基于健康信念模型的小学生狂犬病疫苗接种意愿及影响因素分析

Analysis on factors of rabies vaccination willingness of primary school students based on health belief model

目的了解北京市小学生狂犬病暴露情况、狂犬病疫苗接种意愿及其影响因素。方法采用方便抽样方法在北京市选取2所小学共263名学生,基于健康信念模型(health belief model,HBM)自编问卷对其狂犬病暴露情况、疫苗接种意愿进行调查。结果研究对象中21.48%有狂犬病暴露史。郊区学生感知行为益处差异有统计学意义(Z=-2.210,P<0.05)、感知行为障碍差异有统计学意义(Z=-2.375,P<0.05)、提示因素得分差异有统计学意义(Z=-2.005,P<0.05),均高于城区。接触猫狗频率>2次/周的学生提示因素得分最高,差异有统计学意义(χ^(2)=11.344,P<0.05)。未来二级暴露后狂犬病疫苗接种意愿为89.45%,Logistic回归分析显示感知疾病易感性得分高(OR=1.562)、有暴露史(OR=5.081)的二级暴露后疫苗接种意愿高。结论北京市小学生狂犬病暴露情况仍较严重,狂犬病二级暴露后的疫苗接种意愿较低,感知疾病易感性和有狂犬病暴露史是愿意接种疫苗的保护因素,未来可基于HBM加强健康教育,重点强调疾病的易感性,并且重点关注尚无狂犬病暴露史的人群。

Objective To analyze the exposure situation,vaccination willingness and factors of rabies among primary school students in Beijing.Methods A total of 263 students from 2 primary schools in Beijing were selected by convenience sampling,self-developed questionnaire based on the health belief model(HBM)was used to investigate the exposure and rabies vaccination willingness of students.Results The 21.48%students among research subjects were found to have the history of exposure to rabies.The differences in perceived behavioral benefits among suburban students were statistically significant(Z=-2.210,P<0.05),and the differences in perceived behavioral barriers were statistically significant(Z=-2.375,P<0.05),the difference in the factor score was statistically significant(Z=-2.005,P<0.05),and both such factors were higher than such indexes of urban areas students.The frequency of students exposed to cats or dogs greater than twice weekly had maximum score,and the difference was statistically significant(χ^(2)=11.344,P<0.05).The rate of students′vaccination willingness after gradeⅡexposure was 89.45%.Multiple Logistic regression analysis showed that the vaccination willingness of students with maximum scores(OR=1.562)in perceived susceptibility and a history of exposure rabies(OR=5.081)after gradeⅡexposure was maximum.Conclusion The situation of rabies exposure of primary school students in Beijing remains being severe,and vaccination willingness after gradeⅡexposure to rabies is not satisfactory,the perception of disease susceptibility and rabies exposure history are protective factors for people′s willing to be vaccinated.The health education is advised to be strengthened based on HBM with emphasis on disease susceptibility and people without rabies exposure history in the future.