Appiah Bernard, Gebretsadik Lakew Abebe, Mamo Abebe, Kmush Brittany, Asefa Yisalemush, France Christopher R, Samman Elfreda, Alemayehu Tena, Abafogi Mahdiya, Ahmed Md Koushik, Forastiere Laura, Singh Gursimar Kaur, Larsen David, Morankar Sudhakar
Department of Public Health, Research Program on Health Communication and Public Engagement (H-COPE), Syracuse University, Syracuse, New York, United States of America.
Centre for Science and Health Communication, Accra, Ghana.
PLOS Glob Public Health. 2022 Nov 2;2(11):e0001002. doi: 10.1371/journal.pgph.0001002. eCollection 2022.
Mass media interventions have the potential to reach large audiences and influence health behaviours and outcomes. To date, no study has evaluated the effect of a radio-only campaign on infant vaccination coverage, timeliness, and related morbidity in a low-income country. We implemented the "10+10+30" radio campaign involving broadcasting a weekly 10-minute radio drama series on vaccination, followed by a 10-minute discussion by community health workers, and then a 30-minute listener phone-in segment in Jimma Zone, Ethiopia for three months. To assess the impact of 10+10+30, which was aired on a community radio station, we recruited mothers of infants up to 5 weeks old in intervention district clusters that were inside the radio station's reception range (n = 328 dyads) and control district clusters that were outside of the range (n = 332 dyads). Intention-to-treat and per-protocol analyses, adjusted for pre-intervention differences between the districts, were conducted to examine the co-primary outcome of Penta-3 vaccination coverage and timeliness as well as those of other vaccines and outcomes related to infant morbidity. Both intention-to-treat and per-protocol analyses revealed higher vaccine coverage (p<0.001) and more timely vaccine administration (p<0.001) in the intervention district relative to the control district, with infants in the intervention district being 39% more likely to receive a Penta 3 vaccination (adjusted RR: 1.39, p<0.001). In addition, adjusted regression analyses of maternal retrospective reports over a two-week period revealed 80% less infant diarrhoea (RR: 0.20, p<0.001), 40% less fever (RR: 0.60, p<0.001) and 58% less cough (RR: 0.42, p<0.001) in the intervention district relative to the control district. This study provides compelling initial evidence that a radio drama integrated with discussion and phone-in components may improve infant vaccination coverage and timeliness, and may reduce infant morbidity. Randomized controlled trials are needed to confirm and extend these findings with other samples.
大众媒体干预措施有可能覆盖大量受众,并影响健康行为和结果。迄今为止,尚无研究评估仅通过广播开展的活动对低收入国家婴儿疫苗接种覆盖率、及时性及相关发病率的影响。我们在埃塞俄比亚的吉马地区开展了“10 + 10 + 30”广播活动,为期三个月,内容包括每周播放一档10分钟的关于疫苗接种的广播连续剧,随后由社区卫生工作者进行10分钟的讨论,然后是30分钟的听众来电环节。为评估在社区广播电台播出的“10 + 10 + 30”活动的影响,我们在广播电台接收范围内的干预区集群(n = 328对)和范围外的对照区集群(n = 332对)招募了5周龄及以下婴儿的母亲。进行了意向性分析和符合方案分析,并对各区干预前的差异进行了调整,以检验三联疫苗(Penta - 3)接种覆盖率和及时性以及其他疫苗的共同主要结局,还有与婴儿发病率相关的结局。意向性分析和符合方案分析均显示,与对照区相比,干预区的疫苗接种覆盖率更高(p<0.001),疫苗接种更及时(p<0.001),干预区的婴儿接种三联疫苗的可能性比对照区高39%(调整后的相对危险度:1.39,p<0.001)。此外,对母亲在两周内的回顾性报告进行的调整回归分析显示,与对照区相比,干预区婴儿腹泻减少80%(相对危险度:0.20,p<0.001),发热减少40%(相对危险度:0.60,p<0.001),咳嗽减少58%(相对危险度:0.42,p<0.001)。这项研究提供了令人信服的初步证据,表明结合了讨论和来电环节的广播连续剧可能会提高婴儿疫苗接种覆盖率和及时性,并可能降低婴儿发病率。需要通过随机对照试验,用其他样本证实并扩展这些发现。