Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
Acad Pediatr. 2021 May-Jun;21(4S):S9-S16. doi: 10.1016/j.acap.2021.01.017.
Behavioral science offers several ideas about what it takes to get people to vaccinate. Colleagues and I previously reviewed the evidence for these propositions and put forward what has become known as the Increasing Vaccination Model. To make the model more accessible to practitioners, the current paper summarizes the main insights from the earlier work. First, observational studies show clearly that thoughts and feelings are correlated with vaccine uptake. Such constructs include perceived risk of harm from infectious disease and confidence in vaccine safety and efficacy. However, interventions have not generally shown that changing thoughts and feelings increases vaccine uptake. Second, social processes are promising in observational studies. Such constructs include social norms, altruism, and sharing through social media. More research is needed in this promising area before it will be possible to conclude whether social processes are effective intervention targets. Third, interventions that directly change behavior-without trying to change what people think or feel or their social experience-are reliably effective ways to increase vaccine uptake. Such interventions include reminders, defaults, and vaccine requirements. Finally, the most potent intervention for increasing vaccine uptake is a health care provider recommendation, but it is still unclear whether such recommendations are effective because they increase confidence, set a social norm, or reflect a direct behavior change technique. The paper ends by describing use of the model by a World Health Organization working group as it considers opportunities to address low vaccination uptake globally.
行为科学提供了一些关于如何让人们接种疫苗的想法。我和同事之前回顾了这些主张的证据，并提出了所谓的“增加疫苗接种模型”。为了使该模型更容易为从业者所接受，当前的论文总结了早期工作的主要见解。首先，观察性研究清楚地表明，思想和感受与疫苗接种率相关。这些结构包括对传染病危害的感知风险以及对疫苗安全性和有效性的信心。但是，干预措施通常并未表明改变思想和感受会增加疫苗接种率。其次，社会过程在观察性研究中很有前途。这些结构包括社会规范、利他主义和通过社交媒体分享。在这个有前途的领域中，需要进行更多的研究，才能得出社会过程是否是有效的干预目标的结论。第三，直接改变行为的干预措施-而不是试图改变人们的想法、感受或社会经验-是可靠地增加疫苗接种率的方法。此类干预措施包括提醒、默认设置和疫苗要求。最后，增加疫苗接种率最有效的干预措施是医疗保健提供者的建议，但尚不清楚此类建议是否有效，因为它们可以提高信心、设定社会规范或反映直接的行为改变技术。本文最后描述了世界卫生组织工作组使用该模型的情况，因为它考虑了在全球范围内解决低疫苗接种率的机会。
