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约旦对非传染性疾病患者进行 COVID-19 疫苗接种咨询:评估干预措施。

Counselling of non-communicable diseases' patients for COVID-19 vaccine uptake in Jordan: Evaluating the intervention.

机构信息

WHO Country Office for Jordan, Amman, Jordan.

Noncommunicable Diseases Directorate, Ministry of Health, Amman, Jordan.

出版信息

Vaccine. 2022 Nov 2;40(46):6658-6663. doi: 10.1016/j.vaccine.2022.09.083. Epub 2022 Oct 3.

Abstract

BACKGROUND

People with noncommunicable diseases (NCDs) are at a significantly higher risk of worst outcomes if infected with COVID-19 and thus amongst the main target population for vaccination. Despite prioritizing them for vaccination, the number of vaccinated patients with comorbidities stalled post vaccine introduction. Despite that the government along with partners ran a national awareness campaign to ramp up vaccination coverage, the coverage remained suboptimal. Thus, a one-to-one health counselling initiative was implemented to explore the acceptance of COVID-19 vaccines by the NCDs patients and address the main issues surrounding vaccine hesitancy. This study evaluates the impact of this intervention by analyzing the change in COVID-19 vaccine acceptance.

METHODS

In this analytical observational study, a random sample of 57,794 people living with NCDs were approached. Out of them, 12,144 received one-to-one counselling by a group of trained health professionals. The counselled group's vaccine acceptance was assessed on a Likert scale from 1 to 5 pre- and post- counselling. Moreover, a random sample was followed up 2 months after initial counselling to measure their vaccine acceptance and update their vaccination status.

RESULTS

44.5% of total respondents were already registered in the vaccination platform. On a scale from 1 to 5, the overall mean confidence significantly increased by 1.63 from 2.48 pre-counselling to 4.11 post-counselling. Two-months post counselling, a random sample was contacted again and had a mean vaccine confidence of 3.71, which is significantly higher than pre-counselling confidence level despite a significant decrease to post-counselling results.

DISCUSSION

Implementing an intervention that targets all key factors impacting health decisions, such as health literacy, risk appraisal and response efficacy, helps reach an adaptive response and increase vaccine confidence. Scholars should be cautious when implementing an intervention since it could lead to maladaptive defensive responses. One-to-one interventions are more effective in population when addressing new interventions and vaccines.

摘要

背景

患有非传染性疾病(NCDs)的人如果感染 COVID-19,其预后会显著恶化,因此属于疫苗接种的主要目标人群。尽管将他们列为优先接种疫苗的人群,但在疫苗推出后,患有合并症的接种人数停滞不前。尽管政府和合作伙伴开展了全国性的提高疫苗接种率的宣传活动,但覆盖率仍不理想。因此,实施了一对一的健康咨询计划,以探讨 NCD 患者对 COVID-19 疫苗的接受程度,并解决疫苗犹豫的主要问题。本研究通过分析 COVID-19 疫苗接受率的变化来评估这一干预措施的影响。

方法

在这项分析性观察研究中,对 57794 名患有 NCD 的随机样本进行了调查。其中,12144 人接受了一组经过培训的卫生专业人员的一对一咨询。在咨询前后,通过李克特量表对被咨询组的疫苗接受程度进行评估,分值为 1 到 5。此外,对随机样本进行了为期 2 个月的随访,以衡量他们的疫苗接受程度并更新他们的疫苗接种状况。

结果

总受访者中有 44.5%已经在疫苗接种平台上注册。在 1 到 5 的量表上,总体信心平均值从咨询前的 2.48 显著增加到咨询后的 4.11。咨询两个月后,再次联系了一个随机样本,他们的疫苗信心平均值为 3.71,尽管与咨询后的结果相比有所下降,但明显高于咨询前的信心水平。

讨论

实施针对影响健康决策的所有关键因素的干预措施,如健康素养、风险评估和反应效能,有助于实现适应性反应并提高疫苗信心。学者在实施干预措施时应谨慎,因为它可能导致适应性防御反应。在涉及新的干预措施和疫苗时,一对一干预在人群中更为有效。

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