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Qu S, Zhou M, Campy KS, He W. Predictors of parental acceptance to live attenuated influenza vaccine for children. Hum Vaccin Immunother 2024; 20:2356343. [PMID: 38835204 PMCID: PMC11155699 DOI: 10.1080/21645515.2024.2356343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 05/14/2024] [Indexed: 06/06/2024] Open
Abstract
To determine the influencing factors of Chinese parents' intention and behavior for children to receive live attenuated influenza vaccine during the 2022-2023 influenza season. A theoretical model was developed and included seven constructs, and structural equation modeling was used to test 11 hypotheses. From October 2022 to December 2023, a survey was conducted across 38 medical institutions in four Chinese cities and their subordinate districts, counties, and rural areas. Parents who accompanied their children for vaccinations were selected through a randomization process based on their child's medical card numbers. Measures were taken to minimize method bias, including a diverse geographical representation and random sampling. The survey resulted in the collection of 936 valid responses, exceeding the recommended sample size for structural equation model analysis and providing robust statistical inferences. During the study period, 936 respondents were included in the study. Perceived ease of use was verified to be a predictor of perceived usefulness and perceived value. Perceived usefulness was verified as a predictor of perceived value and behavioral intention. Knowledge was a significant antecedent of perceived value and risk perception of influenza disease. Risk perception of influenza disease was proved to be a significant predictor of perceived value and self-reported vaccination behavior. Perceived value significantly affected behavioral intention, and behavioral intention significantly affected self-reported vaccination behavior. Six demographic variables significantly moderate the theoretical models. The low vaccination coverage of live attenuated influenza vaccine (LAIV) among children in China suggests a need for a deeper understanding of the factors that influence vaccination rates. Particularly, effective strategies are necessary from policymakers and practitioners to elevate childhood LAIV coverage.
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Affiliation(s)
- Shujuan Qu
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Min Zhou
- School of Business Administration, Hunan University of Technology and Business, Changsha, China
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Kathryn S. Campy
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
| | - Wei He
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
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Juaneda J, Estrella-Porter P, Blanco-Calvo C, Orrico-Sánchez A, Lluch-Rodrigo JA, Pastor-Villalba E. Enhanced Timeliness and Co-Administration of Meningitis B Vaccination in Children: Impact of Funding in Valencian Community, Spain. Vaccines (Basel) 2024; 12:623. [PMID: 38932352 PMCID: PMC11209211 DOI: 10.3390/vaccines12060623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/03/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
Public funding of vaccines may enhance vaccination rates, co-administration, and timeliness. The impacts of including the serogroup B meningococcus vaccine (MenB) into the national immunisation schedule on vaccination rates, co-administration rates, and timeliness were assessed using a population-based pre-funding (2022) and post-funding (2023) study design. MenB vaccination rates improved after funding and were in line with previously funded vaccines. Co-administration rates also increased significantly. Timely administration increased, protecting children at an early age. Public funding has a positive impact on vaccine accessibility and early protection. Consistent population characteristics highlight the role of funding.
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Affiliation(s)
- Juan Juaneda
- Directorate-General for Public Health, Conselleria de Sanitat, 46010 Valencia, Spain; (P.E.-P.); (C.B.-C.); (J.A.L.-R.); (E.P.-V.)
- Preventive Medicine and Public Health, Hospital La Fe, 46026 Valencia, Spain
| | - Pablo Estrella-Porter
- Directorate-General for Public Health, Conselleria de Sanitat, 46010 Valencia, Spain; (P.E.-P.); (C.B.-C.); (J.A.L.-R.); (E.P.-V.)
- Preventive Medicine, Hospital Clínico Universitario, 46010 Valencia, Spain
| | - Carolina Blanco-Calvo
- Directorate-General for Public Health, Conselleria de Sanitat, 46010 Valencia, Spain; (P.E.-P.); (C.B.-C.); (J.A.L.-R.); (E.P.-V.)
