Labbé Sara, Bacon Simon L, Wu Nana, Ribeiro Paula A B, Boucher Vincent Gosselin, Stojanovic Jovana, Voisard Brigitte, Deslauriers Frédérique, Tremblay Noémie, Hébert-Auger Lydia, Lavoie Kim L
Department of Psychology, University of Quebec at Montreal (UQAM), CP 8888, Succursale Centre-Ville, Montreal, Quebec H3C 3P8, Canada.
Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l'Ile-de-Montréal (CIUSSS-NIM), Montreal H4J 1C5, Canada.
Transl Behav Med. 2025 Jan 16;15(1). doi: 10.1093/tbm/ibae069.
Traditional approaches to increase vaccination rely upon educating patients about vaccines. However, research shows that "knowing" vaccines are important is often insufficient: patients need to believe that getting vaccinated is important. Evidence-based motivational approaches, such as motivational interviewing/communication (MI/MC), have become increasingly popular for promoting good health behaviors, including vaccination. The objective of this review was to compare the efficacy of educational and MI/MC interventions on vaccination rates relative to each other and to usual/standard care. Pubmed, PsycINFO, and Cochrane trials databases were searched to identify articles that assessed vaccination rates post-patient education or MI/MC vaccine counseling in the context of adult or child vaccination (PROSPERO: CRD42019140255). Following the screening, 118 studies were included (108 educational and 10 MI/MC). The pooled effect sizes for vaccination rates corresponded to 52% for educational interventions (95% CI: 0.48-0.56) and 45% for MI/MC interventions (95% CI: 0.29-0.62) (P = .417). Fifty-nine randomized controlled studies (55 educational and 4 MI/MC) showed that, compared with usual/standard of care, exposure to education and MI/MC was associated with a 10% (RR =1.10; 95% CI =1.03-1.16, P = .002) and 7% (RR =1.07; 95% CI =0.78-1.45, P = .691) increased likelihood of getting vaccinated, respectively. Results suggest comparable efficacy of educational and MI/MC interventions on vaccination uptake and a small superiority of educational interventions compared with usual/standard of care. The overall poor quality of the studies, including lack of fidelity assessments of MI/MC studies, contributes to low confidence in the results and highlights the need for better quality intervention trials examining the efficacy of MI/MC for vaccine uptake.
提高疫苗接种率的传统方法依赖于对患者进行疫苗知识教育。然而，研究表明，仅仅“知道”疫苗很重要往往是不够的：患者需要相信接种疫苗是重要的。基于证据的激励方法，如动机性访谈/沟通（MI/MC），在促进包括疫苗接种在内的良好健康行为方面越来越受欢迎。本综述的目的是比较教育干预和MI/MC干预相对于彼此以及相对于常规/标准护理在疫苗接种率方面的效果。检索了PubMed、PsycINFO和Cochrane试验数据库，以识别在成人或儿童疫苗接种背景下评估患者教育或MI/MC疫苗咨询后疫苗接种率的文章（国际前瞻性注册系统：CRD42019140255）。筛选后，纳入了118项研究（108项教育干预研究和10项MI/MC研究）。教育干预的疫苗接种率合并效应量为52%（95%置信区间：0.48 - 0.56），MI/MC干预的为45%（95%置信区间：0.29 - 0.62）（P = 0.417）。59项随机对照研究（55项教育干预研究和4项MI/MC研究）表明，与常规/标准护理相比，接受教育干预和MI/MC干预后接种疫苗的可能性分别增加了10%（风险比 = 1.10；95%置信区间 = 1.03 - 1.16，P = 0.002）和7%（风险比 = 1.07；95%置信区间 = 0.78 - 1.45，P = 0.691）。结果表明教育干预和MI/MC干预在疫苗接种率方面效果相当，且教育干预相对于常规/标准护理有小幅优势。这些研究的总体质量较差，包括缺乏对MI/MC研究的保真度评估，这导致对结果的信心较低，并突出了需要进行质量更高的干预试验来检验MI/MC对疫苗接种效果的必要性。
