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与阻碍看护人接受 HPV 疫苗接种相关的因素 - 阿根廷的一项横断面研究。

Factors associated with hindering the acceptance of HPV vaccination among caregivers - A cross-sectional study in Argentina.

机构信息

Universidad de Buenos Aires, Buenos Aires, Argentina.

Universidad Nacional del Nordeste, Chaco, Argentina.

出版信息

PLoS One. 2020 Mar 10;15(3):e0229793. doi: 10.1371/journal.pone.0229793. eCollection 2020.

Abstract

BACKGROUND

The northeastern region of Argentina has the highest age-adjusted cervical cancer mortality rates. Given the strong link between HPV infections and cervical cancer, one of the main interventions is the population-based use of HPV vaccines. However, the acceptability is not very clear in low- and middle-income countries. The purpose of this study was to estimate the level of HPV vaccine acceptance and associated determinants among caregivers of girls in a northeastern city of Argentina.

METHODS

A school-based survey was conducted in 2015 using a multistage sampling method. The primary sample unit were schools stratified by socioeconomic status selected at random, and caregivers of school girls were interviewed. The acceptability was determined using the adapted Theory of Planned Behavior. We performed logistic regression models to assess associated determinants.

RESULTS

The study included 347 caregivers. The intention to vaccinate was 59.88%. A positive attitude of caregivers (aOR 4.67; 3.11-7.03) and positive influence of social norms (aOR 1.95; 1.03-3.70) were the main predictors independently associated to the intention to vaccinate against HPV. In contrast, practicing a Christian non-Catholic religion decreased the intention to vaccinate against HPV (OR 0.59; 0.36-0.95). All other factors evaluated were not significantly associated with intention to vaccinate against HPV.

CONCLUSIONS

This study shows that evaluating attitudes, normative social beliefs, and perceived self-efficacy regarding HPV vaccination can be of utmost importance for mapping and planning of health-related strategies in developing countries.

摘要

背景

阿根廷东北部地区的宫颈癌死亡率经年龄调整后最高。鉴于 HPV 感染与宫颈癌之间存在很强的关联,主要干预措施之一是在人群中使用 HPV 疫苗。然而,在中低收入国家,HPV 疫苗的可接受性尚不清楚。本研究旨在评估阿根廷东北部一个城市中女孩的照顾者对 HPV 疫苗的接受程度及其相关决定因素。

方法

2015 年采用多阶段抽样方法进行了一项基于学校的调查。主要抽样单位为按社会经济地位分层随机选择的学校,对学校女生的照顾者进行了访谈。采用经过改编的计划行为理论来确定可接受性。我们进行了逻辑回归模型分析以评估相关决定因素。

结果

该研究共纳入了 347 名照顾者。接种疫苗的意愿为 59.88%。照顾者的积极态度(优势比 4.67;3.11-7.03)和积极的社会规范影响(优势比 1.95;1.03-3.70)是与接种 HPV 疫苗的意愿呈独立正相关的主要预测因素。相比之下,信奉基督教非天主教会降低了接种 HPV 疫苗的意愿(比值比 0.59;0.36-0.95)。评估的其他所有因素与接种 HPV 疫苗的意愿均无显著相关性。

结论

本研究表明,评估针对 HPV 疫苗接种的态度、规范的社会信念和感知的自我效能感对于制定和规划发展中国家的卫生相关策略至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1f0/7064251/d4314ebd383e/pone.0229793.g001.jpg

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