A randomized trial of maternal influenza immunization decision-making: A test of persuasive messaging models
A randomized trial of maternal influenza immunization decision-making: A test of persuasive messaging models
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DOI：
10.1080/21645515.2016.1199309
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发表时间：
2016-01-01
影响因子：
4.8
通讯作者：
Omer, Saad B.
中科院分区：
文献类型：
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作者：
Frew, Paula M.;Kriss, Jennifer L.;Omer, Saad B.
目的：我们试图检验在佐治亚州亚特兰大市的黑人/非裔美国孕妇中说服性沟通干预对流感疫苗接种的有效性。方法：2013年1月至4月，我们从乔治亚州亚特兰大招募了年龄在18至50岁的黑人/非裔美国孕妇，参与了一项流感免疫信息传递的前瞻性随机对照试验。符合条件的参与者被随机分为3个研究组。我们对所有组在产后30天进行流感免疫接种随访问卷调查。卡方检验和t检验评估组间差异，结果意向治疗评估采用对数二项回归模型。结果：在106名参与者中，95名女性完成了研究（90%的保留率），其中31人被随机分配到情感信息干预组（怀孕暂停视频），30人被随机分配到认知信息干预组（健康怀孕疫苗视频），34人被分配到比较条件组（收到流感疫苗信息声明）。这三组在基线人口统计学特征和报告的健康行为上是平衡的。在基线时，大多数妇女（63%,n = 60）报告在过去5年内未接受季节性流感免疫接种。她们表示在当前怀孕期间获得流感免疫接种的可能性很低（0-10评分为2.1 +/- 2.8）。在产后30天的随访中，流感免疫接种在所有参与者中都很低（7-13%），表明在单次接触情感信息（RR = 1.10; 95% CI: 0.30-4.01）或认知信息干预（RR = 0.57; 95% CI: 0.11-2.88）后没有效果。妇女们列举了不接种流感疫苗的各种原因。其中包括担心疫苗危害（47%,n = 40），低流感感染风险（31%,n = 26）和未接种疫苗史（24%,n = 20）。结论：研究结果反映了单一接触不同的孕产妇流感免疫信息方法对疫苗行为的局限性。对于这一人群，重复流感免疫暴露可能需要改变信息格式、内容和相关性，以提高覆盖率。
Objective: We sought to examine the effectiveness of persuasive communication interventions on influenza vaccination uptake among black/African American pregnant women in Atlanta, Georgia. Methods: We recruited black/African American pregnant women ages 18 to 50 y from Atlanta, GA to participate in a prospective, randomized controlled trial of influenza immunization messaging conducted from January to April 2013. Eligible participants were randomized to 3 study arms. We conducted follow-up questionnaires on influenza immunization at 30-days post-partum with all groups. Chi-square and t tests evaluated group differences, and outcome intention-to-treat assessment utilized log-binomial regression models. Results: Of the 106 enrolled, 95 women completed the study (90% retention), of which 31 were randomly assigned to affective messaging intervention (Pregnant Pause video), 30 to cognitive messaging intervention (Vaccines for a Healthy Pregnancy video), and 34 to a comparison condition (receipt of the Influenza Vaccine Information Statement). The three groups were balanced on baseline demographic characteristics and reported health behaviors. At baseline, most women (63%, n = 60) reported no receipt of seasonal influenza immunization during the previous 5 y. They expressed a low likelihood (2.1 +/- 2.8 on 0-10 scale) of obtaining influenza immunization during their current pregnancy. At 30-days postpartum follow-up, influenza immunization was low among all participants (7-13%) demonstrating no effect after a single exposure to either affective messaging (RR = 1.10; 95% CI: 0.30-4.01) or cognitive messaging interventions (RR = 0.57; 95% CI: 0.11-2.88). Women cited various reasons for not obtaining maternal influenza immunizations. These included concern about vaccine harm (47%, n = 40), low perceived influenza infection risk (31%, n = 26), and a history of immunization nonreceipt (24%, n = 20). Conclusion: The findings reflect the limitations associated with a single exposure to varying maternal influenza immunization message approaches on vaccine behavior. For this population, repeated influenza immunization exposures may be warranted with alterations in message format, content, and relevance for coverage improvement.