Heidelberg Institute of Global Health, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine - Department of Health, Muntinlupa City, Philippines.
BMJ Glob Health. 2023 Oct;8(10). doi: 10.1136/bmjgh-2023-012613.
The public's confidence in vaccinations has eroded, and anti-vaccination movements have gained traction around the world, including in the Philippines. 'Salubong', a Filipino term, refers to welcoming someone back into one's life and elicits ideas about friendship and family relationships. We extended this concept to vaccines in efforts to design an intervention that would re-welcome vaccines into homes.
Using human-centred design, we developed and refined a story-based intervention that engages Filipino families, community leaders and community health workers. We conducted a randomised controlled trial among 719 caregivers of small children to test the developed intervention against a control video. We assessed the binary improvement (improvement vs no improvement) and the amount of improvement in vaccine attitudes and intentions after intervention exposure.
Although the intervention group began with marginally higher baseline vaccine attitude scores, we found that 62% of the intervention group improved their vaccine attitude scores versus 37% of the control group (Fisher's exact, p<0.001). Among individuals whose scores improved after watching the assigned video, the intervention group saw higher mean attitude score improvements on the 5-point scale (Cohen's d=0.32 with 95% CI 0.10 to 0.54, two-sided t-test, p<0.01). We observed similar patterns among participants who stated that they had previously delayed or refused a vaccine for their child: 67% of 74 in the intervention group improved their vaccine attitude scores versus 42% of 54 in the control group (Fisher's exact, p<0.001). Among the subset of these individuals whose scores improved after watching the assigned video, the intervention group saw higher mean attitude score improvements on the 5-point scale that were marginally significant (Cohen's d=0.35 with 95% CI -0.01 to 0.70, two-sided t-test, p=0.06).
Our results provide solid evidence for the potential of co-designed vaccine confidence campaigns and regulations.
公众对疫苗的信心已经减弱，反疫苗运动在全球范围内兴起，包括在菲律宾。“Salubong”是一个菲律宾术语，指的是欢迎某人回到自己的生活中，并引发了关于友谊和家庭关系的想法。我们将这个概念扩展到疫苗上，以设计一种干预措施，将疫苗重新引入家庭。
我们使用以人为中心的设计方法，开发并完善了一种基于故事的干预措施，该措施涉及菲律宾家庭、社区领袖和社区卫生工作者。我们在 719 名幼儿照顾者中进行了一项随机对照试验，以测试开发的干预措施与对照视频相比的效果。我们评估了干预暴露后疫苗态度和意图的二元改善（改善与未改善）和改善程度。
尽管干预组在疫苗态度得分方面的基线略高，但我们发现，与对照组（Fisher 精确检验，p<0.001）相比，62%的干预组改善了他们的疫苗态度得分。在观看指定视频后分数提高的个体中，干预组在 5 分制上的平均态度得分提高幅度更高（Cohen's d=0.32，95%置信区间为 0.10 至 0.54，双侧 t 检验，p<0.01）。我们在那些表示之前曾延迟或拒绝为孩子接种疫苗的参与者中观察到类似的模式：干预组中 74 名参与者中有 67%改善了他们的疫苗态度得分，而对照组中 54 名参与者中有 42%（Fisher 精确检验，p<0.001）。在观看指定视频后分数提高的这些个体中，干预组在 5 分制上的平均态度得分提高幅度更高，但在统计学上无显著意义（Cohen's d=0.35，95%置信区间为-0.01 至 0.70，双侧 t 检验，p=0.06）。
我们的结果为精心设计的疫苗信心运动和法规提供了有力的证据。
