MacDougall Donna M, Halperin Beth A, Langley Joanne M, MacKinnon-Cameron Donna, Li Li, Halperin Scott A
Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, NS, Canada; School of Nursing, St. Francis Xavier University, Antigonish, NS, Canada.
Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, NS, Canada; School of Nursing, Dalhousie University, Halifax, NS, Canada; Department of Pediatrics, Dalhousie University, Halifax, NS, Canada.
Vaccine. 2016 Jan 27;34(5):687-695. doi: 10.1016/j.vaccine.2015.09.089. Epub 2015 Oct 14.
In Canada, rotavirus vaccine is recommended for all infants, but not all provinces/territories have publicly funded programs. We compared public and healthcare provider (HCP) knowledge, attitudes, beliefs, and behaviors in a province with a public health nurse-delivered, publicly funded rotavirus vaccination program to a province with a publicly funded, physician-delivered program. A third province with no vaccination program acted as a control.
Information about knowledge, attitudes, beliefs, and behaviors of parents whose children were eligible for the universal program and healthcare providers responsible for administering the vaccine were collected through the use of two validated surveys distributed in public health clinics, physicians' offices, and via e-mail. Early and postvaccine-program survey results were compared.
A total of 722 early implementation and 709 postimplementation parent surveys and 180 early and 141 postimplementation HCP surveys were analyzed. HCP and public attitudes toward rotavirus vaccination were generally positive and didn't change over time. More parents postprogram were aware of the NACI recommendation and the vaccination program and reported that their healthcare provider discussed rotavirus infection and vaccine with them. Prior to the program across all sites, more physicians than nurses were aware of the national recommendation regarding rotavirus vaccine. In the postprogram survey, however, more nurses were aware of the national recommendation and their provincial universal rotavirus vaccination program. Nurses had higher knowledge scores than physicians in the postprogram survey (p<0.001). Parents of young infants were also more knowledgeable about rotavirus and rotavirus vaccine in the two areas where universal programs were in place (p<0.001).
Implementation of a universal rotavirus vaccination program was associated with an increase in knowledge and more positive attitudes toward rotavirus vaccine amongst parents of eligible infants. Nurses involved in a public health-delivered vaccination program were more knowledgeable and had more positive attitudes toward the vaccine than physicians in a jurisdiction where vaccine was physician-delivered.
在加拿大,建议所有婴儿接种轮状病毒疫苗,但并非所有省份/地区都有公共资助项目。我们将一个由公共卫生护士提供公共资助轮状病毒疫苗接种项目的省份与一个由医生提供公共资助项目的省份的公众和医疗服务提供者(HCP)的知识、态度、信念及行为进行了比较。第三个没有疫苗接种项目的省份作为对照。
通过在公共卫生诊所、医生办公室发放并通过电子邮件发送两份经过验证的调查问卷,收集符合普遍项目条件的儿童家长以及负责接种疫苗的医疗服务提供者的知识、态度、信念及行为信息。比较疫苗接种项目实施初期和实施后的调查结果。
共分析了722份实施初期和709份实施后的家长调查问卷,以及180份实施初期和141份实施后的HCP调查问卷。HCP和公众对轮状病毒疫苗接种的态度总体上是积极的,且未随时间变化。项目实施后,更多家长知晓国家免疫咨询委员会(NACI)的建议和疫苗接种项目,并报告其医疗服务提供者与他们讨论了轮状病毒感染和疫苗相关事宜。在项目实施前,所有地点的医生比护士更了解关于轮状病毒疫苗的国家建议。然而,在项目实施后的调查中,更多护士知晓国家建议及其所在省份的普遍轮状病毒疫苗接种项目。在项目实施后的调查中,护士的知识得分高于医生(p<0.001)。在实施普遍项目的两个地区,幼儿家长对轮状病毒和轮状病毒疫苗也了解得更多(p<0.001)。
实施普遍轮状病毒疫苗接种项目与符合条件婴儿的家长对轮状病毒疫苗的知识增加及态度更积极相关。在由公共卫生机构提供疫苗接种项目的地区,参与其中的护士比由医生提供疫苗接种服务地区的医生对疫苗更了解,态度也更积极。