School of Public Health, Fudan University, Shanghai, China.
Hum Vaccin Immunother. 2024 Dec 31;20(1):2389578. doi: 10.1080/21645515.2024.2389578. Epub 2024 Aug 22.
Vaccination decisions are influenced by various psychological and practical factors. In China, non-National Immunization Program (non-NIP) vaccines, which are voluntary and self-paid, add uncertainty and autonomy to the decision-making process. Effective communication between providers and recipients is crucial but understudied. This study aims to integrate their perspectives, identify strategies for facilitating vaccination decisions, and analyze their mechanisms. From July to December 2023, semi-structured interviews were conducted with 17 caregivers and 12 vaccination providers across five Chinese provinces. Participants shared their experiences and decision-making processes regarding non-NIP vaccines. The Behaviour Change Wheel framework guided the analysis, utilizing iterative coding and directed content analysis. Thirteen Behavior Change Techniques were identified, with feedback, monitoring, and environmental restructuring being the most common. Key intervention functions included Persuasion, Education, and Training. We further mapped how these interventions influence non-NIP vaccine decisions. Capability was enhanced through education and effective communication, providing necessary knowledge and skills. Opportunity was increased via infrastructural improvements and societal support, making vaccines more accessible and endorsed by the community. Motivation was driven by clear communication of vaccination benefits and risks, reinforced by societal norms through public health messaging. By understanding the mechanisms influencing vaccination behaviors and interacting with stakeholders, tailored strategies can be developed. Healthcare providers can enhance service accessibility and offer evidence-based guidance with reminders, monitoring, and incentives to ensure compliance. For recipients, reliable information, sustained engagement, timely communication, and motivational opportunities are essential. A multi-dimensional approach involving multiple stakeholders is crucial for promoting non-NIP vaccine uptake.
疫苗接种决策受到各种心理和实际因素的影响。在中国，非国家免疫规划（NIP）疫苗是自愿和自费的，这给决策过程增加了不确定性和自主性。提供者和接受者之间的有效沟通至关重要，但研究不足。本研究旨在整合他们的观点，确定促进疫苗接种决策的策略，并分析其机制。2023 年 7 月至 12 月，在中国五个省份，对 17 名照顾者和 12 名疫苗接种提供者进行了半结构化访谈。参与者分享了他们在非 NIP 疫苗方面的经验和决策过程。行为改变车轮框架指导了分析，利用迭代编码和有针对性的内容分析。确定了 13 种行为改变技术，其中反馈、监测和环境重构最为常见。主要干预功能包括说服、教育和培训。我们进一步绘制了这些干预措施如何影响非 NIP 疫苗决策。通过教育和有效的沟通增强能力，提供必要的知识和技能。通过基础设施改善和社会支持增加机会，使疫苗更易获得并得到社区的认可。通过清楚地沟通疫苗的益处和风险来推动动机，通过公共卫生信息传递强化社会规范。通过了解影响疫苗接种行为的机制并与利益相关者互动，可以制定有针对性的策略。医疗保健提供者可以通过提醒、监测和激励措施来提高服务的可及性，并提供基于证据的指导，以确保遵守规定。对于接受者，可靠的信息、持续的参与、及时的沟通和激励机会至关重要。涉及多个利益相关者的多维度方法对于促进非 NIP 疫苗接种至关重要。
