| Objective:To understand the knowledge level of immunization programs status in pregnant women and evaluate the effect of health education on knowledge and behavior change.Methods:During January to March,2007, a stratified randomized sampling method was implemented, and a random sample of Tianjin was drawn for the study population. The strategy of sampling in this study was designed based on social economic status. In brief, a 3-step randomized sampling procedure was carried out following:first, two urban districts, two suburbs and two counties were drawn as the first stage-sampling; second,22 hospitals were selected based on the prenatal examination condition in 2006 as second level unit; finally,1440 pregnant women with gestational age of more than 12 weeks and lived in Tianjin for over 3 months, who received prenatal examination in above-mentioned hospitals, were recruited. Data on age, education, occupation, knowledge level on immunization, coverage of vaccine, and so on were collected from participants through the interview following a structured questionnaire. Then,1440 pregnant women were randomly assigned into intervention group with health education and control group, each group including 720 pregnant women. The prenatal examination of two groups was appointed in different time, for avoiding the influence of health education on study result. The relevant knowledge on immunization was gotten after the intervention program, and the status of their baby's vaccination were followed up in order to evaluate the intervention effect of the health education program.Results:The results of baseline investigation showed that the awareness rate of EPI vaccine only was 13.26%. Awareness rate on vaccinated time, vaccinated place, application time for immunization record and place were 71.29%,41.74%,24.65% and 33.75% respectively. The awareness rate in 26-30 years old group was highest (15.19%) and that of=20 years old group was lowest (5.00%), there were significant difference (χ2=19.54, P<0.01). The awareness rate of pregnant women with different education level were also different (χ2=39.36, P<0.01), who with college education had highest rate (19.02%), who with high school and elementary school education were 8.69% and 7.09% respectively. The awareness rate of pregnant women who were leader, worker and farmer were 18.26%,11.58%, and 3.64% respectively (χ2=48.34, P<0.01). Before intervention, there were no significant difference in the awareness rates between intervention group (14.41%) and control group(11.38%) (χ2=1.45,,P>0.05). After intervention, the awareness rate was 42.72% vs.12.89% in intervention group and control group, there were significant difference (χ2=161.98, P<0.01). As a result, one and half years passed after intervention, the baby's vaccine coverage rate in time was 95.98%, for hepatitis B vaccine,96.43% for BCG, 93.30% for DPT,83.48% for measles vaccine,86.38% for JEV,76.79% for MPV, was and 53.35% for full coverage rate in time in intervention group, whereas 92.23%, 94.92%,86.32%,73.20%,69.96%,69.53% and 33.45% respectively in control group. The knowledge rates of expanded program on immunization between intervention group and control group had significant difference (χ2=4.27, P=0.03). There was no significant difference about the recent effect of immunization programs intervention among different population (P>0.05); however, immunization programs intervention (OR=2.035,95%CI=1.574-2.632) and high education level of prangnants (OR=1.214, 95%CI=1.045-1.409) were associated with high full coverage vaccination rate in time.95.52% of participants wanted to get the knowledge of vaccination. The most 3 desirable approaches to get the knowledge were from doctors (31.55%), professional books (23.19%) and professional lectures (19.97%), respectively.Conclusions:The awareness rate of vaccination is low in pregnant women. However, they have desirabilities to get the knowledge of vaccination and the intervention program of health education can increase the awareness rate of pregnant women and vaccine coverage rate in time in their children. The ways of taking a propaganda and health education program in pregnant women in pregnant school should be recommended. |
