Is the cultural context of MMR rejection a key to an effective public health discourse?
Is the cultural context of MMR rejection a key to an effective public health discourse?
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DOI：
10.1016/j.puhe.2006.03.011
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发表时间：
2006-09-01
期刊：
影响因子：
5.2
通讯作者：
Fairhead, J. R.
中科院分区：
文献类型：
--
作者：
Cassell, J. A.;Leach, M.;Fairhead, J. R.
目的：（1）探讨与麻疹、腮腺炎和风疹三联疫苗接种率低相关的社会文化因素和健康观念。(2)描述和探讨与不遵守MMR相关的健康信念的流行情况，以期在公众争议后持续低吸收的背景下，改善个人相关性和信息对父母的影响。方法：我们通过民族志研究，调查了母亲对孕产妇死亡率的经历和态度，该数据库与英国布莱顿儿童健康数据库中的母婴信息相关联。母亲通过家庭健康史中的儿童健康概念来解释MMR风险，大多数遵守者和不遵守者都认为每个孩子的免疫系统都是独一无二的。不依从的文化“风险因素”与使用补充医疗保健（如顺势疗法）密切相关，有证据表明维生素K的排斥与MMR不依从有关。百分之四十，无论是合规者和非合规者，没有考虑可能的好处，其他儿童MMR.Conclusions：这些研究结果有矛盾和挑战性的后果，促进免疫接种的政策背景下，越来越强调健康的选择。它们表明，需要免疫接种信息，承认和解决免疫的外行概念。(c)2006年，皇家公共卫生研究所。由爱思唯尔有限公司出版。保留所有权利。
Objectives: (1) To explore the social and cultural influences, and health beliefs associated with low uptake of MMR (meastes, mumps and rubella vaccine). (2) To describe and explore the prevalence of health beliefs associated with noncompliance with MMR, with a view to improving the personal relevance and impact of information for parents, in the context of persisting low uptake following public controversy.Methods: We undertook a survey of mothers' experiences of and attitudes to the MMR, developed through ethnographic study, which was linked to maternal and child information on the Child Health Database in Brighton, England.Results: Mothers interpret MMR risk through concepts of child health embedded in family health history, with a majority both of compliers and non-compliers holding that each child's immune system is unique. Cultural 'risk factors' for non-compliance relate strongly to the use of complementary healthcare, such as homeopathy, with evidence that rejection of vitamin K is associated with MMR non-compliance. Forty per cent, both of compliers and non-compliers, did not consider the possible benefits to other children of MMR.Conclusions: These findings have paradoxical and challenging consequences for the promotion of immunization in the policy context of increasing emphasis on healthy choices. They demonstrate the need for immunization information that acknowledges and addresses lay concepts of immunity. (c) 2006 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.