PDF(Pubmed)
Abstract：
BACKGROUND: Low rates of COVID-19 vaccination remain a substantial public health challenge. Despite early successes, vaccinations of Alaskans trail the US average, drawing attention to the need for better-designed and targeted vaccine confidence interventions. Our objective was to assess levels of community trust and theory-driven predictors of vaccination status to inform the design of future programs.
METHODS: We conducted a cross-sectional, telephone-based survey of 940 Alaskan adults between May and June 2022. Data were collected on vaccination status (including initial vaccination and receipt of booster shots), trust in local community members, demographic characteristics, and thematic questions designed using the Capability, Opportunity, Motivation - Behavior (COM-B) model to examine possible predictors (barriers/facilitators) of vaccination status.
RESULTS: Among those who are not fully vaccinated and boosted, we observe significantly lower trust placed in many immediate community members, especially health workers (e.g., doctors, nurses, specialty care physicians, health administrators). Firefighters and emergency medical technicians enjoy the most community trust, followed by medical professionals. Among those who received only a primary vaccine series, we find that perceptions of whether close friends are vaccinated, a sense of professional responsibility, and age were the strongest predictors vaccination status. Among the unvaccinated, we find significant predictive power from the same variables, as well as perceptions of whether family members are vaccinated, perceived risks from non-vaccination and whether vaccination is a healthy choice.
CONCLUSIONS: These findings will help inform the design and targeting of future vaccine promotion interventions to adult populations in Alaska. Interventions that leverage reflective motivation and social opportunity domains of the COM-B framework may be most effective. Local community members including firefighters and emergency medical technicians, as well as medical professionals may be perceived as the most trustworthy and influential messengers among those who are not fully vaccinated and boosted.
METHODS: We conducted a cross-sectional, telephone-based survey of 940 Alaskan adults between May and June 2022. Data were collected on vaccination status (including initial vaccination and receipt of booster shots), trust in local community members, demographic characteristics, and thematic questions designed using the Capability, Opportunity, Motivation - Behavior (COM-B) model to examine possible predictors (barriers/facilitators) of vaccination status.
RESULTS: Among those who are not fully vaccinated and boosted, we observe significantly lower trust placed in many immediate community members, especially health workers (e.g., doctors, nurses, specialty care physicians, health administrators). Firefighters and emergency medical technicians enjoy the most community trust, followed by medical professionals. Among those who received only a primary vaccine series, we find that perceptions of whether close friends are vaccinated, a sense of professional responsibility, and age were the strongest predictors vaccination status. Among the unvaccinated, we find significant predictive power from the same variables, as well as perceptions of whether family members are vaccinated, perceived risks from non-vaccination and whether vaccination is a healthy choice.
CONCLUSIONS: These findings will help inform the design and targeting of future vaccine promotion interventions to adult populations in Alaska. Interventions that leverage reflective motivation and social opportunity domains of the COM-B framework may be most effective. Local community members including firefighters and emergency medical technicians, as well as medical professionals may be perceived as the most trustworthy and influential messengers among those who are not fully vaccinated and boosted.
摘要：
背景：COVID-19疫苗接种率低仍然是一个重大的公共卫生挑战。尽管早期的成功,阿拉斯加人的疫苗接种量落后于美国平均水平,提请注意需要更好设计和有针对性的疫苗信心干预措施。我们的目标是评估社区信任水平和理论驱动的疫苗接种状况预测因子，以指导未来计划的设计。
方法：我们进行了横截面，2022年5月至6月间对940名阿拉斯加成年人进行的电话调查。收集有关疫苗接种状况的数据（包括初始疫苗接种和接受加强注射），信任当地社区成员，人口特征，和使用能力设计的主题问题，机会,动机-行为（COM-B）模型，以检查疫苗接种状态的可能预测因素（障碍/促进因素）。
结果：在未完全接种和加强疫苗的人群中，我们观察到许多直接社区成员的信任度大大降低，尤其是卫生工作者(例如，医生,护士,专业护理医生，健康管理员)。消防员和紧急医疗技术人员享有最多的社区信任，其次是医疗专业人员。在那些只接受初级疫苗系列的人中，我们发现对亲密朋友是否接种疫苗的看法，有职业责任感,和年龄是最强的预测疫苗接种状况。在未接种疫苗的人群中，我们从相同的变量中发现了显著的预测能力，以及对家庭成员是否接种疫苗的看法，非疫苗接种的感知风险以及疫苗接种是否是健康的选择。
结论：这些发现将有助于为阿拉斯加成年人群的未来疫苗推广干预措施的设计和目标提供信息。利用COM-B框架的反思性动机和社会机会域的干预措施可能最有效。当地社区成员，包括消防员和紧急医疗技术人员，以及医疗专业人员可能被认为是那些没有完全接种疫苗和加强疫苗接种的人中最值得信赖和最有影响力的信使。
方法：我们进行了横截面，2022年5月至6月间对940名阿拉斯加成年人进行的电话调查。收集有关疫苗接种状况的数据（包括初始疫苗接种和接受加强注射），信任当地社区成员，人口特征，和使用能力设计的主题问题，机会,动机-行为（COM-B）模型，以检查疫苗接种状态的可能预测因素（障碍/促进因素）。
结果：在未完全接种和加强疫苗的人群中，我们观察到许多直接社区成员的信任度大大降低，尤其是卫生工作者(例如，医生,护士,专业护理医生，健康管理员)。消防员和紧急医疗技术人员享有最多的社区信任，其次是医疗专业人员。在那些只接受初级疫苗系列的人中，我们发现对亲密朋友是否接种疫苗的看法，有职业责任感,和年龄是最强的预测疫苗接种状况。在未接种疫苗的人群中，我们从相同的变量中发现了显著的预测能力，以及对家庭成员是否接种疫苗的看法，非疫苗接种的感知风险以及疫苗接种是否是健康的选择。
结论：这些发现将有助于为阿拉斯加成年人群的未来疫苗推广干预措施的设计和目标提供信息。利用COM-B框架的反思性动机和社会机会域的干预措施可能最有效。当地社区成员，包括消防员和紧急医疗技术人员，以及医疗专业人员可能被认为是那些没有完全接种疫苗和加强疫苗接种的人中最值得信赖和最有影响力的信使。
