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首页> 外文期刊>BMC Public Health >Needles, Jabs and Jags : a qualitative exploration of barriers and facilitators to child and adult immunisation uptake among Gypsies, Travellers and Roma
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Needles, Jabs and Jags : a qualitative exploration of barriers and facilitators to child and adult immunisation uptake among Gypsies, Travellers and Roma

机译：针头，戳刺和锯齿：定性探索吉普赛人，旅行者和罗姆人对儿童和成人免疫接种的障碍和促进者

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Background Gypsies, Travellers and Roma (referred to as Travellers) are less likely to access health services including immunisation. To improve immunisation rates, it is necessary to understand what helps and hinders individuals in these communities in taking up immunisations. This study had two aims. 1. Investigate the views of Travellers in the UK on the barriers and facilitators to acceptability and uptake of immunisations and explore their ideas for improving immunisation uptake; 2. Examine whether and how these responses vary across and within communities, and for different vaccines (childhood and adult). Methods This was a qualitative, cross-sectional interview study informed by the Social Ecological Model. Semi-structured interviews were conducted with 174 Travellers from six communities: Romanian Roma, English Gypsy/Irish Travellers (Bristol), English Gypsy (York), Romanian/Slovakian Roma, Scottish Show people (Glasgow) and Irish Traveller (London). The focus was childhood and selected adult vaccines. Data were analysed using the Framework approach. Results Common accounts of barriers and facilitators were identified across all six Traveller communities, similar to those documented for the general population. All Roma communities experienced additional barriers of language and being in a new country. Men and women described similar barriers and facilitators although women spoke more of discrimination and low literacy. There was broad acceptance of childhood and adult immunisation across and within communities, with current parents perceived as more positive than their elders. A minority of English-speaking Travellers worried about multiple/combined childhood vaccines, adult flu and whooping cough and described barriers to booking and attending immunisation. Cultural concerns about antenatal vaccines and HPV vaccination were most evident in the Bristol English Gypsy/Irish Traveller community. Language, literacy, discrimination, poor school attendance, poverty and housing were identified as barriers across different communities. Trustful relationships with health professionals were important and continuity of care valued. Conclusions The experience of many Travellers in this study, and the context through which they make health decisions, is changing. This large study identified key issues that should be considered when taking action to improve uptake of immunisations in Traveller families and reduce the persistent inequalities in coverage. Trial registration Current Controlled Trials ISRCTN20019630 .
机译：背景吉普赛人，旅行者和罗姆人（称为旅行者）获得医疗服务（包括免疫接种）的可能性较小。为了提高免疫接种率，有必要了解哪些因素可以帮助和阻碍这些社区的人们进行免疫接种。这项研究有两个目的。 1.研究英国旅行者对接受和接受免疫接种的障碍和促进者的看法，并探讨他们的想法，以提高免疫接种的接受度; 2.检查这些反应在社区内和社区之间以及针对不同的疫苗（儿童和成人）是否以及如何变化。方法这是一项基于社会生态模型的定性，横断面访谈研究。对来自六个社区的174名旅行者进行了半结构化访谈：罗马尼亚罗姆人，英国吉普赛人/爱尔兰旅行者（布里斯托尔），英国吉普赛人（约克），罗马尼亚/斯洛伐克罗马人，苏格兰表演者（格拉斯哥）和爱尔兰旅行者（伦敦）。重点是儿童期和选定的成人疫苗。使用框架方法分析数据。结果在所有六个Traveler社区中都发现了常见的障碍和促进者账户，与针对普通人群的记录相似。罗姆人所有社区在语言上和在一个新国家中都遇到了其他语言障碍。男性和女性描述了类似的障碍和促进者，尽管女性更多地谈论歧视和低识字率。社区内部和社区内部普遍接受了儿童免疫接种和成人免疫接种，目前的父母比父母的父母更积极。少数几个说英语的旅行者担心多种/多种儿童疫苗，成人流感和百日咳的困扰，并描述了预约和参加免疫接种的障碍。在布里斯托尔的英国吉普赛人/爱尔兰旅行者社区中，最明显的是人们对产前疫苗和HPV疫苗的文化关注。语言，素养，歧视，入学率低下，贫困和住房被确定为不同社区之间的障碍。与卫生专业人员的可信赖关系非常重要，重视护理的连续性。结论许多旅行者在本研究中的经验以及他们做出健康决定的环境正在发生变化。这项大型研究确定了采取行动以改善旅行者家庭中的免疫接种率并减少覆盖范围持续存在的不平等现象时应考虑的关键问题。试用注册电流控制试验ISRCTN20019630。

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