Robert Wood Johnson Foundation Clinical Scholars Program, Department of Obstetrics and Gynecology, University of Pennsylvania, 423 Guardian Drive, 1303 Blockley Hall, Philadelphia, PA 19104, USA.
Matern Child Health J. 2011 Nov;15(8):1203-9. doi: 10.1007/s10995-010-0693-5.
To determine how risk perceptions, worry, and distrust relate to pregnant women's intentions to accept the H1N1 vaccine. Cross-sectional survey of 173 pregnant women recruited from two OB/GYN practices at an urban academic medical center. Survey items were adapted from validated measures of risk, worry, and health care distrust. Vaccination intention was analyzed as a dichotomous variable. Analyses were with student's t tests, chi squared tests, and logistic regression. Study participants were, on average, 25.6 years old with parity=2.8. 55% of respondents were Black; 32% completed a high school diploma or less; and half were publically or un- insured. 63% of the respondents reported that they "definitely" or "probably" would accept the H1N1 vaccine. Intention to receive the H1N1 vaccine did not vary by sociodemographic factors nor by source of health information. In univariate analysis, intention was related to higher risk perceptions about probability of and susceptibility to H1N1 influenza (57.9 vs. 31.8%, P=.001 and 67.0 vs. 45.3%, P=.005, respectively), worry about getting H1N1 influenza (48.1 vs. 15.6%, P=<.001), and less distrust in the health care system (mean score 1.07 vs. 1.51, P<.001). In multivariable analysis, only worry about getting H1N1 was related to vaccination intention (OR=3.43, P=.04). Worry about acquiring disease was a stronger predictor of vaccine intention than risk perceptions, distrust, or worry about vaccine safety. With growing numbers of vaccines being offered during pregnancy and immediately postpartum, these results have important implications for future vaccination intervention, education, and messaging efforts in urban settings.
为了确定风险认知、担忧和不信任如何与孕妇接受 H1N1 疫苗的意愿相关。在城市学术医疗中心的两个妇产科诊所招募了 173 名孕妇进行横断面调查。调查项目改编自风险、担忧和医疗保健不信任的经过验证的测量方法。疫苗接种意愿被分析为二分类变量。分析采用学生 t 检验、卡方检验和逻辑回归。研究参与者的平均年龄为 25.6 岁，生育次数为 2.8。55%的受访者为黑人；32%完成了高中学历或以下；一半人没有公共或私人保险。63%的受访者表示他们“肯定”或“可能”会接受 H1N1 疫苗。接受 H1N1 疫苗的意愿不受社会人口因素或健康信息来源的影响。在单变量分析中，意愿与对 H1N1 流感的发病概率和易感性的更高风险认知有关（57.9%比 31.8%，P=.001 和 67.0%比 45.3%，P=.005），对感染 H1N1 流感的担忧（48.1%比 15.6%，P<.001），以及对医疗保健系统的信任度降低（平均得分 1.07 比 1.51，P<.001）。在多变量分析中，只有对感染 H1N1 的担忧与疫苗接种意愿相关（OR=3.43，P=.04）。对患病的担忧是疫苗接种意愿的一个更强的预测因素，而不是风险认知、不信任或对疫苗安全性的担忧。随着越来越多的疫苗在怀孕期间和产后立即提供，这些结果对未来在城市环境中进行疫苗接种干预、教育和信息传递工作具有重要意义。
