Patey Andrea M, Amarbayan Mungunzul M, Lee Kate, Bruce Marcia, Bettinger Julie A, Pringle Wendy, Donald Maoliosa, Castillo Eliana
Centre for Implementation Research, Ottawa Hospital Research Institute, ON, Canada.
School of Epidemiology and Public Health, University of Ottawa, ON, Canada.
JBI Evid Implement. 2025 Apr 1;23(2):201-230. doi: 10.1097/XEB.0000000000000460.
Vaccination during pregnancy is recommended but uptake is low and evidence on the topic is limited.
This study aimed to identify the drivers of current behavior and barriers to change for health care practitioners (HCPs) and pregnant patients in Canada.
This study is an in-depth qualitative investigation of the factors influencing HCPs' vaccination communication during pregnancy, as well as factors influencing pregnant patients' vaccination uptake in Canada using the Theoretical Domains Framework. Three data sources were used: (1) perinatal HCP interviews before COVID-19; (2) perinatal HCP interviews regarding vaccine communication after COVID-19; and (3) survey of pregnant or lactating women after COVID-19.
Forty-seven interviews and 169 participant responses were included. Perinatal HCPs reported limited information on vaccine communication or difficulty keeping up-to-date ( Environmental context and resources ; Knowledge; Beliefs about capabilities ). HCPs lacked confidence and struggled with lack of training to address vaccine hesitancy without alienating patients ( Beliefs about capabilities; Skills ). Pregnant or lactating women struggled with the amount of information they felt was imposed on them, had concerns about the perceived negative consequences of vaccination, and felt pressure to understand what was best for them and their babies ( Knowledge; Beliefs about consequences; Social influences ).
Our study provides a theory-based approach to identify influencing factors that can be mapped to theory-based intervention components, improving the likelihood of intervention effectiveness. The study is the first step in adapting an existing intervention to improve vaccine communication during pregnancy, ultimately, increasing vaccination uptake.
建议在孕期进行疫苗接种,但接种率较低,且关于该主题的证据有限。
本研究旨在确定加拿大医疗保健从业者(HCPs)和孕妇当前行为的驱动因素以及改变的障碍。
本研究是一项深入的定性调查,使用理论领域框架探讨影响加拿大孕期HCPs疫苗接种沟通的因素,以及影响孕妇疫苗接种率的因素。使用了三个数据源:(1)COVID-19之前围产期HCPs的访谈;(2)COVID-19之后围产期HCPs关于疫苗沟通的访谈;以及(3)COVID-19之后对孕妇或哺乳期妇女的调查。
纳入了47次访谈和169份参与者回复。围产期HCPs报告称,关于疫苗接种沟通的信息有限,或难以跟上最新情况(环境背景与资源;知识;对能力的信念)。HCPs缺乏信心,且在缺乏培训以解决疫苗犹豫问题同时又不疏远患者方面存在困难(对能力的信念;技能)。孕妇或哺乳期妇女对她们认为强加给她们的信息量感到困扰,担心疫苗接种的感知负面后果,并感到有压力去了解什么对自己和宝宝是最好的(知识;对后果的信念;社会影响)。
我们的研究提供了一种基于理论的方法来识别影响因素,这些因素可映射到基于理论的干预组件,提高干预有效性的可能性。该研究是调整现有干预措施以改善孕期疫苗接种沟通的第一步,最终提高疫苗接种率。