University of Nottingham, School of Medicine, Nottingham, UK.
National Institute for Health Research (NIHR) ARC Wessex, UK; University of Southampton, Department of Psychology, Southampton, UK.
Public Health. 2021 Dec;201:98-107. doi: 10.1016/j.puhe.2021.10.006. Epub 2021 Oct 18.
Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) was identified in late 2019, spreading to over 200 countries and resulting in almost two million deaths worldwide. The emergence of safe and effective vaccines provides a route out of the pandemic, with vaccination uptake of 75-90% needed to achieve population protection. Vaccine hesitancy is problematic for vaccine rollout; global reports suggest only 73% of the population may agree to being vaccinated. As a result, there is an urgent need to develop equitable and accessible interventions to address vaccine hesitancy at the population level.
& Method: We report the development of a scalable digital intervention seeking to address COVID-19 vaccine hesitancy and enhance uptake of COVID-19 vaccines in the United Kingdom. Guided by motivational interviewing (MI) principles, the intervention includes a series of therapeutic dialogues addressing 10 key concerns of vaccine-hesitant individuals. Development of the intervention occurred linearly across four stages. During stage 1, we identified common reasons for COVID-19 vaccine hesitancy through analysis of existing survey data, a rapid systematic literature review, and public engagement workshops. Stage 2 comprised qualitative interviews with medical, immunological, and public health experts. Rapid content and thematic analysis of the data provided evidence-based responses to common vaccine concerns. Stage 3 involved the development of therapeutic dialogues through workshops with psychological and digital behaviour change experts. Dialogues were developed to address concerns using MI principles, including embracing resistance and supporting self-efficacy. Finally, stage 4 involved digitisation of the dialogues and pilot testing with members of the public.
The digital intervention provides an evidence-based approach to addressing vaccine hesitancy through MI principles. The dialogues are user-selected, allowing exploration of relevant issues associated with hesitancy in a non-judgmental context. The text-based content and digital format allow for rapid modification to changing information and scalability for wider dissemination.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）于 2019 年末被发现，迅速传播至 200 多个国家，导致全球近 200 万人死亡。安全有效的疫苗的出现为疫情结束提供了出路，需要接种疫苗的人群达到 75-90%才能实现群体保护。疫苗犹豫对疫苗的推广存在问题；全球报告表明，只有 73%的人口可能同意接种疫苗。因此，迫切需要制定公平和可及的干预措施，以解决人群层面的疫苗犹豫问题。
我们报告了一种可扩展的数字干预措施的开发，旨在解决 COVID-19 疫苗犹豫问题，并提高英国 COVID-19 疫苗的接种率。该干预措施以动机访谈（MI）原则为指导，包括一系列针对疫苗犹豫个体的 10 个关键问题的治疗对话。干预措施的开发是线性进行的，共分为四个阶段。在第一阶段，我们通过分析现有调查数据、快速系统文献综述和公众参与研讨会，确定了 COVID-19 疫苗犹豫的常见原因。第二阶段包括对医学、免疫学和公共卫生专家的定性访谈。对数据的快速内容和主题分析提供了针对常见疫苗问题的循证回应。第三阶段涉及通过与心理和数字行为改变专家的研讨会开发治疗对话。通过 MI 原则开发对话，以解决问题，包括接受抵触情绪和支持自我效能感。最后，第四阶段涉及对话的数字化和与公众成员的试点测试。
该数字干预措施提供了一种基于 MI 原则的循证方法来解决疫苗犹豫问题。对话是用户选择的，允许在非评判的环境中探索与犹豫相关的相关问题。基于文本的内容和数字格式允许快速修改不断变化的信息，并可进行扩展以更广泛地传播。
