中国四地中学生校园氛围对流感疫苗接种的影响

杨丽萍; 潘琦; 奴比娅·阿马尔江; 肖惠迪; 王龙; 李梦龙; 加吾兰·祖农; 高爱钰; 胡翼飞

doi:10.16835/j.cnki.1000-9817.2022.06.014

中国四地中学生校园氛围对流感疫苗接种的影响

doi: 10.16835/j.cnki.1000-9817.2022.06.014

1.
首都医科大学公共卫生学院儿少卫生与妇幼保健学系，北京 100069
2.
南航北京分公司航卫室
3.
北京市东城区青少年健康中心

基金项目:

国家自然科学基金 72061137007

详细信息

作者简介:
杨丽萍(1985-)，女，北京市人，在读硕士，主要研究方向为儿童青少年期生长发育及影响因素

通讯作者:
胡翼飞，E-mail：huyifei@yahoo.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G478 R179 R186
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- 被引次数: 0
出版历程
- 收稿日期: 2021-12-09
- 修回日期: 2022-03-18
- 网络出版日期: 2022-06-23
- 刊出日期: 2022-06-25

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

1.
Department of Child and Adolescent Health and Maternal Health, School of Public Health, Capital Medical University, Beijing (100069), China

摘要

摘要: 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。
- 流感疫苗 /
- 接种 /
- 健康促进 /
- 回归分析 /
- 学生
Abstract: 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.
- Influenza vaccines /
- Vaccination /
- Health promotion /
- Regression analysis /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 不同人口统计学特征中学生流感疫苗接种率比较

Table 1. Comparison of influenza vaccination rates among middle school students with different demographic indicators

人口统计学指标	选项	人数	接种人数	χ²值	P值
性别	男	4 570	1 769(38.7)	1.02	0.31
	女	4 575	1 724(37.7)
学段	初中	5 702	2 132(37.4)	4.16	0.04
	高中	3 443	1 361(39.5)
地区	北京	4 999	2 598(52.0)	886.27	< 0.01
	其余三地	4 146	895(21.6)
上学方式	住宿	1 822	969(53.2)	216.51	< 0.01
	走读	7 323	2 524(34.5)
年级	初一	2 347	948(40.4)	26.39	< 0.01
	初二	1 768	645(36.5)
	初三	1 587	539(34.0)
	高一	1 373	569(41.4)
	高二	1 244	464(37.3)
	高三	826	328(39.7)
注：()内数字为接种率/%。

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表 2 不同校园氛围指标构成在中学生是否接种流感疫苗组间比较

Table 2. Comparison of different campus atmosphere indexes in whether middle school students are vaccinated with influenza vaccine

校园氛围	接种人数 (n=3 493)	未接种人数 (n=5 652)	χ²值	P值
如果班主任告诉我要接种流感疫苗，我的接种意愿是
不同意	151(4.3)	349(6.2)	318.91	< 0.01
不确定	598(17.1)	1 870(33.1)
同意	2 744(78.6)	3 433(60.7)
看到周围同学接种疫苗后，我的接种意愿是
不同意	352(10.1)	793(14.0)	238.38	< 0.01
不确定	625(17.9)	1 690(29.9)
同意	2 516(72.0)	3 169(56.1)
我很清楚流感疫苗接种是怎么一回事，且能够给别人解释
不同意	295(8.4)	820(14.5)	182.59	< 0.01
不确定	838(24.0)	1 801(31.9)
同意	2 360(67.6)	3 031(53.6)
跟其他人讨论过流感疫苗接种这件事
不同意	468(13.4)	1 219(21.6)	116.85	< 0.01
不确定	566(16.2)	1 024(18.1)
同意	2 459(70.4)	3 409(60.3)
觉得跟其他人讨论疫苗接种是有价值的
不同意	233(6.7)	590(10.4)	80.12	< 0.01
不确定	695(19.9)	1 400(24.8)
同意	2 565(73.4)	3 662(64.8)
当和别人公开讨论疫苗接种，我会对他人的想法有积极的影响
不同意	292(8.4)	689(12.2)	92.23	< 0.01
不确定	930(26.6)	1 850(32.7)
同意	2 271(65.0)	3 113(55.1)
当和别人公开讨论疫苗接种，他人会对我的想法有积极的影响
不同意	390(11.2)	820(14.5)	56.80	< 0.01
不确定	929(26.6)	1 760(31.1)
同意	2 174(62.2)	3 072(54.4)
注：()内数字为构成比/%。

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表 3 中学生接种流感疫苗影响因素多因素Logistic回归分析[OR值(OR值95%CI)]

Table 3. Multivariate Logistic regression analysis of the factors affecting influenza vaccination in middle school students[OR(OR 95%CI)]

自变量	人数	调整前	调整后
如果班主任告诉我要接种流感疫苗，我的接种意愿是
不同意	500	1.00	1.00
不确定	2 468	1.35(1.09~1.67)^**	0.91(0.73~1.13)
同意	6 177	0.54(0.44~0.66)^**	0.39(0.32~0.48)^**
看到周围同学接种疫苗后，我的接种意愿是
不同意	1 145	1.00	1.00
不确定	2 315	1.20(1.03~1.40)^*	0.65(0.55~0.77)^**
同意	5 685	0.56(0.49~0.64)^**	0.29(0.25~0.33)^**
我很清楚流感疫苗接种是怎么一回事，且能够给别人解释
不同意	1 115	1.29(1.11~1.51)^**	1.18(1.00~1.39)^*
不确定	2 639	1.00	1.00
同意	5 391	0.60(0.54~0.66)^**	0.68(0.61~0.75)^**
跟其他人讨论过流感疫苗接种这件事
不同意	1 687	1.44(1.25~1.67)^**	1.37(1.17~1.60)^**
不确定	1 590	1.00	1.00
同意	5 868	0.77(0.68~0.86)^**	0.76(0.67~0.86)^**
觉得跟其他人讨论疫苗接种是有价值的
不同意	823	1.26(1.05~1.50)^*	1.30(1.08~1.57)^**
不确定	2 095	1.00	1.00
同意	6 227	0.71(0.64~0.79)^**	0.66(0.59~0.73)^**
当和别人公开讨论疫苗接种，我会对他人的想法有积极的影响
不同意	981	1.19(1.01~1.39)^*	1.10(0.93~1.30)
不确定	2 780	1.00	1.00
同意	5 384	0.69(0.63~0.76)^**	0.61(0.55~0.68)^**
当和别人公开讨论疫苗接种，他人会对我的想法有积极的影响
不同意	1 210	1.00	1.00
不确定	2 689	0.90(0.78~1.04)	0.97(0.83~1.13)
同意	5 246	0.67(0.59~0.77)^**	0.62(0.54~0.71)^**
注：多因素模型调整了学生年级、所在城市、是否住宿；P < 0.05，*P < 0.01。

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