Marsh Heather A, Malik Fauzia, Shapiro Eve, Omer Saad B, Frew Paula M
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Matern Child Health J. 2014 Sep;18(7):1639-47. doi: 10.1007/s10995-013-1404-9.
We explored the attitudes, opinions, and concerns of African American women regarding influenza vaccination during pregnancy. As influenza immunization coverage rates remain suboptimal in the United States among this population, we elicited message framing strategies for multicomponent interventions aimed at decreasing future incident cases of maternal and neonatal influenza. Semi-structured in-depth interviews (N = 21) were conducted with pregnant African American women at urban OB/GYN clinics who had not received an influenza vaccine. Interviews were transcribed, subjected to intercoder reliability assessment, and content analyzed to identify common thematic factors related to acceptance of the influenza vaccine and health communication message preferences. Four major themes were identified. These were communication approaches, normal vaccine behavior, pregnancy vaccination, and positive versus negative framing. Two strong themes emerged: positively-framed messages were preferred over negatively-framed messages and those emphasizing the health of the infant. Additionally, previous immunization, message source, and vaccine misperceptions also played important roles in decision-making. The majority of women indicated that positively framed messages focusing on the infant's health would encourage them to receive an influenza vaccine. Messages emphasizing immunization benefits such as protection against preterm birth and low birth weight outcomes have potential to overcome widespread negative community perceptions and cultural beliefs. Additionally, messages transmitted via interpersonal networks and social media strongly influence motivation to obtain vaccination during pregnancy. The findings of this study will assist in developing tailored messages that change pregnant African American women's influenza vaccination decision-making to achieve improved coverage.
我们探讨了非裔美国女性对孕期流感疫苗接种的态度、看法和担忧。由于美国这一人群的流感疫苗接种覆盖率仍未达到最佳水平，我们针对旨在减少未来孕产妇和新生儿流感发病病例的多成分干预措施，引出了信息构建策略。对城市妇产科诊所中未接种流感疫苗的怀孕非裔美国女性进行了半结构化深度访谈（N = 21）。访谈内容进行了转录，接受了编码员间信度评估，并进行了内容分析，以确定与接受流感疫苗和健康传播信息偏好相关的常见主题因素。确定了四个主要主题。分别是沟通方式、正常疫苗接种行为、孕期疫苗接种以及正面框架与负面框架。出现了两个突出主题：与负面框架信息相比，正面框架信息更受青睐，且更强调婴儿健康。此外，既往免疫接种、信息来源和疫苗误解在决策过程中也发挥了重要作用。大多数女性表示，聚焦婴儿健康的正面框架信息会促使她们接种流感疫苗。强调免疫接种益处（如预防早产和低出生体重结局）的信息有可能克服社区普遍存在的负面认知和文化观念。此外，通过人际网络和社交媒体传播的信息会强烈影响孕期接种疫苗的积极性。本研究结果将有助于制定针对性的信息，改变怀孕非裔美国女性的流感疫苗接种决策，以提高接种覆盖率。
