1 Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina.
2 Lineberger Comprehensive Cancer Center, University of North Carolina.
Psychol Sci Public Interest. 2017 Dec;18(3):149-207. doi: 10.1177/1529100618760521.
Vaccination is one of the great achievements of the 20th century, yet persistent public-health problems include inadequate, delayed, and unstable vaccination uptake. Psychology offers three general propositions for understanding and intervening to increase uptake where vaccines are available and affordable. The first proposition is that thoughts and feelings can motivate getting vaccinated. Hundreds of studies have shown that risk beliefs and anticipated regret about infectious disease correlate reliably with getting vaccinated; low confidence in vaccine effectiveness and concern about safety correlate reliably with not getting vaccinated. We were surprised to find that few randomized trials have successfully changed what people think and feel about vaccines, and those few that succeeded were minimally effective in increasing uptake. The second proposition is that social processes can motivate getting vaccinated. Substantial research has shown that social norms are associated with vaccination, but few interventions examined whether normative messages increase vaccination uptake. Many experimental studies have relied on hypothetical scenarios to demonstrate that altruism and free riding (i.e., taking advantage of the protection provided by others) can affect intended behavior, but few randomized trials have tested strategies to change social processes to increase vaccination uptake. The third proposition is that interventions can facilitate vaccination directly by leveraging, but not trying to change, what people think and feel. These interventions are by far the most plentiful and effective in the literature. To increase vaccine uptake, these interventions build on existing favorable intentions by facilitating action (through reminders, prompts, and primes) and reducing barriers (through logistics and healthy defaults); these interventions also shape behavior (through incentives, sanctions, and requirements). Although identification of principles for changing thoughts and feelings to motivate vaccination is a work in progress, psychological principles can now inform the design of systems and policies to directly facilitate action.
接种疫苗是 20 世纪的伟大成就之一，但持续存在的公共卫生问题包括接种不足、延迟和不稳定。心理学提供了三个理解和干预的一般建议，以增加可用且负担得起的疫苗的接种率。第一个建议是，思想和感受可以激发人们接种疫苗。数百项研究表明，对传染病的风险信念和预期遗憾与接种疫苗可靠相关；对疫苗有效性的信心低和对安全性的担忧与不接种疫苗可靠相关。我们惊讶地发现，很少有随机试验成功地改变了人们对疫苗的想法和感受，而那些成功的试验在增加接种率方面的效果也很有限。第二个建议是，社会过程可以激发人们接种疫苗。大量研究表明，社会规范与接种疫苗有关，但很少有干预措施研究规范性信息是否能增加接种率。许多实验研究依赖于假设情景来证明利他主义和搭便车（即利用他人提供的保护）可以影响预期行为，但很少有随机试验测试改变社会过程以增加接种率的策略。第三个建议是，干预措施可以通过利用（但不试图改变）人们的想法和感受来直接促进接种疫苗。这些干预措施在文献中是迄今为止最丰富和最有效的。为了增加疫苗接种率，这些干预措施通过提醒、提示和激发来促进行动（通过提醒、提示和激发），并减少障碍（通过后勤和健康默认），从而利用现有的有利意图；这些干预措施还通过激励、制裁和要求来塑造行为。虽然改变思想和感受以激发接种疫苗的原则的确定仍在进行中，但心理学原则现在可以为直接促进行动的系统和政策的设计提供信息。