- Preventive Medicine, Hospital Universitario Doctor Peset, 46017 Valencia, Spain
| | - Alejandro Orrico-Sánchez
- Vaccines Research Unit, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), 46017 Valencia, Spain;
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Universidad Católica de Valencia San Vicente Mártir, 46001 Valencia, Spain
| | - José Antonio Lluch-Rodrigo
- Directorate-General for Public Health, Conselleria de Sanitat, 46010 Valencia, Spain; (P.E.-P.); (C.B.-C.); (J.A.L.-R.); (E.P.-V.)
| | - Eliseo Pastor-Villalba
- Directorate-General for Public Health, Conselleria de Sanitat, 46010 Valencia, Spain; (P.E.-P.); (C.B.-C.); (J.A.L.-R.); (E.P.-V.)
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Qu S, Yang M, He W, Xie H, Zhou M, Campy KS, Tao X. Determinants of parental self-reported uptake of influenza vaccination in preschool children during the COVID-19 pandemic. Hum Vaccin Immunother 2023; 19:2268392. [PMID: 37964617 PMCID: PMC10653755 DOI: 10.1080/21645515.2023.2268392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/05/2023] [Indexed: 11/16/2023] Open
Abstract
In China, the coverage rate of influenza vaccination among the general population is significantly lower than that of high-income countries, with only 2.46% of the population vaccinated. Preschool-aged children are particularly susceptible to influenza viruses, yet the factors that influence parents' willingness to vaccinate their children are not well understood. To address this research gap, we developed a theoretical model grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT), which explores six key factors influencing parental self-reported uptake of influenza vaccination in preschool children: performance expectancy, effort expectancy, social influence, facilitating conditions, knowledge, and behavioral intention. We collected data from 872 parents of children in five major cities in China and employed structural equation modeling to examine the significance of the theoretical model and explore the potential moderating effects of demographic variables on path relationships. Our analysis revealed that several positive factors influenced parents' intention of influenza vaccination for preschool children, including effort expectancy (β = 0.38), social influence (β = 0.17), and knowledge (β = 0.52). Facilitating conditions (β = 0.34), knowledge (β = 0.40), and behavioral intention (β = 0.34) were found to be associated with self-reported uptake. Furthermore, we observed significant moderating effects of the child's gender and age, as well as the guardian's category and income, on the theoretical models. Parents' willingness to vaccinate preschool children against influenza is influenced by both psychological and demographic variables. Further studies are needed to determine if these relationships persist over time and across different regions.
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Affiliation(s)
- Shujuan Qu
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Minghua Yang
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Wei He
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Hao Xie
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Min Zhou
- School of Business Administration, Hunan University of Technology and Business, Changsha, China
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Kathryn S. Campy
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
| | - Xinyu Tao
- Graduate School of Science and Engineering, Chuo University, Tokyo, Japan
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Parental Preferences of Influenza Vaccination for Children in China: A National Survey with a Discrete Choice Experiment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042145. [PMID: 35206343 PMCID: PMC8871809 DOI: 10.3390/ijerph19042145] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/30/2022] [Accepted: 02/10/2022] [Indexed: 12/22/2022]
Abstract
The influenza vaccination coverage among children is low in China. We aimed to conduct a nationwide survey to quantify parental preferences and willingness to pay (WTP) for influenza vaccination for their children. Parents with children aged six months to 18 years from six provinces in China were investigated by a discrete choice experiment regarding six influenza vaccination attributes. Mixed logit models were used to estimate the relative importance of vaccine attributes and parents’ WTP. Interaction analysis and subgroup analysis were conducted to explore preference heterogeneity. A total of 1206 parents were included in the analysis. Parents reported vaccine effectiveness as the most important vaccine attribute. The mode of vaccine administration had no significant impact on parents’ preferences. Parents aged over 30 years with higher education or income levels were more likely to prefer no influenza vaccination for their children. The largest marginal WTP (CNY 802.57) for vaccination and the largest increase in vaccine uptake (41.85%) occurred with improved vaccine effectiveness from 30% to 80%. Parents from central regions or mid-latitude areas had a relatively lower WTP than those from other regions. No significant difference in the relative importance of vaccine attributes were observed among parents from various regions of China.
