Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts.
Department of Communication Studies, Indiana University School of Liberal Arts, Indianapolis, Indiana.
J Adolesc Health. 2020 Aug;67(2):253-261. doi: 10.1016/j.jadohealth.2020.01.024. Epub 2020 Mar 18.
The aim of the study was to determine whether supplementing a bundled recommendation (recommendation for all 11- to 12-year-old platform vaccines) with tailored messaging that addressed one versus all parental concerns improved human papillomavirus (HPV) vaccination intent among mothers.
We conducted a Web-based randomized controlled trial, randomizing mothers who did not intend to vaccinate their 11- to 14-year-old child against HPV to (1) bundled recommendation video ("control"); (2) control + video addressing the top HPV vaccine concern; or (3) control + ≥1 videos addressing all concerns. Outcomes were HPV vaccination intent (1 = extremely unlikely and 10 = extremely likely) and strength of main concern (1 = a little concerned and 10 = very concerned). We assessed differences in intervention effects using generalized linear models for vaccine intent and mixed models for the strength of main concern.
Of the 762 mothers, 51% had a female child, 82% of children were white, and 90% were non-Hispanic. The mean intent to vaccinate postintervention ranged from 3.5 (95% confidence interval [CI] = 3.1-3.8) in the control group to 4.2 (95% CI = 3.9-4.6) in the all-concerns group (p = .01). The mean strength of the concerns declined pre- to postintervention by .1 (95% CI = -.1 to .3) in the control group (p = .42), .6 (95% CI = .4-.9) in the top concern group (p < .001), and .7 (95% CI = .5-1.0) in the all-concerns group (p < .001). However, the mean strength of the main concerns postintervention remained high (≥7.0 for each group).
Tailored messages addressing all concerns improved HPV vaccination intent and reduced the strength of the main concern more than bundled messages alone, but intent remained low and strength of the main concerns remained high in this vaccine-hesitant population.
本研究旨在确定在针对所有 11-12 岁人群的捆绑推荐(推荐所有 11-12 岁人群接种平台疫苗)中加入针对一个或所有父母关注点的定制信息,是否能提高母亲对人乳头瘤病毒(HPV)疫苗接种的意愿。
我们进行了一项基于网络的随机对照试验,将不打算为 11-14 岁孩子接种 HPV 疫苗的母亲随机分为三组:(1)捆绑推荐视频(“对照组”);(2)对照组+针对 HPV 疫苗最关注问题的视频;或(3)对照组+≥1 个针对所有关注点的视频。结果为 HPV 疫苗接种意愿(1=极不可能,10=极有可能)和主要关注点的强度(1=有点关注,10=非常关注)。我们使用广义线性模型评估疫苗接种意愿的干预效果,使用混合模型评估主要关注点的强度。
在 762 名母亲中,51%的孩子为女性,82%的孩子为白人,90%为非西班牙裔。干预后,疫苗接种意愿的平均值从对照组的 3.5(95%置信区间[CI]为 3.1-3.8)到所有关注点组的 4.2(95% CI 为 3.9-4.6)(p=.01)。对照组的主要关注点强度在干预前后下降了 0.1(95% CI 为-.1 至.3)(p=.42),在关注重点组下降了 0.6(95% CI 为.4-.9)(p<.001),在所有关注点组下降了 0.7(95% CI 为.5-1.0)(p<.001)。然而,主要关注点的平均强度在干预后仍然很高(每组均≥7.0)。
针对所有关注点的定制信息比捆绑信息更能提高 HPV 疫苗接种意愿,降低主要关注点的强度,但在这个对疫苗持犹豫态度的人群中,意愿仍然很低,主要关注点的强度仍然很高。