Sylwer fod y cymhwysiad hwn dan ddatblygiad. Os ydych chi'n gweld unrhyw gamgymeriadau neu os nad yw rhywbeth yn gweithio, cysylltwch â ni yn evidence.service@wales.nhs.uk.
Adolygiad Systematig
This report aimed to determine the effectiveness of community-wide education interventions when implemented alone in increasing vaccination rates or reducing rates of vaccine preventable illness and found insufficient evidence. Evidence is considered insufficient due to inconsistent results and concerns about the applicability of evidence to more diverse communities in the United States where improvements in vaccination rates are needed.
This Task Force finding is based on evidence from a Community Guide systematic review completed in 2010 (6 studies with 8 study arms, search period 1980-2009) combined with more recent evidence (1 study, search period 2009- February 2012). Based on the combined evidence, the Task Force reaffirms its finding of insufficient evidence.
The Task Force considered evidence from 7 studies with 9 study arms. Among the studies providing a common measure of change in vaccination rates (4 studies with 6 arms) there was a median increase of 6 percentage points (range of values: 0.4 to 12.2 percentage points).
Three studies evaluated mass media activities using different measures of change. In a targeted community in Australia, pneumococcal vaccines dispatched to service providers increased during the period of a mass media campaign. In Finland, a mass media campaign briefly increased MMR vaccine receipt for children 6 years of age, though changes were not reported for younger children. In the U.S., a mass media campaign addressing flu-related topics among a nationally representative population of older adults found a positive association between flu-related media reports and influenza vaccination rates in the weeks following the campaign (annual vaccination rates increased by 2.3-7.9 percentage points, p<0.001).
One U.S. study observed moderate increases in vaccination rates for hepatitis B vaccine following intensive communitywide educational efforts in two Vietnamese-American communities. Characteristics of the study communities that may have contributed to intervention effectiveness included: (1) popular Vietnamese-language media, (2) established Vietnamese service organizations, and (3) culturally appropriate strategies and materials.
Community-wide education is commonly implemented in combination with additional interventions (such as efforts to expand and enhance access to vaccinations). In another review, the Task Force found strong evidence of effectiveness for community-based interventions implemented in combination to increase vaccination rates, and five of the included studies used community-wide education in the combination of interventions.
This CPSTF report states that although the evidence identified in this systematic review is insufficient to determine the effectiveness of community-wide education when implemented alone, two studies suggest that these interventions may be useful with certain communities. More research is needed to understand the potential applicability of these interventions to other populations, and for other vaccines.
The Task Force acknowledges an important role for mass media (and the potential role of social media) in disseminating
information to large audiences and shaping public attitudes and behaviours.
Vaccine manufacturers have been increasing direct-to-consumer mass and small media advertising to promote new vaccines. While evidence from private sector marketing campaigns on vaccine uptake was not included in this review, the Task Force considered the applicability of these marketing experiences to public health efforts. They determined that community-wide educational efforts may have greater impact when used to inform members of the community about new vaccines (such as HPV), or new recommendations (such as the universal recommendation for seasonal influenza), and in situations of public health urgency (such as the H1N1 pandemic). The effectiveness of community-wide education to increase vaccination rates in these circumstances remains an important issue for further evaluation research.