中国四地中学生校园氛围对流感疫苗接种的影响

  目的  探讨在校中学生流感疫苗接种影响因素，为提高中学生流感疫苗接种率提供理论基础。  方法  采用定性定量结合的研究方法。使用网络推送问卷星方法调查北京、安徽、陕西、广东4地9 145名在校中学生。多因素Logistic回归模型分析中学生接种流感疫苗的影响因素。采用立意调查方法，选取35名在校中学生进行半结构式访谈，使用NVivo plus软件进行资料分析。  结果  受调查中学生自报告流感疫苗接种率为38.2%。不曾与他人讨论过流感疫苗(OR=1.37，95%CI=1.17~1.60)、觉得与他人讨论流感疫苗是无价值的(OR=1.30，95%CI=1.08~1.57)与疫苗接种呈负相关(P值均 < 0.05)；班主任建议(OR=0.39，95%CI=0.32~0.48)、周围同学接种(OR=0.29，95%CI=0.25~0.33)、很清楚疫苗是怎么回事并能清楚解释(OR=0.68，95%CI=0.61~0.75)、与他人讨论(OR=0.76，95%CI=0.67~0.86)、觉得讨论是有价值的(OR=0.66，95%CI=0.59~0.73)、可以正向带动他人(OR=0.61，95%CI=0.55~0.68)、受到他人积极影响(OR=0.62，95%CI=0.54~0.71)与疫苗接种呈正相关(P值均 < 0.05)。访谈结果显示，班主任对流感疫苗的认知和态度可直接或间接影响学生的接种决定，积极的班级整体氛围可提高学生接种率。  结论  学校可通过发挥班主任引导作用、组织学生开展流感话题讨论的方式提高学生流感疫苗接种率。

Influence of school climate on influenza vaccination among middle school students in four cities in China

  Objective  This study aims to explore the influencing factors of influenza vaccination in middle school students, and to provide a theoretical basis for improving the influenza vaccination rate and inform interventions.  Methods  By using mixed research method, a combination of qualitative research and quantitative research, a survey was conducted among 9 145 middle school students selected from Beijing, Anhui, Shaanxi, Guangdong via the online survey using Wenjuanxing software. Multivariate Logistic regression models were used to analyze the influencing factors of influenza vaccination. After a purposeful sampling, 35 middle school students were invited for semi-structured interviews and NVivo plus software were used for data analysis.  Results  The self-reported influenza vaccination rate of the middle school students was 38.2%. No experience of discussing an influenza vaccine with others (OR=1.37, 95%CI=1.17-1.60) and devaluing the discussion about vaccination (OR=1.30, 95%CI=1.08-1.57) was negatively associated with vaccination(P < 0.05); The head teacher suggestion(OR=0.39, 95%CI=0.32-0.48), peers' vaccination(OR=0.29, 95%CI=0.25-0.33), and awareness of what the vaccine was and being able to explain it clearly(OR=0.68, 95%CI=0.61-0.75), discussing with others(OR=0.76, 95%CI=0.67-0.86), feeling the discussion is valuable(OR=0.66, 95%CI=0.59-0.73), being able to positively influence others(OR=0.61, 95%CI=0.55-0.68), being positively influenced by others (OR=0.62, 95%CI=0.54-0.71) were more likely to take vaccination via separated models(P < 0.05). The interview results showed that the teacher's cognition and attitude towards the influenza vaccine could directly or indirectly affect the students' vaccination decision, and the positive school opinion atmosphere may improve students' vaccination rate.  Conclusion  It is suggested that the schools should increase students' vaccination rate through head teachers' guidance and organizing students to participate in discussion on influenza topics.