Chen Siyu, Wang Shuyi, Cheung Doug H, Fang Yuan, Sun Fenghua, Mo Phoenix K H, Wang Zixin
Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong.
Appl Psychol Health Well Being. 2025 May;17(2):e70022. doi: 10.1111/aphw.70022.
Vaccine hesitancy remains a significant public health challenge globally, requiring innovative, evidence-based approaches to improve uptake. This systematic review and meta-analysis evaluated the effectiveness of stage-of-change (SOC)-tailored interventions, the customized strategies based on an individual's readiness for behavioral changes, in promoting vaccination uptake. Data were synthesized from randomized controlled trials (RCTs), quasi-experimental, and non-experimental studies identified through MEDLINE, PubMed, Web of Science, Embase, Global Health, and APA PsycInfo databases. Five eligible studies published between 2004 and 2023 were included, with three RCTs and one quasi-experimental study contributing to the meta-analysis. The pooled standard mean difference (SMD) for vaccination uptake was 0.54 (95% confidence interval [CI]: 0.49, 0.59, p < .001), indicating a significant medium effect size with no heterogeneity (I = 0%, p = .88). Subgroup analyses showed SOC-tailored interventions were particularly effective for older adults (SMD = 0.57, 95% CI: 0.22 to 0.92, p = .03) and for parents or caregivers to increase children's vaccination uptake (SMD = 0.53, 95% CI: 0.32 to 0.74, p = .02). These findings provided preliminary evidence on the effectiveness of SOC-tailored interventions in addressing vaccine hesitancy. Future research should explore geographically diverse settings and cost-effective delivery methods to maximize the impact.
疫苗犹豫仍然是全球重大的公共卫生挑战,需要采用创新的、基于证据的方法来提高疫苗接种率。本系统评价和荟萃分析评估了基于行为改变阶段(SOC)的量身定制干预措施(即根据个体行为改变的准备程度制定的策略)在促进疫苗接种方面的有效性。数据来自通过MEDLINE、PubMed、科学网、Embase、全球卫生和美国心理学会心理学文摘数据库检索到的随机对照试验(RCT)、准实验和非实验研究。纳入了2004年至2023年发表的五项符合条件的研究,其中三项RCT和一项准实验研究纳入了荟萃分析。疫苗接种的合并标准平均差(SMD)为0.54(95%置信区间[CI]:0.49,0.59,p < .001),表明有显著的中等效应量且无异质性(I = 0%,p = .88)。亚组分析表明,基于SOC的量身定制干预措施对老年人(SMD = 0.57,95%CI:0.22至0.92,p = .03)以及对提高儿童疫苗接种率的父母或照顾者特别有效(SMD = 0.53,95%CI:0.32至0.74,p = .02)。这些发现为基于SOC的量身定制干预措施在解决疫苗犹豫问题方面的有效性提供了初步证据。未来的研究应探索不同地理区域的情况和具有成本效益的实施方法,以最大限度地扩大影响。