Effectiveness of interventions to increase vaccine uptake: component network meta-analysis.

Methods

Component network meta-analysis.

成分网络荟萃分析。

Systematic reviewof randomised controlled trials in high and upper middle income countries.

对高收入和上中等收入国家的随机对照试验进行系统评价。

237 studies with 570 intervention arms and 4 361 717 participants.

237项研究，包含570个干预组和4,361,717名参与者。

Any intervention targeting vaccine recipients or their caregivers aiming to increase demand for, or access to, vaccinations on the UK immunisation schedule.

任何针对疫苗接种者或其护理人员的干预措施，旨在增加对英国免疫计划疫苗的需求或获取途径。

Key content and delivery features of interventions were identified using a bespoke coding framework co-developed with stakeholders.

使用与利益相关者共同开发的定制编码框架，确定了干预措施的关键内容和传递特征。

The outcome of interest was vaccine uptake.

我们关注的结果是疫苗接种率。

Bayesian component level meta-regression estimated relative effects of intervention components as ratios of odds ratios with 95% credible intervals (CrIs).

贝叶斯组分水平元回归估计了干预措施组分的相对效果，以比值比的比率表示，并附有95%可信区间(CrIs)。

Results

Of the included studies, 110 were at low risk of bias, 96 had some concerns, and 31 were at high risk. 40% (n=1 744 686) of the participants were male.

在纳入的研究中，110项研究偏倚风险低，96项存在一些疑问，31项偏倚风险高。参与者中有40%（n=1,744,686）为男性。

For children, there was evidence of beneficial effects for payments to cover costs (ratio of odds ratios 3.01, 95% CrI 1.49 to 6.06) and decision aids (2.73, 1.14 to 7.06), and some evidence for extended opportunities (1.37, 0.98 to 1.95) and social factors (1.27, 0.99 to 1.65).

对于儿童来说，有证据表明支付覆盖成本（比值比3.01，95% CrI 1.49至6.06）和决策辅助工具（2.73，1.14至7.06）有益效果，对于扩展机会（1.37，0.98至1.95）和社会因素（1.27，0.99至1.65）也有一些证据。

For adolescents and young adults, there were beneficial effects for personal delivery formats (2.13, 1.09 to 4.40), delivery by community members alongside healthcare professionals (6.42, 1.94 to 25.62), and social factors (2.62, 1.45 to 5.04), and negative effects for decision aids (0.43, 0.18 to 0.98) and human versus non-human interaction (0.47, 0.21 to 1.02).

对于青少年和青年人，个人交付格式（2.13，95% CI 1.09 至 4.40）、社区成员与医疗专业人员共同交付（6.42，95% CI 1.94 至 25.62）以及社会因素（2.62，95% CI 1.45 至 5.04）显示出有益效果，而决策辅助工具（0.43，95% CI 0.18 至 0.98）和人与非人互动（0.47，95% CI 0.21 至 1.02）则显示出负面影响。

For adults, beneficial effects were shown for human interaction (1.86, 1.42 to 2.45), extended opportunities (1.63, 1.35 to 2.00), help with appointment scheduling (1.38, 1.06 to 1.78), payments to cover costs (1.47, 1.03 to 2.16), and motivational interviewing (1.79, 1.21 to 2.64), and there was some evidence for financial incentives (1.15, 0.99 to 1.35) and information on vaccine safety and/or efficacy (1.15, 0.99 to 1.32).

对于成年人，人际互动（1.86，95% CI 1.42 至 2.45）、提供更多机会（1.63，95% CI 1.35 至 2.00）、帮助预约（1.38，95% CI 1.06 至 1.78）、支付覆盖成本（1.47，95% CI 1.03 至 2.16）和动机访谈（1.79，95% CI 1.21 至 2.64）显示出有益效果，同时也有证据表明财务激励（1.15，95% CI 0.99 至 1.35）和关于疫苗安全性和/或有效性的信息（1.15，95% CI 0.99 至 1.32）有一定的效果。

For adults, evidence also showed a negative effect of non-human interaction versus no interaction (0.72, 0.57 to 0.92).

在成人中，证据也显示与无互动相比，非人类互动有负面影响（0.72，95% CI 0.57 至 0.92）。

Subgroup analyses showed variation for underserved populations and in relation to the covid-19 pandemic (before 2020 and 2020 onwards).

亚组分析显示，在服务不足的人群以及与COVID-19大流行相关方面存在差异（2020年之前和2020年及以后）。

Conclusions

Overall, extended opportunities, appointment scheduling help, financial incentives, payments to cover costs, and motivational interviewing were effective content components of interventions to increase vaccine uptake.

总体而言，延长机会、预约安排帮助、经济激励、支付覆盖成本以及动机访谈是提高疫苗接种率干预措施的有效内容组成部分。

Effective delivery components overall were human interaction and delivery by community members alongside healthcare professionals.

总体而言，有效交付组成部分是人际互动以及社区成员与医疗专业人员共同交付。

However, effective components varied by age group, for underserved populations, and in analyses investigating the impact of the covid-19 pandemic.

然而，有效成分因年龄组、服务不足的人群以及在分析COVID-19大流行影响的研究中而异。

These findings have important implications for designing, optimising, and implementing targeted interventions, highlighting which components are effective across different populations and contexts.

这些发现对于设计、优化和实施针对性干预措施具有重要意义，强调了哪些成分在不同人群和环境中是有效的。

Consideration of the economic data on interventions should further support resource informed decision making.

考虑干预措施的经济数据应进一步支持基于资源信息的决策制定。