Determinants of rotavirus vaccine uptake in Hong Kong children: path analysis
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摘要Background and aims
Since the licensure of rotavirus vaccines in Hong Kong in 2006, they are only available in private sector and vaccine uptake is relatively low. Rotavirus vaccines have not yet been incorporated in the government’s universal Childhood Immunisation Programme (CIP). In this analysis, we used path model to investigate determinants of the vaccine uptake.

As part of a knowledge, attitudes and practices study related to pneumonia and diarrhoea, 500 eligible mothers were recruited postnatally from two public hospitals in 2014. Mothers completed a telephone questionnaire based on the Health Belief Model (HBM) approximately one month later. Children’s rotavirus vaccination histories were documented and copies of immunisation records were sought when they were at 6-10 months old. Path analysis was used to examine determinants of rotavirus vaccines uptake. Univariate regressions were performed with rotavirus vaccines uptake as outcome and potential factors including demographic variables, infant feeding practices, knowledge and attitudes in relation to diarrhoea and rotavirus vaccines as exposures. Significant factors from the univariate analyses, knowledge score of diarrhoea and HBM attitude scores were entered into the initial path model simultaneously. Direct and indirect effects from each factor on vaccination decisions were considered. Insignificant pathways between attitude scores or items were removed one by one and variables with no significant pathways connected with the others were dropped from the model. Correlations between variables were added in the misfit models based on modification indices and theoretical soundness. Standardised parameter estimates of the remaining pathways in the final path models were obtained. Acceptable model fit was indicated by three model fit indices: Comparative Fit Index (CFI) ≥ 0.96, Tucker-Lewis Index (TLI) ≥ 0.96 and Root Mean Square Error of Approximation (RMSEA) ≤ 0.06.

Among the 314 subjects, whose mothers responded to the final questionnaires and provided immunisation records, 147 (47%) had received rotavirus vaccines. By univariate analyses, potential factors associated with rotavirus vaccine uptake included: (1) maternal place of birth (immigration status), (2) monthly household income, (3) diarrhoea knowledge score at birth, (4) HBM construct scores of perceived severity of diarrhoea, perceived benefits and cues to action of rotavirus vaccination, (5) confidence in safety of vaccines not included in the CIP and (6) disagreement in worthiness of getting vaccines not included in the CIP. In addition to these, the initial path model also included the HBM construct scores of perceived susceptibility of diarrhoea and self-efficacy to vaccinate the child. Hence, the full HBM could be considered to be included in the initial path model. The final path model had a satisfactory fit.

Hong Kong-born mothers, compared to China-immigrants, and mothers perceiving rotavirus vaccination as beneficial were more likely to give rotavirus vaccine in their children while family monthly household income had direct effects on perceived benefits of rotavirus vaccine. Although further efforts are needed to better inform all mothers of the benefits of this vaccine, its inclusion in the CIP will likely be required to attain high coverage of this vaccine in Hong Kong children.
著者Yeung KHT, Tarrant M, Fung GPG, Tam WH, Nelson EAS
會議名稱Thirteenth International Rotavirus Symposium 2018

上次更新時間 2020-06-05 於 16:12