基于KAP理论的二类疫苗接种行为结构方程模型

Structural equation model analysis of categoryⅡvaccine behavior based on knowledge-attitude-practice theory

目的调查贵州省学龄儿童家长的二类疫苗接种知识、态度和行为,探索其影响因素,为促进二类疫苗接种提供建议。方法采用分层抽样的方法,在贵州省铜仁市选择1个区和1个县的若干小学作为抽样地点,使用结构化问卷对纳入的儿童家长进行面对面调查,利用结构方程模型探究儿童家长对二类疫苗的知识、态度和接种行为的关系。结果共计收到有效问卷517份,接种组家长对于二类疫苗效果知识问题回答正确率高于未接种组,接种组家长更认同二类疫苗的作用和功效,未接种组家长更担心二类疫苗的风险问题。家长受教育程度越高(γ=0.266)越赞同疫苗的效果(β=0.469)、越反对疫苗的风险(β=0.398),会促进二类疫苗的接种行为;家长的受教育程度负向影响家长对于疫苗效果的态度(γ=-0.725)。结论应当关注受教育程度低的家长,帮助他们正确理解二类疫苗相关知识;对于文化程度较高的家长,应侧重二类疫苗安全性和有效性的宣讲,打消家长过分对疫苗效果和安全性的质疑,促进二类疫苗接种。

Objective To provide suggestions for promoting the practice of categoryⅡvaccine,the knowledge,attitude,practice(KAP)as well as impact factors of categoryⅡvaccine among parents of school-aged children in Tongren City,Guizhou Province were assessed.Methods Stratified sampling was used to select several primary schools in one district and one country of Tongren City,Guizhou Province.A structured questionnaire was used to investigate the parents′KAP of categoryⅡvaccine and the structural equation model was used to explore the association of parents′KAP.Results A total of 517 valid questionnaires were received in this study.Parents in the vaccinated group had a higher rate of correct answers to questions about the effectiveness of categoryⅡvaccine than those in the unvaccinated group.Parents in the vaccinated group were more likely to agree on the effectiveness of categoryⅡvaccine,while parents in the unvaccinated group were more concerned about the risk of categoryⅡvaccine.Higher parental educational level(γ=0.266),higher agreement on the effectiveness of the vaccine(β=0.469),and opposition to the risks of the vaccine promoted vaccination behavior for the categoryⅡvaccine(β=0.398);parental education negatively affected parental attitudes toward the effects of the vaccine(γ=-0.725).Conclusions Attention should be paid to poorly educated parents to help them properly understand knowledge about categoryⅡvaccine.For parents with higher education level,emphases should be placed on the explanation of the safety and effectiveness of categoryⅡvaccine,in order to dispel parents′doubts and promote practice of categoryⅡvaccines.