基于社会生态理论模型的女大学生HPV疫苗犹豫的质性研究

Qualitative Study on HPV Vaccine Hesitancy of Female College Students Based on Social-Ecological Model

目的 应用社会生态理论模型探析女大学生对于人乳头瘤病毒(HPV)疫苗犹豫的真实感受和影响因素,为国内后续开展HPV疫苗接种干预及相关研究提供理论依据。方法 采用目的抽样法,选取2023年2-4月在嘉兴市某大学就读的17名女大学生为访谈对象,基于社会生态理论模型确定访谈提纲并进行半结构化访谈,采用主题分析法归纳分析访谈资料。结果 根据访谈结果,基于社会生态理论模型的3个层面提炼出女大学生HPV疫苗犹豫的相关因素,包括3个主题及10个亚主题。(1)微观系统层面:女大学生的HPV及HPV疫苗相关知识和认知不足(不了解HPV疫苗,认为自身感染HPV的风险低,对性经历与接种HPV疫苗关系存在误解,对HPV疫苗不信任);(2)中观系统层面:女大学生HPV疫苗接种决策和接种行为受社会环境影响(跟随同伴的行为和决策意向,听从家长建议,认为无法获得准确全面的HPV疫苗信息,受到HPV疫苗污名化舆论影响);(3)宏观系统层面:女大学生HPV疫苗接种的经济负担重及社会保障有待完善(HPV疫苗接种成本较高,HPV疫苗供应少且接种不便利)。结论女大学生普遍存在HPV疫苗犹豫,且受各层面复杂因素影响,应引起更多的关注。建议家庭、学校、社会加强相关宣传教育工作,政府也可给予相关政策支持及完善HPV疫苗接种服务体系以破解HPV疫苗接种犹豫的影响因素,调动女大学生接种疫苗的积极性,提高HPV疫苗覆盖率。

Objective To explore the true feelings and influencing factors of human papillomavirus(HPV)vaccine hesitancy among female college students using a social-ecological model,aiming to provide a theoretical basis for subsequent HPV vaccination intervention and related studies in China.Methods A total of 17 female college students who studied at a university in Jiaxing from February to April 2023 were selected by purposive sampling to receive interviews.The interview outline was determined based on the social-ecological model,then semi-structured interviews were conducted and thematic analysis was conducted with interview data.Results According to the interview results,the factors contributing to HPV vaccine hesitancy of female college students were extracted based on the 3 aspects of the social-ecological model,including 3 themes and 10 sub-themes.(1) Microsystem:Lack of understanding of HPV and HPV vaccine among female college students(They do not understand the HPV vaccine,believe they are at low risk of HPV infection,misunderstand the relationship between sexual experience and HPV vaccination,and distrust the vaccine's efficacy);(2) Mesosystem:Influence of social environment on female college students' HPV vaccination decisions and behaviors(They tend to follow the behaviors and decisions of their peers,listen to the suggestions of their parents,feel it challenging to access accurate and comprehensive information about HPV vaccine and are swayed by public opinion that may stigmatize the vaccine);(3) Macrosystem:Heavy economic burden and incomplete social security associated with HPV vaccination for female college students(The cost of HPV vaccination is high,the supply of HPV vaccine is limited and getting vaccinated can be inconvenient).Conclusion Female college students are generally hesitant to receive HPV vaccination due to a range of complex factors.This issue requires increased attention and understanding.Families,schools and society should enhance education on HPV while the government can provide relevant policy support and improve the HPV vaccination service system.These efforts aim to address factors contributing to HPV vaccine hesitancy and encourage female college students to get vaccinated,thereby increasing HPV vaccination coverage.