在产房推广疫苗接种——动机性访谈技术可减少犹豫，增强接种意愿：魁北克 2014 年 3 月至 2015 年 2 月一项多中心非对照前后干预 RCT 嵌套研究的结果
Promoting vaccination in maternity wards ─ motivational interview technique reduces hesitancy and enhances intention to vaccinate, results from a multicentre non-controlled pre- and post-intervention RCT-nested study, Quebec, March 2014 to February 2015.
机构信息
Centre de recherche du CHUS, Sherbrooke, Québec, Canada.
Centre hospitalier universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Québec, Canada.
出版信息
Euro Surveill. 2019 Sep;24(36). doi: 10.2807/1560-7917.ES.2019.24.36.1800641.
BackgroundMany countries are grappling with growing numbers of parents who delay or refuse recommended vaccinations for their children. This has created a need for strategies to address vaccine hesitancy (VH) and better support parental decision-making regarding vaccination.AimTo assess vaccination intention (VI) and VH among parents who received an individual motivational-interview (MI) based intervention on infant immunisation during post-partum stay at a maternity ward between March 2014 and February 2015.MethodsThis non-controlled pre-/post-intervention study was conducted using the results from parents enrolled in the intervention arm of the PromoVaQ randomised control trial (RCT), which was conducted in four maternity wards across the Province of Quebec. Participants (n = 1,223) completed pre- and post-intervention questionnaires on VI and VH using Opel's score. Pre-/post-intervention measures were compared using McNemar's test for categorical variables and Wilcoxon signed-rank test for continuous variables.ResultsPre-intervention: overall VI was 78% and significantly differed across maternity wards (74%, 77%, 84%, 79%, p = 0.02). Post-intervention: VI rose significantly across maternity wards (89%, 85%, 95%, 93%) and the overall increase in VI was 12% (78% vs 90%, p < 0.0001). VH corroborated these observations, pre- vs post-intervention, for each maternity ward (28% vs 16%, 29% vs 21%, 27% vs 17%, 24% vs 13%). Overall, VH was curbed post-intervention by 40% (27% vs 16%; p < 0.0001).ConclusionsCompared with pre-intervention status, participants who received the MI-based intervention on immunisation displayed lower hesitancy and greater intention to vaccinate their infant at 2 months of age.
背景
许多国家都面临着越来越多的父母延迟或拒绝为孩子接种推荐疫苗的问题。这就需要制定策略来解决疫苗犹豫（VH）问题，并更好地支持父母在接种疫苗方面做出决策。
目的
评估 2014 年 3 月至 2015 年 2 月在一家妇产科病房接受基于个体动机访谈（MI）的婴儿免疫干预的父母的疫苗接种意向（VI）和 VH。
方法
这项非对照的预/后干预研究使用了 PromoVaQ 随机对照试验（RCT）干预组父母的研究结果，该试验在魁北克省的四家妇产科病房进行。参与者（n=1223）使用 Opel 的评分在预干预和干预后分别完成了 VI 和 VH 的问卷。使用 McNemar 检验对分类变量和 Wilcoxon 符号秩检验对连续变量进行了预/后干预测量的比较。
结果
预干预
总体 VI 为 78%，且在不同的妇产科病房之间存在显著差异（74%、77%、84%、79%，p=0.02）。干预后：妇产科病房的 VI 显著上升（89%、85%、95%、93%），VI 总体上升 12%（78%与 90%，p<0.0001）。VH 也证实了这一观察结果，即干预前后，每个妇产科病房的 VH 都有所下降（28%与 16%、29%与 21%、27%与 17%、24%与 13%）。总体而言，VH 在干预后下降了 40%（27%与 16%；p<0.0001）。
结论
与干预前相比，接受基于 MI 的免疫干预的参与者对在 2 个月大时为婴儿接种疫苗的犹豫程度较低，接种意愿较高。
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