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de Oliveira Costa J, Gianacas C, Beard F, Gonzalez-Chica D, Chidwick K, Osman R, MacIntyre CR, Havard A. Cumulative annual coverage of meningococcal B vaccination in Australian general practice for three at-risk groups, 2014 to 2019. Hum Vaccin Immunother 2021; 17:3692-3701. [PMID: 34047673 DOI: 10.1080/21645515.2021.1923349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Neisseria meningitidis serogroup B (MenB) is the most common cause of meningococcal disease in adolescents and young adults. In Australia, MenB vaccination has been available through private prescription since 2014 and has been recommended for at-risk groups including adolescents, young adults who smoke and people medically at risk. For each of these at-risk groups, we estimated cumulative annual coverage of MenB vaccination between 2014 and 2019. We also evaluated factors associated with vaccination coverage in 2019. Our analyses used electronic health records in the national MedicineInsight database for people regularly attending general practices. Cumulative vaccination coverage increased among the at-risk groups between 2014 and 2019: from 0.09% to 1.65% for adolescents, from 0.01% to 0.15% for young adults who smoke, and from 0.35% to 12.09% for people medically at risk. However, vaccination coverage in 2019 remained very low across these groups. Data sparsity prevented the evaluation of factors associated with vaccination coverage for smokers. We observed variation in the relative risk of being vaccinated by age, sex, socioeconomic and clinical factors for adolescents and people medically at risk. Still, the absolute magnitude of coverage was low across all subgroups examined, and indicates a need for strategies to increase vaccination uptake among at-risk groups irrespective of patient and practice characteristics. Our study provides baseline data for monitoring menB vaccination uptake among recommended groups in light of limited national data, especially for medically at-risk groups.
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Affiliation(s)
- Juliana de Oliveira Costa
- NPS MedicineWise, Sydney, Australia.,Medicines Policy Research Unit, Centre for Big Data Research in Health, UNSW Sydney, Sydney, Australia
| | | | - Frank Beard
- National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, Australia.,School of Public Health, University of Sydney, Sydney, Australia
| | - David Gonzalez-Chica
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | | | | | - C Raina MacIntyre
- Biosecurity Program, The Kirby Institute, UNSW Sydney, Sydney, Australia
| | - Alys Havard
- NPS MedicineWise, Sydney, Australia.,Medicines Policy Research Unit, Centre for Big Data Research in Health, UNSW Sydney, Sydney, Australia
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Carlson SJ, Quinn HE, Blyth CC, Cheng A, Clark J, Francis JR, Marshall HS, Macartney K, Leask J. Barriers to influenza vaccination of children hospitalised for acute respiratory illness: A cross-sectional survey. J Paediatr Child Health 2021; 57:409-418. [PMID: 33094543 DOI: 10.1111/jpc.15235] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/10/2020] [Accepted: 09/21/2020] [Indexed: 12/24/2022]
Abstract
AIM To identify barriers to influenza vaccination of children hospitalised for acute respiratory illness in Australia. METHODS A total of 595 parents of children hospitalised with acute respiratory illness across five tertiary hospitals in 2019 participated in an online survey. Multivariate logistic regression identified factors most strongly associated with influenza vaccination barriers. RESULTS Odds of influenza vaccination were lower with lack of health-care provider (HCP) recommendation (adjusted odds ratio (aOR) 0.18; 95% confidence interval (CI): 0.08-0.38); if parents had difficulties (aOR 0.19; 95% CI: 0.08-0.47) or were 'neutral' (aOR 0.23; 95% CI: 0.06-0.82) in remembering to make an appointment; and if parents had difficulties (aOR 0.21; 95% CI: 0.07-0.62) or were 'neutral' (aOR 0.24; 95% CI: 0.07-0.79) regarding getting an appointment for vaccination. Odds were also lower if parents did not believe (aOR 0.27; 95% CI: 0.08-0.90) or were 'neutral' (aOR 0.15; 95% CI: 0.04-0.49) regarding whether the people most important to them would have their child/ren vaccinated against influenza. Children had lower odds of vaccination if parents did not support (aOR 0.09; 95% CI: 0.01-0.82) or were ambivalent (aOR 0.09; 95% CI: 0.01-0.56) in their support for influenza vaccination. Finally, lack of history of influenza vaccination of child (aOR 0.38; 95% CI: 0.18-0.81) and respondent (aOR 0.25; 95% CI: 0.11-0.56) were associated with lack of receipt of influenza vaccine before admission for acute respiratory infection. CONCLUSIONS Assisting parents in remembering and accessing influenza vaccination and encouraging health-care providers to recommend vaccination may increase uptake.
