PPM is a promising strategy to strengthen global TB care and control, but is affected by contextual characteristics in different areas. The scaling-up of PPM should contain essential commonalities, particularly substantial financial support and continuous material input. Additionally, it is important to improve program governance and training for the health providers involved, through integrated collaborative mechanisms.

ObjectiveChina launched its health reform in 2009. This study aimed to assess changes in preventive care utilisation (PCU) and its relationship with the healthcare reform.DesignA cross-sectional study using demographic characteristics, socioeconomic status, environmental factors, and lifestyle and health status data of adults from five waves (2004–2015) of the China Health and Nutrition Survey (CHNS) was conducted. Multilevel mixed-effects logistic regression models were used.SettingData were derived from urban and rural communities of nine provinces in China.ParticipantsData were obtained from five waves of the CHNS, with 9960 participants in 2004, 9888 in 2006, 10 286 in 2009, 9709 in 2011, and 10 628 in 2015.OutcomeThe primary outcome was PCU.ResultsPCU in 2004–2015 among adults was 3.29%, 3.13%, 3.77%, 4.95% and 2.73%, respectively. Whether before or after the health reform, having a history of disease and female gender were positive influencing factors of PCU. Before 2009, PCU was significantly associated with gender, income, medical insurance status and region. Age, medical insurance status, history of drinking and education level significantly affected PCU in 2009–2011. Having medical insurance was no longer a positive influencing factor of PCU, while high income had a negative effect on PCU, in 2011–2015.ConclusionsPCU from 2004 to 2015 was low and the health reform in China may lack sustainable effect on PCU. Further studies on how to ensure sustainability of PCU are necessary, and further reforms on preventive care services should be aimed at different ages, rural areas and participants without history of disease.

Background: Rural-to-urban migrant workers are susceptible to hepatitis B (HB) because they lack self-protection awareness and social support. The present study aimed to investigate the current status of risk behaviors (RB) regarding HB among migrant workers and the influencing factors defined by the Theory of Planned Behavior (TPB).Methods: A cross-sectional study was performed by two-stage cluster sampling from June to December 2018 in Chongqing, China. Logistic regression was adopted to explore factors associated with HB-related RB and behavioral intention (BI). Results: A total of 1299 migrant workers were recruited in the surveys, among whom 29.56% respondents have performed HB-related RB and 85.53% had the BI. 58.19%of respondents having sexual activities never wore a condom. The risk scores of attitudes towards behavior (AB), subjective norms (SN), experience of behavior (EB) and regret feeling (RF) were positively associated with BI, while the sores of AB, EB and BI were positively associated with RB.Conclusions: A considerable proportion of migrant workers have had HB-related risk behaviors or had the behavioral intention. Theory-grounded education, focused on the identified TPB variables, may play a significant role in improving the cognition and behaviors towards HB.