positively influenced parents′ willingness to participate. Having three or more education staff at the vaccination clinic (OR = 0.635, 95%CI: 0.464 - 0.868) negatively influenced parents′ willingness to participate. At the individual level, educational level (junior high school: OR = 1.544, 95%CI: 1.015 - 2.351; senior high school or secondary vocational school: OR = 1.994, 95%CI: 1.240 - 3.207; junior college: OR = 2.319, 95%CI: 1.410 - 3.814; bachelor′s degree or above: OR = 2.217, 95%CI: 1.317 - 3.731), monthly household income (¥5000 - < 8000: OR = 1.629, 95%CI: 1.159 - 2.289; ¥8000 - < 10000: OR = 1.787, 95%CI: 1.044 - 3.058), having purchased other insurance for their children (OR = 2.801, 95%CI: 1.886 - 4.160), understanding of AEFI (OR = 1.612, 95%CI: 1.133 - 2.294), and having received information about the compensation insurance policy during maternity care (OR = 1.551, 95%CI: 1.039 - 2.313) positively influenced parents′ willingness to participate. Grandparents or other relatives being the primary caregiver (OR = 0.539, 95%CI: 0.297 - 0.978), belonging to an ethnic minority group (OR = 0.763, 95%CI: 0.599 - 0.973), and having two or more children (OR = 0.688, 95%CI: 0.546 - 0.868) negatively influenced parents′ willingness to participate. Random forest results showed that the top five factors influencing parents′ willingness to participate were parental education level, monthly household income, having purchased other insurance for their children, length of time responsible for education work, and level of understanding of AEFI.

Conclusions

The willingness of parents in Anshun city to participate in supplementary insurance for AEFI is relatively low. Influencing factors include those at both the individual parent level and the vaccination clinic level. Measures should be taken at multiple levels to increase parents′ willingness to participate.

supplementary insurance  /  willingness  /  influencing factors  /  multilevel model  /  random forest  /  Anshun city
李文霞, 王子云, 王应刚, 孙正勇, 曾飞, 彭旭, 张永婷, 万琴, 李阳. 安顺市儿童预防接种异常反应补充保险家长参保意愿及影响因素. 中国公共卫生, 2025 , 41 (6) : 673 -680 . DOI: 10.11847/zgggws1146352
Wenxia LI, Ziyun WANG, Yinggang WANG, Zhengyong SUN, Fei ZENG, Xu PENG, Yongting ZHANG, Qin WAN, Yang LI. Parental willingness to participate in supplementary insurance for adverse events following immunization for children in Anshun city and its influencing factors: a cross-sectional study[J]. Chinese Journal of Public Health, 2025 , 41 (6) : 673 -680 . DOI: 10.11847/zgggws1146352
Year 2025 volume 41 Issue 6
81
40
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Article Info
doi: 10.11847/zgggws1146352
  • Receive Date:2024-11-06
  • Online Date:2026-10-25
  • Published:2025-06-10
Article Data
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History
  • Received:2024-11-06
  • Revised:2024-12-27
  • Accepted:2025-02-17
Affiliations
    1Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang 561113, China
    2Anshun Municipal Center for Disease Control and Prevention, Anshun 561000, China

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LI Yang, E-mail:
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