عنوان مقاله:
تأثیر رسانه های جمعی بر مصرف واکسن های فلج اطفال در هنگام شیوع خاموش این بیماری
Mass media effect on vaccines uptake during silent polio outbreak
سال انتشار: 2018
رشته: مدیریت، مهندسی فناوری اطلاعات، پزشکی
گرایش: مدیریت فناوری اطلاعات، اپیدمیولوژی، اینترنت و شبکه های گسترده
دانلود رایگان این مقاله:
دانلود مقاله واکسن های فلج اطفال
مشاهده سایر مقالات جدید:
مقالات ISI مهندسی فناوری اطلاعات
4. Discussion
The present study shows the impact of media exposure on the use of vaccinations during outbreak. We demonstrated the association of quantified media exposure (by EVA) and both bOPV vaccines during polio mass media campaign in addition to the routine vaccinations, as observed in a change of their utilization which followed the media exposure consistently. We showed that increased bOPV uptake was associated with media exposure mostly among Jews and higher SES individuals. In addition, we showed variable change among non-bOPV routine vaccines uptake. Media exposure may influence the public behaviour specifically during infectious diseases outbreaks. For instance, the use of hygiene preventive measurements was positively related to H1N1 coverage during the 2009–2010 outbreak. The timing of the exposure is also crucial to create the desirable effect on public health. As our results suggest, the most prominent effect was seen several days after media exposure. The importance of the timing of media exposure was previously reported during the H1N1 outbreak in Europe, as media attention was declined before the epidemic reached its peak, resulting in a decrease in H1N1 vaccines uptake and eventually more deaths in the second wave of the outbreak, where effective vaccine was in reach. However, our study innovates by showing the impact of the media exposure in a daily resolution on the public behaviour. In addition to the timing of media exposure, the selection of the risk communication strategy is crucial for the success of the vaccination activities. Vaccines uptake during the 2009–2010 H1N1 outbreak were higher when the media framing were more transparent and put responsibility on the general public itself.
In the 2013 silent polio outbreak, the challenge was even more complex. The MoH supplemental immunization activities took place in special circumstances where virus transmission occurred without a single case of clinical infection. The MoH efforts were made to increase bOPV uptake only among the 1–10 years old children, a population characterized with relatively high routine immunization rate, to prevent viral transmission. To cope with the communication challenges of ‘‘marketing” the public a live vaccine which was withdrawn from the Israeli immunization schedule in 2004, a special media response team was formed by the Israeli MoH in the early stages of 2013 silent polio outbreak. Our finding suggest that by facilitating risk communication strategy which fitted public needs during the polio outbreak, the Israeli MoH managed to optimize the utilization of health resources (bOPV uptake) during the crisis in a well-planned and public oriented manner. During the polio crisis, it emerged that bOPV uptake and some of non-bOPV vaccines among Bedouin and lower SES were not associated with media exposure (as opposed to the Jews and higher SES population).
During routine (‘‘non crisis”) periods, it is unclear whether SES is associated with the uptake of scheduled immunization [26–29]. However, during disease outbreaks it emerged that high SES groups tend to implement effective preventive measures at a higher rate than lower SES [30,31]. This was explained by lower barriers to information access and consequently more knowledge attained among higher SES groups, which proved to be associated positively with the adoption of recommended prevention measures and negatively with the adoption of incorrect protective behaviours. In the case of the polio transmission, we showed that the lower SES and Bedouin populations had weaker association (though still significant) between media exposure and bOPV uptake compared to Jews and higher SES groups. In a study that explored the effect of SES on bOPV uptake during this crisis, it was reported that while the coverage of bOPV was higher among the Arab population compared to Jews (92.4% vs. 59.2%), there was an inverse correlation between SES and compliance to bOPV in the Jewish population compared to a linear correlation in the Arab population. The authors gave two possible explanations for this discrepancy: the enormous efforts the MoH dedicated to the Arab community during the campaign due to high incidence of polio isolations in this population, and cultural differences as oriental (including Arab) societies tend to prefer collective interests, compared to Western societies that prefer the interest of the individual. Interestingly, due to the weaker media/OPV association among Arabs that we found, it appears that there might be additional explanations for this finding. It has been proposed that lower SES groups showed also lower health literacy, which could exacerbate non-effective communication and undesirable health behaviour adaption among these groups. Moreover, infectious disease outbreak risk communication has distinct and specific needs, such as building an equal partnership between the governmental agents and the public, engaging two-way communication with the public and maintaining public trust despite. These measures have to be taken despite the uncertainty which accompanied outbreaks. Lower SES communities are less trustworthy of the official government channels, and rely more on traditional communication channels (face-to-face, local community and religious leaders. Hence, the MoH mass media campaign (which also included face-to-face contacts with local Bedouin leaders) could have had its impact regardless of the use of ‘‘classical media” channels [37]. The adoption of an ecological holistic strategy by the MoH, which included involvement of local stakeholders and trusted local leaders specifically within the Arab communities, may have contributed to the impact of the MoH mass media campaign in this population, and proved its superiority over the classical media form that we investigated in this research [25,38,39].
چکیده
پیشینه: جداسازی موتانت وحشی ویروس فلج اطفال نوع1 از فاضلاب روزمره اسرائیل در سال 2013 موجب تشکیل کمپین ملی واکسن های خوراکی ضدویروس فلج اطفال (OPV) شد. در آن دوره، رسانه های جمعی اخبار مربوط به شیوع این بیماری را بطور مستمر تحت پوشش قرار دادند. اهداف: بررسی ارتباط بین تأثیر رسانه ها و مصرف واکسن های خوراکی و غیرخوراکی فلج اطفال طی دوره شیوع خاموش این بیماری در سال 2013 در اسرائیل. مواد و روش‌ها: داده های مربوط به میزان واکسیناسیون روزانه افراد طی دوره شیوع این بیماری را از وزارت بهداشت (MoH) دریافت کردیم. برای ارزیابی ارتباط بین تأثیر روزانه رسانه ها و مصرف واکسن، آنالیز روند رکوردگیری چندمتغیره را انجام دادیم. این آنالیز براساس قومیت و وضعیت اجتماعی-اقتصادی (SES) افراد طبقه بندی شد.
