Centre for Digital Public Health in Emergencies, Department for Risk and Disaster Reduction, University College London, London, United Kingdom.
JMIR Form Res. 2024 Oct 24;8:e55706. doi: 10.2196/55706.
University students, who often live in close quarters and engage in frequent social interaction, face a heightened risk of influenza morbidity. Still, vaccination rates among this group, particularly Chinese students, remain consistently low due to limited awareness and insufficient access to vaccinations.
This study examines the effectiveness of a cocreated WeChat-based intervention that targets mainland Chinese university students in the United Kingdom, aiming to improve their knowledge, attitude, and behavior (KAB) toward seasonal influenza vaccination.
A quasi-experimental mixed methods design was used, incorporating an intervention and comparison group, with baseline and follow-up self-reported surveys. The study was conducted from December 19, 2022, to January 16, 2023. The primary outcome is the KAB score, which was measured before and after the intervention phases. System-recorded data and user feedback were included in the analysis as secondary outcomes. A series of hypothesis testing methods were applied to test the primary outcomes, and path analysis was used to explore the relationships.
Our study included 596 students, of which 303 (50.8%) were in the intervention group and 293 (49.2%) were in the control group. The intervention group showed significant improvements in knowledge, attitude, and intended behavior scores over time, whereas the control group had only a slight increase in intended behavior scores. When comparing changes between the 2 groups, the intervention group displayed significant differences in knowledge and attitude scores compared to the control group, while intended behavior scores did not significantly differ. After the intervention, the actual vaccination rate was slightly higher in the intervention group (63/303, 20.8%) compared to the control group (54/293, 18.4%). Path analysis found that the intervention had a significant direct impact on knowledge but not on attitudes; knowledge strongly influenced attitudes, and both knowledge and attitudes significantly influenced intended behavior; and there was a strong correlation between intended and actual behavior. In the intervention group, participants expressed a high level of satisfaction and positive review of the content and its use.
This study demonstrates how a WeChat intervention effectively improves KAB related to seasonal influenza vaccination among Chinese students, highlighting the potential of social media interventions to drive vaccination behavior change. It contributes to the broader research on digital health intervention effectiveness and lays the groundwork for tailoring similar interventions to different health contexts and populations.
大学生通常居住在相对封闭的环境中，并进行频繁的社交互动，因此他们患流感的风险较高。然而，由于缺乏意识和疫苗接种机会有限，该群体（尤其是中国留学生）的疫苗接种率一直较低。
本研究旨在评估一种针对在英中国大陆大学生的、基于微信的共创干预措施的有效性，以提高他们对季节性流感疫苗接种的知识、态度和行为（KAB）。
本研究采用准实验混合方法设计，包括干预组和对照组，在基线和随访时进行自我报告调查。研究于 2022 年 12 月 19 日至 2023 年 1 月 16 日进行。主要结局指标是 KAB 评分，在干预前后进行测量。系统记录的数据和用户反馈也被纳入分析作为次要结局指标。我们应用了一系列假设检验方法来检验主要结局指标，并使用路径分析来探讨其中的关系。
本研究共纳入 596 名学生，其中 303 名（50.8%）在干预组，293 名（49.2%）在对照组。干预组的知识、态度和意向行为评分随着时间的推移显著提高，而对照组的意向行为评分仅略有增加。当比较两组之间的变化时，干预组在知识和态度评分方面与对照组有显著差异，而意向行为评分则没有显著差异。干预后，干预组的实际接种率（63/303，20.8%）略高于对照组（54/293，18.4%）。路径分析发现，干预对知识有显著的直接影响，但对态度没有影响；知识强烈影响态度，知识和态度都对意向行为有显著影响；意向行为和实际行为之间存在很强的相关性。在干预组中，参与者对内容及其使用表示高度满意和积极评价。
本研究证明了微信干预措施如何有效地提高中国学生对季节性流感疫苗接种的 KAB，突显了社交媒体干预措施在推动疫苗接种行为改变方面的潜力。它为数字健康干预措施的有效性研究做出了贡献，并为在不同健康背景和人群中定制类似的干预措施奠定了基础。
