Corace Kimberly M, Srigley Jocelyn A, Hargadon Daniel P, Yu Dorothy, MacDonald Tara K, Fabrigar Leandre R, Garber Gary E
University of Ottawa, Ottawa K1N 6N5, Canada; University of Ottawa Institute of Mental Health Research, Ottawa K1Z 7K4, Canada; Ottawa Hospital Research Institute, Ottawa K1Y 4E9, Canada.
Public Health Ontario, Toronto M5G 1V2, Canada; University of British Columbia, Vancouver V6T 1Z4, Canada.
Vaccine. 2016 Jun 14;34(28):3235-42. doi: 10.1016/j.vaccine.2016.04.071. Epub 2016 May 5.
Influenza vaccination of healthcare workers (HCW) is important for protecting staff and patients, yet vaccine coverage among HCW remains below recommended targets. Psychological theories of behavior change may help guide interventions to improve vaccine uptake. Our objectives were to: (1) review the effectiveness of interventions based on psychological theories of behavior change to improve HCW influenza vaccination rates, and (2) determine which psychological theories have been used to predict HCW influenza vaccination uptake.
MEDLINE, EMBASE, CINAHL, PsycINFO, The Joanna Briggs Institute, SocINDEX, and Cochrane Database of Systematic Reviews were searched for studies that applied psychological theories of behavior change to improve and/or predict influenza vaccination uptake among HCW.
The literature search yielded a total of 1810 publications; 10 articles met eligibility criteria. All studies used behavior change theories to predict HCW vaccination behavior; none evaluated interventions based on these theories. The Health Belief Model was the most frequently employed theory to predict influenza vaccination uptake among HCW. The remaining predictive studies employed the Theory of Planned Behavior, the Risk Perception Attitude, and the Triandis Model of Interpersonal Behavior. The behavior change framework constructs were successful in differentiating between vaccinated and non-vaccinated HCW. Key constructs identified included: attitudes regarding the efficacy and safety of influenza vaccination, perceptions of risk and benefit to self and others, self-efficacy, cues to action, and social-professional norms. The behavior change frameworks, along with sociodemographic variables, successfully predicted 85-95% of HCW influenza vaccination uptake.
Vaccination is a complex behavior. Our results suggest that psychological theories of behavior change are promising tools to increase HCW influenza vaccination uptake. Future studies are needed to develop and evaluate novel interventions based on behavior change theories, which may help achieve recommended HCW vaccination targets.
医护人员接种流感疫苗对于保护工作人员和患者很重要，但医护人员中的疫苗接种率仍低于推荐目标。行为改变的心理学理论可能有助于指导干预措施以提高疫苗接种率。我们的目标是：（1）回顾基于行为改变心理学理论的干预措施提高医护人员流感疫苗接种率的有效性，以及（2）确定哪些心理学理论已被用于预测医护人员的流感疫苗接种情况。
检索MEDLINE、EMBASE、CINAHL、PsycINFO、乔安娜·布里格斯循证卫生保健中心、社会科学索引和Cochrane系统评价数据库，查找应用行为改变心理学理论来改善和/或预测医护人员流感疫苗接种情况的研究。
文献检索共获得1810篇出版物；10篇文章符合纳入标准。所有研究都使用行为改变理论来预测医护人员的疫苗接种行为；没有一项研究评估基于这些理论的干预措施。健康信念模型是预测医护人员流感疫苗接种情况最常使用的理论。其余的预测性研究采用了计划行为理论、风险感知态度和人际行为的Triandis模型。行为改变框架结构成功地区分了接种疫苗和未接种疫苗的医护人员。确定的关键结构包括：对流感疫苗效力和安全性的态度、对自身和他人风险与益处的认知、自我效能感、行动线索以及社会-职业规范。行为改变框架与社会人口统计学变量一起，成功预测了85%-95%的医护人员流感疫苗接种情况。
接种疫苗是一种复杂行为。我们的结果表明，行为改变心理学理论是提高医护人员流感疫苗接种率的有前景的工具。未来需要开展研究来开发和评估基于行为改变理论的新型干预措施，这可能有助于实现推荐的医护人员疫苗接种目标。
