Understanding attitudes toward adolescent vaccination and the decision-making dynamic among adolescents, parents and providers
Understanding attitudes toward adolescent vaccination and the decision-making dynamic among adolescents, parents and providers
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DOI：
10.1186/1471-2458-12-509
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发表时间：
2012-07-07
影响因子：
4.5
通讯作者：
Dempsey, Amanda F.
中科院分区：
文献类型：
--
作者：
Gowda, Charitha;Schaffer, Sarah E.;Dempsey, Amanda F.
背景资料：随着一些新的疫苗建议专门针对青少年，提高青少年疫苗接种率已成为一个主要的卫生优先事项。疫苗接种态度是新干预措施的一个重要、可改变的目标。先前的研究主要研究了青少年，父母或医疗保健提供者的态度和信仰，而没有探索这些利益相关者之间的决策动态。我们试图找出潜在的修改障碍，在疫苗的决定过程中，青少年，家长和医疗服务提供者，可以通过实施干预措施，在青少年的medical home.Methods：我们进行了一项定性研究的青少年，他们的父母和医疗服务提供者，从四个初级保健的做法在密歇根州招募。对于每一种做法，进行了三个单独的焦点小组讨论（青少年，家长和医疗保健提供者，共12个焦点小组），以探讨疫苗接种的态度，可能的干预措施，以提高疫苗的吸收和获得和使用的技术进行疫苗接种干预。从焦点小组讨论中出现的主题进行了分类，使用归纳，迭代的过程中，和分析重点突出的三个perspectives.Results之间的相似性和差异：参与者包括32名青少年，33名家长和28个供应商。大多数父母和青少年是女性。三个群体普遍认识到缺乏对推荐的青少年疫苗接种的了解，并认为这是免疫接种率低的根本原因。值得注意的是，每个群体似乎都没有充分认识到其他利益攸关方在青少年疫苗接种方面面临的挑战。青少年被认为在疫苗决策动态中发挥的作用比以前所建议的更大。提供者为基础的干预措施，如教育工具和疫苗召回通知被确定为任何免疫接种计划的重要组成部分。总体而言，有很高的接受度，所有利益相关者对整合技术，如电子邮件和互联网到新的疫苗接种interventions.Conclusions：我们确定了潜在的可修改的态度障碍，青少年疫苗接种的三个关键利益相关者。然而，在这三个方面的态度和偏好存在着明显的差异，这表明干预措施要取得成功，就需要与目标受众建立积极的伙伴关系。
Background: With several new vaccine recommendations specifically targeting adolescents, improving adolescent vaccination rates has become a major health priority. Vaccination attitudes are an important, modifiable target for new interventions. Prior research has examined primarily the attitudes and beliefs of adolescents, parents or healthcare providers separately without exploring the decision-making dynamic among these stakeholders. We sought to identify potentially modifiable barriers in the vaccine decision process among adolescents, parents and healthcare providers that could be addressed through interventions implemented within the adolescent's medical home.Methods: We conducted a qualitative study of adolescents, their parents and healthcare providers, recruited from four primary care practices in Michigan. For each practice, three separate focus group discussions (adolescents, parents and healthcare providers, for a total of 12 focus groups) were conducted to explore vaccination attitudes, possible interventions to improve vaccine uptake and access to and use of technology for vaccination interventions. Themes that emerged from the focus group discussions were categorized using an inductive, iterative process, and analysis focused on highlighting similarities and differences among the three perspectives.Results: Participants included 32 adolescents, 33 parents and 28 providers. The majority of parents and adolescents were female. Lack of knowledge about recommended adolescent vaccinations was universally recognized among the three groups and was perceived to be the underlying driver of low immunization rates. Notably, each group did not appear to fully appreciate the challenges faced by the other stakeholders with respect to adolescent vaccination. Adolescents were seen as having a greater role in the vaccine decision-making dynamic than previously suggested. Provider-based interventions such as educational tools and reminder-recall notices were identified as important components of any immunization program. Overall, there was high receptivity among all stakeholders toward integrating technology such as email and Internet into new vaccination interventions.Conclusions: We identified potentially modifiable attitudinal barriers to adolescent vaccination among the three key stakeholders. However, there were notable differences in attitudes and preferences across the three perspectives, indicating that for an intervention to be successful it will require a dynamic partnership with the target audiences.