RTI International, Berkeley, CA, USA.
RTI International, Berkeley, CA, USA.
Vaccine. 2022 Nov 15;40(48):6908-6916. doi: 10.1016/j.vaccine.2022.10.027. Epub 2022 Oct 20.
Interactive stories are a relatively newer form of storytelling with great potential to correct misinformation while increasing self-efficacy, which is crucial to vaccine acceptance. To address COVID-19 vaccine hesitancy and medical mistrust in young Black adults (BYA), we sought to adapt a pre-existing application ("app"; Tough Talks) designed to address HIV disclosure decision-making through choose-your-own adventure (CYOA) narratives and other activities. The adapted app (Tough Talks - COVID) uses a similar approach to situate COVID-19 vaccination decision-making within social contexts and to encourage greater deliberation about decisions. To inform content for the CYOA narratives, we conducted an online survey that was used to elicit the behavioral, cognitive, and environmental determinants influencing COVID-19 vaccine hesitancy among 150 BYA (ages 18-29) in Georgia, Alabama, and North Carolina. The survey included scenario questions that were developed with input from a youth advisory board to understand responses to peer and family influences. In two scenarios that involved discussions with family and friends about vaccination status, most respondents chose to be honest about their vaccination status. However, vaccinated individuals perceived more social pressure and stigma about not being vaccinated than unvaccinated respondents who were not as motivated by social pressure. Personal choice/agency in the face of perceived vaccine risks was a more common theme for unvaccinated respondents. Results suggest that relying on changing social norms alone may not impact barriers to vaccination in unvaccinated young adults without also addressing other barriers to vaccination such as concerns about autonomy and vaccine safety. Based on these findings, CYOA narratives in the app were adapted to include discussions with family and friends but also to touch on themes of personal choice as well as other topics that influence behaviors besides norms such as safety, side effects, and risk of COVID-19 in an evolving pandemic.
互动故事是一种相对较新的叙事形式，具有纠正错误信息和提高自我效能的巨大潜力，这对疫苗接种的接受至关重要。为了解决年轻黑人成年人（BYA）对 COVID-19 疫苗的犹豫和对医疗的不信任，我们试图改编一个现有的应用程序（“应用程序”；Tough Talks），该程序旨在通过选择自己的冒险（CYOA）叙事和其他活动来解决 HIV 披露决策。改编后的应用程序（Tough Talks-COVID）采用类似的方法将 COVID-19 疫苗接种决策置于社会背景下，并鼓励对决策进行更多的审议。为了为 CYOA 叙事提供内容，我们进行了一项在线调查，该调查用于了解影响 150 名 BYA（年龄在 18-29 岁之间）在佐治亚州、阿拉巴马州和北卡罗来纳州对 COVID-19 疫苗犹豫不决的行为、认知和环境决定因素。该调查包括情景问题，这些问题是在青年咨询委员会的参与下制定的，以了解对同伴和家庭影响的反应。在涉及与家人和朋友讨论接种状况的两个情景中，大多数受访者选择诚实地说出自己的接种状况。然而，接种疫苗的人比未接种疫苗的人感受到更多的关于未接种疫苗的社会压力和耻辱，而未接种疫苗的人则没有那么多的社会压力。在面对感知到的疫苗风险时，个人选择/代理权是未接种疫苗的受访者的一个更为常见的主题。研究结果表明，仅依靠改变社会规范可能无法消除未接种疫苗的年轻成年人接种疫苗的障碍，而不解决其他疫苗接种障碍，如对自主权和疫苗安全性的担忧。基于这些发现，应用程序中的 CYOA 叙事进行了改编，包括与家人和朋友的讨论，但也涉及个人选择主题以及影响行为的其他主题，除了规范之外，如安全、副作用和在不断演变的大流行中的 COVID-19 风险。
