【作者】 王帅；

【导师】 杨克青； 齐芝娉；

【作者基本信息】 华南理工大学 ， 新闻与传播（专业学位）， 2023， 硕士

【摘要】 宫颈癌是一个全球性的公共卫生问题,也是目前唯一可以通过疫苗接种进行预防的恶性肿瘤。多个国家推行青少年免疫接种,以降低宫颈癌的发生率。近年来,我国也将青少年作为HPV疫苗接种的首要推广人群,启动一系列疫苗接种工作。但目前我国青少年HPV疫苗接种率不足3%,青少年HPV疫苗接种科普和推广工作面临着严峻的挑战。如何在复杂的信息环境下了解疫苗接种决策机制、精准划分受众、制定有效的传播策略以提高疫苗接种率,成为业界和学界亟需解决的问题。研究表明,疫苗认知是疫苗接种的先决条件。公共卫生领域的研究进行了诸多疫苗知晓对于疫苗接种的影响研究。多项研究结果表明,随着疫苗知晓率的提升,疫苗知晓率对接种率的影响日渐式微。健康传播领域的研究基于社会认知角度,并不认为疫苗认知是一个简单的疫苗知晓率,而将其视为一个知识性认知过程。健康传播研究注重从个体心理感知测量疫苗认知。青少年是否接种HPV疫苗是由监护人来进行决策,诸多健康研究表明,其中母亲的作用更为关键。因此,青少年HPV疫苗接种决策,不仅需要考量母亲是否充分了解疫苗知识,还要了解母亲对青少年HPV疫苗接种的信息需求,同时还需要结合母亲在青少年HPV疫苗接种过程中的涉入程度来进行分析。因此,本文从健康传播学的角度出发,对母亲决策过程进行深入分析,基于问题解决情境理论“认知-动机-信息行为”的理论框架,构建“认知-动机-信息行为-接种行为”的接种决策模型。从“问题认知、涉入认知、约束认知、情境动机、信息搜集、信息选择”多个维度考量其对决策过程的影响,识别疫苗接种过程中的阻碍因素,并根据“问题认知、涉入认知、约束认知”三个认知维度对母亲决策类型进行划分,在此基础上讨论如何对其提供针对性的信息支持。本文使用混合研究方法,根据对适龄接种人群的母亲进行深度访谈,借助定性研究挖掘中国社会文化和信息环境影响下青少年HPV疫苗接种的特性问题,并以此优化问题解决情境理论框架;定量研究部分则验证研究模型,解释决策形成的过程机制并细分母亲决策类型。研究发现,(1)中国母亲对HPV疫苗接种问题关注度高,并且有着较高的疫苗认知水平,但目前的社会环境不能为母亲提供足够的信息支持以辅助她们进行疫苗决策。(2)“认知-动机-信息行为-接种行为”的决策模型深层次解释了疫苗接种决策过程中认知、动机、信息行为因素的作用机理。个体的涉入认知和约束认知能够预测情境动机,情境动机可以预测信息搜集和信息选择行为,最终信息搜集行为可以预测接种行为。(3)聚类分析划分出四类决策人群:高度卷入疫苗接种议题的行动公众;接种行为最积极的知晓公众;缺乏疫苗信息的潜在公众;未进入疫苗接种议题情境的非公众。基于研究结论,本研究回应了既往研究并提出了中国青少年HPV疫苗接种实践的两个新变化:一是疫苗犹豫转向疫苗慎重。母亲对HPV疫苗接受度高,尚未为女儿接种疫苗的母亲不是在犹豫是否需要为女儿接种疫苗,而是在充分搜集信息为女儿接种最佳的疫苗,母亲在疫苗接种过程中的决策更加慎重。二是个体因素如年龄、社会经济导致的疫苗接种差异正在缩小。本文基于以上研究结论和发现,针对性提出了促进青少年HPV疫苗接种的建议,如为行动公众提供更加专业化、权威性知识和接种推荐,降低潜在公众信息获取和理解障碍等。本研究在理论层面上拓展了问题解决情境理论及其应用情境,也为受众细分研究提供了一种新的研究思路和方法;在实践层面上为我国HPV疫苗接种的科普和推广工作提了供理论与实践指导。更多还原

