Sociocultural Issues in the Introduction of Human Papillomavirus Vaccine in Low-Resource Settings
Sociocultural Issues in the Introduction of Human Papillomavirus Vaccine in Low-Resource Settings
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DOI：
10.1001/archpediatrics.2009.50
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发表时间：
2009-05-01
影响因子：
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通讯作者：
LaMontagne, D. Scott
中科院分区：
文献类型：
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作者：
Bingham, Allison;Drake, Jennifer Kidwell;LaMontagne, D. Scott
目标：(1) 综合不同人群的社会文化结果，涉及疫苗决策、对宫颈癌及其病因的了解、既往疫苗接种经验、人乳头瘤病毒 (HPV) 疫苗问题以及促进接受所需的信息； (2) 根据最近的研究将发现结合起来； (3) 讨论促进疫苗接受的沟通策略的影响。设计：使用基于主题的迭代分析对 4 个国家的社会文化研究进行描述性定性综合。背景：四个发展中国家：印度、秘鲁、乌干达和越南。参与者：基于标准的 252 次焦点小组讨论样本和 470 次与儿童、家长、教师/管理人员、卫生工作者/管理人员和社区/宗教领袖的深度访谈。对越南 879 名儿童和 875 名家长进行了知识、态度和实践调查。结果：我们发现疫苗决策主要由家长完成，儿童也发挥了一定作用。对宫颈癌和 HPV 的了解有限；然而，人们认识到癌症的严重性和宫颈癌的一些症状。受访者普遍支持疫苗接种和政府资助的免疫计划。人们对宫颈癌疫苗的态度是积极的，但对分娩质量、安全性、副作用以及对生育能力的影响的担忧也有所增加。社区要求开展全面的意识提高和健康教育来解决这些问题。结论：社会文化研究有助于从儿童、家长和社区的角度阐明引入新疫苗的复杂性。引入 HPV 疫苗的策略应通过有效沟通、适当的交付和有针对性的宣传来解决社区关切，以使该计划与当地相关。 Arch Pediatr Adolesc Med。 2009年； 163(5):455-461
Objectives: (1) To synthesize sociocultural results from diverse populations related to vaccine decision-making, understanding of cervical cancer and its etiology, experience with previous vaccinations, human papillomavirus (HPV) vaccine concerns, and information needed to foster acceptance; (2) to contextualize findings in light of recent studies; and (3) to discuss implications for communication strategies to facilitate vaccine acceptance.Design: Descriptive qualitative synthesis of sociocultural studies in 4 countries using iterative theme-based analyses.Setting: Four developing countries: India, Peru, Uganda, and Vietnam.Participants: Criterion-based sample of 252 focus-group discussions and 470 in-depth interviews with children, parents, teachers/administrators, health workers/managers, and community/religious leaders. A knowledge, attitudes, and practices survey was administered to 879 children and 875 parents in Vietnam.Results: We found that vaccine decision-making was primarily done by parents, with children having some role. Understanding of cervical cancer and HPV was limited; however, the gravity of cancer and some symptoms of cervical cancer were recognized. Vaccination and government-sponsored immunization programs were generally supported by respondents. Sentiments toward cervical cancer vaccines were positive, but concerns about quality of delivery, safety, adverse effects, and the effect on fertility were raised. Communities requested comprehensive awareness-raising and health education to address these concerns.Conclusion: Sociocultural studies help elucidate the complexities of introducing a new vaccine from the perspective of children, parents, and communities. Strategies for introducing the HPV vaccine should address community concerns through effective communication, appropriate delivery, and targeted advocacy to make the program locally relevant. Arch Pediatr Adolesc Med. 2009; 163(5):455-461