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Affiliation(s)
- Samantha J Carlson
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Helen E Quinn
- National Centre for Immunisation Research and Surveillance, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Christopher C Blyth
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.,Telethon Kids Institute, Perth, Western Australia, Australia
| | - Allen Cheng
- Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Julia Clark
- Department of Infection Management, Children's Health Queensland Hospital, Brisbane, Queensland, Australia.,School of Clinical Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Joshua R Francis
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Paediatrics, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Helen S Marshall
- Women's and Children's Health Network, Adelaide, South Australia, Australia.,Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Kristine Macartney
- National Centre for Immunisation Research and Surveillance, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Julie Leask
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, New South Wales, Australia
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Ruiz H, Halcomb E, Seale H, Horgan A, Rhee J. Knowledge, beliefs and attitudes of general practitioners and general practice nurses regarding influenza vaccination for young children. Aust J Prim Health 2021; 27:276-283. [PMID: 33653508 DOI: 10.1071/py20175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/09/2020] [Indexed: 11/23/2022]
Abstract
Annual vaccination is effective in reducing the harms associated with seasonal influenza. However, the uptake of influenza vaccine has historically been low in children. This paper reports a descriptive survey that sought to explore the beliefs, attitudes, and knowledge of general practitioners (GPs) and general practice nurses (GPNs) towards influenza vaccination in young children. Both GPs and GPNs working in the Illawarra Shoalhaven Local Health District (ISLHD) in NSW, Australia, were invited via email, fax and social media to participate in the study. A total of 121 participants completed the survey. Most participants had a high level of support and knowledge of influenza immunisation in young children. Barriers to influenza immunisation in young children included perceived hesitancy in parents and competing clinical demands. The participants strongly supported funding of the vaccine, with 90.9% feeling that parents would be less likely to vaccinate their children if the vaccine were no longer free. Both GPs and GPNs differed in the use of influenza vaccination resources. The participants had a positive attitude to influenza immunisation in young children and strongly supported continued funding of the vaccine. Dedicated young children's influenza vaccination clinics run by general practices or in the community could reduce the impact of competing clinical demands.
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Affiliation(s)
- Haley Ruiz
- Illawarra Shoalhaven Local Health District (ISLHD) Public Health Unit, King Street, Warrawong, NSW 2502, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Holly Seale
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Alyssa Horgan
- Graduate Medicine, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Joel Rhee
- General Practice Academic Unit, Illawarra Southern Practice Research Network (ISPRN), School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia; and Corresponding author.
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Thangarajah D, Malo JA, Field E, Andrews R, Ware RS, Lambert SB. Effectiveness of quadrivalent influenza vaccination in the first year of a funded childhood program in Queensland, Australia, 2018. Vaccine 2020; 39:729-737. [PMID: 33358414 DOI: 10.1016/j.vaccine.2020.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/31/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Following high influenza activity in 2017, the state of Queensland, Australia, funded a quadrivalent inactivated influenza vaccination program for children aged 6 months to <5 years in 2018. We calculated influenza vaccine effectiveness (VE) among children eligible for this program. METHODS A matched case-control study was conducted. Cases were identified using Queensland 2018 influenza notification data among children age-eligible for funded vaccination. Controls were drawn from Australian Immunisation Register records of Queensland resident children age-eligible for funded influenza vaccine. Up to 10 controls per case were matched for location and birthdate. First dose vaccination was valid if received ≥14 days prior to specimen collection; a second dose was valid if received ≥28 days after first dose receipt. VE was calculated for vaccine doses and adherence to national recommendations for two doses in the first season (schedule completeness) and adjusted (VEadj) for sex and First Nations status. RESULTS There were 1,125 cases and 10,645 matched controls analysed. Overall VEadj against laboratory-confirmed influenza was 51% (95% confidence interval (CI) 41-60). VEadj was 60% (95% CI 46-70) for children who received two doses in 2018, and 60% (95% CI 48-69) for children vaccinated appropriately according to schedule completeness. VE increased with age. CONCLUSIONS Moderate vaccine effectiveness was observed for children eligible for the funded program in Queensland in 2018, adding to the sparse evidence for influenza vaccine use in Australian children. Adhering to the national first season two dose schedule for influenza vaccine receipt in children ensures maximum protection.
