"健康教育+信息提示"对提高儿童流感疫苗接种率的效果:一项基于北京市8所幼儿园的社区试验

Effectiveness of"health education plus message reminder"to improve influenza vaccination coverage among children:a community trial in eight kindergartens in Beijing

目的评估"健康教育+信息提示"对提高幼儿园儿童流感疫苗接种率的效果。方法2015—2016流感流行季在北京市东城区和西城区分别随机4所幼儿园,将全部2443名儿童的家长作为调查对象。将8所幼儿园随机分为干预组和对照组,只给予干预组"健康教育+信息提示"的干预措施。主要结局为干预前后儿童接种流感疫苗行为的变化。应用logistic回归模型分析儿童接种流感疫苗行为变化的影响因素。结果两次均应答者2041人,有效应答率为83.5%。在干预前后,干预组接种率分别为0.4%(4/1067)和2.9%(31/1067),对照组分别为0.8%(8/974)和0.9%(9/974)。干预组接种行为变好、不变和变差者分别占2.8%(30/1067)、96.9%(1034/1067)和0.3%(3/1067),对照组分别占0.7%(7/974)、98.7%(961/974)和0.6%(6/974)。logistic回归模型结果显示,干预组(OR=3.804,P=0.007)、家长知道接种时间地点(OR=2.864,P<0.01)的儿童流感疫苗接种行为变好的可能性更高。结论"健康教育+信息提示"的干预措施能够提高幼儿园儿童流感疫苗接种率,但效果欠佳。

Objective To access the effectiveness of "health education plus message reminder" to improve influenza vaccination coverage among children in the kindergarten.Methods From Dongcheng district and Xicheng district of Beijing, four kindergartens were randomly selected in each district, during the 2015-2016 influenza season. The guardians of all 2 443 children in the 8 kindergartens were recruited as research subjects. The kindergartens were randomly divided into the intervention group and the control group. The measures of "health education plus message reminder" were only applied to the intervention group. The main outcome was the change of children’s influenza vaccination behavior. Logistic regression model was used to identify influencing factors of the changes in influenza vaccination behaviors among children.Results A total of 2 041 participants completed the two surveys, with the response rate of 83.5%. The vaccine coverage rates before and after the intervention measures were 0.4% (4/1 067) and 2.9% (31/1 067) in the intervention group, and 0.8% (8/974) and 0.9% (9/974) in the control group, respectively. After the intervention, percentages of participants who had better, unchanged and worse behaviors in accepting influenza vaccine were 2.8% (30/1 067), 96.9% (1 034/1 067) and 0.3% (3/1 067) in the intervention group, and were 0.7% (7/974), 98.7% (961/974) and 0.6% (6/974) in the control group, respectively. The logistic regression model showed that higher possiblity of better influenza vaccination behaviors among children in the intervention group (OR=3.804, P=0.007) and parents knew the time and place of vaccination (OR=2.864, P<0.001).Conclusions The measures of "health education plus message reminder" improved influenza vaccination coverage among children in the kindergarten, but the effectiveness was unsatisfactory.