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Article History

Received: 2 September 2019

Accepted: 19 May 2020

First Online: 18 June 2020

Ethics approval and consent to participate

: The National Health and Family Planning Commission of the People’s Republic of China and the Health and Family Planning Commission of Tibet autonomous region approved the study. Local health research projects which meet ethical requirements can be implemented with the approval of these two departments. The Medical Ethics Expert Committee of the National Health and Family Planning Commission of the People’s Republic of China is a legitimate ethical review institution in China. It conducts research on major ethical issues in biomedical research involving human beings, directs and supervises the work of provincial medical ethics expert committees, and jointly inspects and evaluates the work of institutional ethics committees.Because of the subjects of this study were Tibetan residents with a low educational level and a large sample size, the investigators use verbal informed consents to inform the respondents of the purpose of the survey in accordance with the prepared electronic version of the informed consent. Verbal consent was approved by the the National Health and Family Planning Commission of the People’s Republic of China and by the Health and Family Planning Commission of the Tibet Autonomous Region. Verbal consents were obtained before the survey from the eligible residents. Consent was obtained from a parent or guardian on behalf of the participants under the age of 16. And all the participants are Chinese, and they resided in China.

: Not applicable.

: The authors declare that they have no competing interests.