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Affiliation(s)
- Dharshi Thangarajah
- Communicable Diseases Branch, Queensland Health, Brisbane, Australia; National Centre for Epidemiology and Population Health, Australian National University, Canberra Australia.
| | - Jonathan A Malo
- Communicable Diseases Branch, Queensland Health, Brisbane, Australia.
| | - Emma Field
- National Centre for Epidemiology and Population Health, Australian National University, Canberra Australia; Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
| | - Ross Andrews
- National Centre for Epidemiology and Population Health, Australian National University, Canberra Australia; Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
| | - Stephen B Lambert
- Communicable Diseases Branch, Queensland Health, Brisbane, Australia; National Centre for Epidemiology and Population Health, Australian National University, Canberra Australia.
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Liao Q, Fielding R, Cheung YTD, Lian J, Yuan J, Lam WWT. Effectiveness and Parental Acceptability of Social Networking Interventions for Promoting Seasonal Influenza Vaccination Among Young Children: Randomized Controlled Trial. J Med Internet Res 2020; 22:e16427. [PMID: 32130136 PMCID: PMC7070348 DOI: 10.2196/16427] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 12/05/2019] [Accepted: 01/26/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Seasonal influenza vaccination (SIV) coverage among young children remains low worldwide. Mobile social networking apps such as WhatsApp Messenger are promising tools for health interventions. OBJECTIVE This was a preliminary study to test the effectiveness and parental acceptability of a social networking intervention that sends weekly vaccination reminders and encourages exchange of SIV-related views and experiences among mothers via WhatsApp discussion groups for promoting childhood SIV. The second objective was to examine the effect of introducing time pressure on mothers' decision making for childhood SIV for vaccination decision making. This was done using countdowns of the recommended vaccination timing. METHODS Mothers of child(ren) aged 6 to 72 months were randomly allocated to control or to one of two social networking intervention groups receiving vaccination reminders with (SNI+TP) or without (SNI-TP) a time pressure component via WhatsApp discussion groups at a ratio of 5:2:2. All participants first completed a baseline assessment. Both the SNI-TP and SNI+TP groups subsequently received weekly vaccination reminders from October to December 2017 and participated in WhatsApp discussions about SIV moderated by a health professional. All participants completed a follow-up assessment from April to May 2018. RESULTS A total of 84.9% (174/205), 71% (57/80), and 75% (60/80) who were allocated to the control, SNI-TP, and SNI+TP groups, respectively, completed the outcome assessment. The social networking intervention significantly promoted mothers' self-efficacy for taking children for SIV (SNI-TP: odds ratio [OR] 2.69 [1.07-6.79]; SNI+TP: OR 2.50 [1.13-5.55]), but did not result in significantly improved children's SIV uptake. Moreover, after adjusting for mothers' working status, introducing additional time pressure reduced the overall SIV uptake in children of working mothers (OR 0.27 [0.10-0.77]) but significantly increased the SIV uptake among children of mothers without a full-time job (OR 6.53 [1.87-22.82]). Most participants' WhatsApp posts were about sharing experience or views (226/434, 52.1%) of which 44.7% (101/226) were categorized as negative, such as their concerns over vaccine safety, side effects and effectiveness. Although participants shared predominantly negative experience or views about SIV at the beginning of the discussion, the moderator was able to encourage the discussion of more positive experience or views and more knowledge and information. Most intervention group participants indicated willingness to receive the same interventions (110/117, 94.0%) and recommend the interventions to other mothers (102/117, 87.2%) in future. CONCLUSIONS Online information support can effectively promote mothers' self-efficacy for taking children for SIV but alone it may not sufficient to address maternal concerns over SIV to achieve a positive vaccination decision. However, the active involvement of health professionals in online discussions can shape positive discussions about vaccination. Time pressure on decision making interacts with maternal work status, facilitating vaccination uptake among mothers who may have more free time, but having the opposite effect among busier working mothers. TRIAL REGISTRATION Hong Kong University Clinical Trials Registry HKUCTR-2250; https://tinyurl.com/vejv276.
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Affiliation(s)
- Qiuyan Liao
- University of Hong Kong, Hong Kong, China (Hong Kong)
| | | | | | - Jinxiao Lian
- The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Jiehu Yuan
- University of Hong Kong, Hong Kong, China (Hong Kong)
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