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Machida M, Nakamura I, Kojima T, Saito R, Nakaya T, Hanibuchi T, Takamiya T, Odagiri Y, Fukushima N, Kikuchi H, Amagasa S, Watanabe H, Inoue S. Acceptance of a COVID-19 Vaccine in Japan during the COVID-19 Pandemic. Vaccines (Basel) 2021; 9:210. [PMID: 33802285 PMCID: PMC8002097 DOI: 10.3390/vaccines9030210] [Citation(s) in RCA: 142] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/24/2021] [Accepted: 02/24/2021] [Indexed: 01/20/2023] Open
Abstract
Vaccination could be a key protective measure against coronavirus disease 2019 (COVID-19), and it is important to understand the acceptability of the COVID-19 vaccine among the general public. However, there is no study on the acceptance of a COVID-19 vaccine in Japan. Therefore, this study aimed to describe the COVID-19 vaccine acceptance and hesitancy situation in Japan and assess the factors associated with such issues. This was a cross-sectional study based on an internet survey completed by 2956 people. Participants were asked to indicate how likely they were to get vaccinated for COVID-19. In addition, the participants responded to questions regarding sociodemographic factors, attitudes, and beliefs regarding COVID-19 infection and vaccination. The proportion of participants with a high likelihood of getting a COVID-19 vaccine was 62.1%. Multiple logistic regression analysis showed that vaccine acceptance was lower among several sociodemographic groups, such as women, adults aged 20-49 years, and those with a low-income level. Several psychological factors, especially the perceived effectiveness of the COVID-19 vaccine, and willingness to protect others by getting oneself vaccinated, were associated with vaccine acceptance. Our results indicate that the perceived effectiveness of the vaccine and willingness to protect others may play an important role in the acceptance of the COVID-19 vaccine.
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Affiliation(s)
- Masaki Machida
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan; (M.M.); (T.T.); (Y.O.); (N.F.); (H.K.); (S.A.)
- Department of Infection Prevention and Control, Tokyo Medical University Hospital, Tokyo 160-0023, Japan; (I.N.); (H.W.)
| | - Itaru Nakamura
- Department of Infection Prevention and Control, Tokyo Medical University Hospital, Tokyo 160-0023, Japan; (I.N.); (H.W.)
| | - Takako Kojima
- Department of International Medical Communications, Tokyo Medical University, Tokyo 160-0023, Japan;
| | - Reiko Saito
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan;
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Miyagi 980-0845, Japan; (T.N.); (T.H.)
| | - Tomoya Hanibuchi
- Graduate School of Environmental Studies, Tohoku University, Miyagi 980-0845, Japan; (T.N.); (T.H.)
| | - Tomoko Takamiya
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan; (M.M.); (T.T.); (Y.O.); (N.F.); (H.K.); (S.A.)
| | - Yuko Odagiri
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan; (M.M.); (T.T.); (Y.O.); (N.F.); (H.K.); (S.A.)
| | - Noritoshi Fukushima
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan; (M.M.); (T.T.); (Y.O.); (N.F.); (H.K.); (S.A.)
| | - Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan; (M.M.); (T.T.); (Y.O.); (N.F.); (H.K.); (S.A.)
| | - Shiho Amagasa
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan; (M.M.); (T.T.); (Y.O.); (N.F.); (H.K.); (S.A.)
| | - Hidehiro Watanabe
- Department of Infection Prevention and Control, Tokyo Medical University Hospital, Tokyo 160-0023, Japan; (I.N.); (H.W.)
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, Japan; (M.M.); (T.T.); (Y.O.); (N.F.); (H.K.); (S.A.)
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Sallam M, Dababseh D, Eid H, Hasan H, Taim D, Al-Mahzoum K, Al-Haidar A, Yaseen A, Ababneh NA, Assaf A, Bakri FG, Matar S, Mahafzah A. Low COVID-19 Vaccine Acceptance Is Correlated with Conspiracy Beliefs among University Students in Jordan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2407. [PMID: 33804558 PMCID: PMC7967761 DOI: 10.3390/ijerph18052407] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/19/2021] [Accepted: 02/25/2021] [Indexed: 12/13/2022]
Abstract
Vaccination to prevent coronavirus disease 2019 (COVID-19) emerged as a promising measure to overcome the negative consequences of the pandemic. Since university students could be considered a knowledgeable group, this study aimed to evaluate COVID-19 vaccine acceptance among this group in Jordan. Additionally, we aimed to examine the association between vaccine conspiracy beliefs and vaccine hesitancy. We used an online survey conducted in January 2021 with a chain-referral sampling approach. Conspiracy beliefs were evaluated using the validated Vaccine Conspiracy Belief Scale (VCBS), with higher scores implying embrace of conspiracies. A total of 1106 respondents completed the survey with female predominance (n = 802, 72.5%). The intention to get COVID-19 vaccines was low: 34.9% (yes) compared to 39.6% (no) and 25.5% (maybe). Higher rates of COVID-19 vaccine acceptance were seen among males (42.1%) and students at Health Schools (43.5%). A Low rate of influenza vaccine acceptance was seen as well (28.8%), in addition to 18.6% of respondents being anti-vaccination altogether. A significantly higher VCBS score was correlated with reluctance to get the vaccine (p < 0.001). Dependence on social media platforms was significantly associated with lower intention to get COVID-19 vaccines (19.8%) compared to dependence on medical doctors, scientists, and scientific journals (47.2%, p < 0.001). The results of this study showed the high prevalence of COVID-19 vaccine hesitancy and its association with conspiracy beliefs among university students in Jordan. The implementation of targeted actions to increase the awareness of such a group is highly recommended. This includes educational programs to dismantle vaccine conspiracy beliefs and awareness campaigns to build recognition of the safety and efficacy of COVID-19 vaccines.
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Affiliation(s)
- Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan; (H.H.); (A.M.)
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22184 Malmö, Sweden
| | - Deema Dababseh
- Department of Dentistry, Jordan University Hospital, Amman 11942, Jordan;
| | - Huda Eid
- School of Dentistry, The University of Jordan, Amman 11942, Jordan; (H.E.); (D.T.); (A.A.-H.)
| | - Hanan Hasan
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan; (H.H.); (A.M.)
| | - Duaa Taim
- School of Dentistry, The University of Jordan, Amman 11942, Jordan; (H.E.); (D.T.); (A.A.-H.)
| | | | - Ayat Al-Haidar
- School of Dentistry, The University of Jordan, Amman 11942, Jordan; (H.E.); (D.T.); (A.A.-H.)
| | - Alaa Yaseen
- Department of Clinical Laboratory Sciences, School of Science, The University of Jordan, Amman 11942, Jordan; (A.Y.); (S.M.)
| | - Nidaa A. Ababneh
- Cell Therapy Center (CTC), The University of Jordan, Amman 11942, Jordan;
| | - Areej Assaf
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman 11942, Jordan;
| | - Faris G. Bakri
- Department of Internal Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan;
- Infectious Diseases and Vaccine Center, University of Jordan, Amman 11942, