Dunn R A, Shenouda P E, Martin D R, Schultz A J
Department of Pediatrics, Michigan State University, East Lansing, Michigan, USA.
Pediatrics. 1998 Aug;102(2):e26. doi: 10.1542/peds.102.2.e26.
To study the effect of an educational videotape about poliovirus vaccines and choices of schedules for parents/guardians of children starting the polio vaccination series.
Prospective, randomized trial comparing two educational interventions.
Five pediatric offices (two university-based, two health maintenance organization staff models, and one private practice) and a local health department immunization clinic in the greater Lansing, MI, area.
A total of 287 parents/guardians of 2- to 3-month-olds presenting for well-child care and due for the first set of immunizations including poliovirus vaccine.
Parents/guardians were randomized to read the vaccine information statement (VIS) alone or to read the VIS and view a 15-minute videotape about polio vaccination and choices of schedules produced by Michigan State University. The intervention groups were similar by race/ethnicity, education, and relationship to the child.
Change in knowledge about the risk of poliomyelitis in the United States, transmission of poliomyelitis, characteristics of the two poliovirus vaccines, and choices of polio vaccination schedules; and parent opinion on effectiveness of the interventions, as measured by pre- and postintervention questionnaires.
Both interventions resulted in increased test scores of knowledge. However, videotape viewers scored significantly higher on their posttest compared with parents/guardians assigned to VIS only. This significant increase was noted across all practice types, two of three major racial/ethnic groups, and educational levels. (The increase for Hispanic parents/guardians approached significance). Reading the VIS did not improve posttest scores for videotape viewers. Reading the VIS did improve posttest scores for those assigned to VIS only, but these scores still were not as high as for videotape viewers who did not read the VIS.
This study demonstrated that a complicated discussion of risks/benefits of two vaccines and their schedules of administration could be communicated effectively via a videotaped presentation. In addition, the videotape was more effective than VIS alone in increasing short-term knowledge, regardless of practice type, race/ethnicity, or educational level. As immunization schedules increase in complexity and parents are asked to make more choices, videotaped information may be a better method to achieve the goal of truly informed consent.
研究关于脊髓灰质炎疫苗及接种程序选择的教育录像带对开始接种脊髓灰质炎疫苗系列的儿童的父母/监护人的影响。
比较两种教育干预措施的前瞻性随机试验。
密歇根州大兰辛地区的五家儿科诊所(两家大学附属医院、两家健康维护组织员工模式诊所和一家私人诊所)以及当地卫生部门的免疫接种诊所。
共有287名2至3个月大儿童的父母/监护人前来进行健康儿童护理并应接种包括脊髓灰质炎疫苗在内的第一组疫苗。
父母/监护人被随机分为仅阅读疫苗信息声明(VIS)组或阅读VIS并观看由密歇根州立大学制作的关于脊髓灰质炎疫苗接种及接种程序选择的15分钟录像带组。干预组在种族/民族、教育程度以及与孩子的关系方面相似。
通过干预前后的问卷测量,了解美国脊髓灰质炎风险、脊髓灰质炎传播、两种脊髓灰质炎疫苗的特点以及脊髓灰质炎接种程序选择方面的知识变化;以及父母对干预措施有效性的看法。
两种干预措施均使知识测试分数提高。然而,与仅被分配阅读VIS的父母/监护人相比,观看录像带的人在测试后的得分显著更高。在所有诊所类型、三个主要种族/民族群体中的两个以及不同教育水平中均观察到了这种显著提高。(西班牙裔父母/监护人得分增加接近显著水平)。阅读VIS对观看录像带的人测试后得分没有改善。阅读VIS对仅被分配阅读VIS的人测试后得分有改善,但这些分数仍不如未阅读VIS的观看录像带的人高。
本研究表明,关于两种疫苗的风险/益处及其接种程序的复杂讨论可以通过录像演示有效地传达。此外,无论诊所类型、种族/民族或教育水平如何,录像带在增加短期知识方面比单独的VIS更有效。随着免疫接种程序变得更加复杂且要求父母做出更多选择,录像信息可能是实现真正知情同意这一目标的更好方法。