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提供者沟通与母亲接种人乳头瘤病毒和流感疫苗的意愿:一项随机健康信息传递试验。

Provider Communication and Mothers' Willingness to Vaccinate Against Human Papillomavirus and Influenza: A Randomized Health Messaging Trial.

机构信息

Department of Pediatrics, Sections of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Ind.

Department of Pediatrics, Children's Health Services Research, Indiana University School of Medicine, Indianapolis, Ind.

出版信息

Acad Pediatr. 2018 Mar;18(2):145-153. doi: 10.1016/j.acap.2017.07.007. Epub 2017 Jul 25.

Abstract

OBJECTIVE

To understand the effect of a health messaging intervention focused on provider communication about vaccination on mothers' willingness to vaccinate children against human papillomavirus (HPV) and seasonal influenza.

METHODS

A total of 2476 mothers of 9- to 13-year-olds in the United States completed a Web-based survey in August 2014. Mothers were randomized to 1 of 2 groups targeting HPV or influenza vaccine. Mothers whose child had not received the target vaccine (ie, zero doses of HPV vaccine/no prior-year administration of influenza vaccine) were randomized to the intervention. The study used a 3 × 2 between-subjects design; illustrated vignettes depicted 1 of 3 levels of provider recommendation strength (brief mention of vaccination, strong recommendation of vaccination, or personal disclosure of vaccination of own children), and presence or absence of information comparing safety of vaccination to the safety of a common daily activity. Outcome was mothers' willingness to have their child receive the target vaccine. Perceived benefits of vaccination were assessed before viewing the intervention and were included as a covariate in analyses, along with child gender.

RESULTS

For HPV vaccine, there was a main effect of safety information (F(1,684) = 7.99, P = .005) and perceived benefits of vaccination (F(1,684) = 221.64, P < .001) on mothers' willingness to vaccinate. For influenza, perceived benefits of vaccination significantly related to willingness to vaccinate (F(1,462) = 105.78, P < .001). Child gender was not associated with willingness.

CONCLUSIONS

Provider communication about vaccination may need to be tailored to the vaccine in question. A next step to increasing coverage for both HPV and influenza vaccines may be an intervention aimed at increasing mothers' perceived benefits of vaccination.

摘要

目的

了解以提供者沟通为重点的健康信息干预措施对母亲接种人乳头瘤病毒 (HPV) 和季节性流感疫苗意愿的影响。

方法

2014 年 8 月,美国共有 2476 名 9 至 13 岁儿童的母亲完成了一项基于网络的调查。母亲被随机分为 2 组,分别针对 HPV 或流感疫苗。那些孩子尚未接种目标疫苗(即,HPV 疫苗 0 剂/上一年未接种流感疫苗)的母亲被随机分配到干预组。该研究采用 3×2 组间设计;说明性情节描绘了提供者建议强度的 3 个水平之一(接种疫苗的简要提及、强烈推荐接种疫苗或透露自己孩子接种疫苗的情况),以及是否存在将疫苗接种的安全性与常见日常活动的安全性进行比较的信息。结果是母亲让孩子接种目标疫苗的意愿。在观看干预措施之前评估了疫苗接种的预期收益,并将其作为协变量纳入分析,同时还包括孩子的性别。

结果

对于 HPV 疫苗,安全性信息(F(1,684) = 7.99,P =.005)和疫苗接种预期收益(F(1,684) = 221.64,P <.001)对母亲接种疫苗的意愿有主要影响。对于流感疫苗,疫苗接种预期收益与接种意愿显著相关(F(1,462) = 105.78,P <.001)。孩子的性别与意愿无关。

结论

疫苗接种方面的提供者沟通可能需要针对具体疫苗进行调整。提高 HPV 和流感疫苗接种率的下一步措施可能是一项旨在增加母亲对疫苗接种预期收益的干预措施。

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