【Abstract】 Cervical cancer is a global public health problem,and it is also the only malignant tumor that can be prevented through vaccination.Many countries promote adolescent immunization to reduce the incidence of cervical cancer.China has also regarded adolescents as the primary promotion group for HPV vaccination,and launched a series of vaccination work.However,the HPV vaccination rate among adolescents in China is less than 3%,and the popularization and promotion of HPV vaccination among adolescents is facing severe challenges.How to understand the decision-making mechanism of vaccination,accurately divide the audience,and formulate effective communication strategies to increase the vaccination rate have become urgent problems for the industry and academia.Research shows that vaccine awareness is a prerequisite for vaccination.Research in the field of public health has conducted many studies on the impact of vaccine awareness on vaccination.The results of many studies show that with the increase of vaccine awareness rate,the impact of vaccine awareness rate on vaccination rate is gradually decreasing.Research in the field of health communication is based on the perspective of social cognition,and does not consider vaccine cognition as a simple vaccine awareness rate,but as a knowledge-based cognition process.Health communication research focuses on measuring vaccine cognition from individual psychological perception.Whether adolescents are vaccinated against HPV is decided by guardians,and many health studies have shown that the role of mothers is more critical.Therefore,the decision-making of HPV vaccination for adolescents not only needs to consider whether the mother fully understands the vaccine knowledge,but also needs to understand the information needs of mothers for HPV vaccination of adolescents.At the same time,it needs to be analyzed in combination with the degree of mother’s involvement in the process of HPV vaccination for adolescents.Therefore,from the perspective of health communication,this paper conducts an in-depth analysis of the decision-making process of adolescent HPV vaccine mothers,and constructs the "cognition-motivation-behavior-vaccination ”decision-making model.Consider its impact on the decision-making behavior process from multiple dimensions of problem cognition,involvement cognition and constraint cognition,situational motivation,information taking,information selecting ",and identify obstacles in the vaccination process.According to the three cognitive dimensions of " problem cognition,involvement cognition and constraint cognition",the mother’s decision-making types are divided,and on this basis,how to provide targeted information support is discussed.This paper uses mixed research methods,based on in-depth interviews with mothers of age-appropriate vaccination groups,and uses qualitative research to explore the characteristics of adolescent HPV vaccination under the influence of Chinese social culture and information environment,and optimizes the theoretical framework of problem-solving situations.The quantitative research part validates the research model,explains the process mechanism of decision formation and subdivides the mother’s decision-making types.The study found that(1)Chinese mothers pay high attention to HPV vaccination and have a high level of vaccine awareness,but the social environment cannot provide mothers with sufficient information support to assist them in making vaccine decisions.(2)The decisionmaking model deeply explained the mechanism of cognition,motivation,and information behavior factors in the vaccination decision-making process.Individual’s involvement cognition and constraint cognition can predict situational motivation,situational motivation can predict information taking and information selecting,and finally information taking can predict vaccination behavior.(3)Cluster analysis divided four types of decision-making groups: the mobile public highly involved in vaccination issues;the informed public with the most active vaccination behavior;the potential public who lacked vaccine information;the non-public who did not enter the context of vaccination issues.Based on the conclusions of the study,this study responds to previous studies and proposes two new changes in the practice of HPV vaccination among Chinese adolescents: one is the shift from vaccine hesitation to vaccine caution.Mothers have a high acceptance of HPV vaccine.Mothers who have not vaccinated their daughters are not hesitating whether to vaccinate their daughters,but are collecting sufficient information to vaccinate their daughters with the best vaccine.Mothers are more cautious in their decision-making during the vaccination process.The second is that the difference in vaccination caused by individual factors is narrowing.Based on the above research conclusions and findings,this paper puts forward targeted recommendations to promote HPV vaccination among adolescents,such as providing more professional and authoritative knowledge and vaccination recommendations for the mobile public,and reducing potential public information acquisition and understanding barriers.This study expands the situational theory of problem solving and its application context at the theoretical level,and also provides a new research idea and method for audience segmentation research.It provides theoretical and practical guidance for the popularization and promotion of HPV vaccination in China.更多还原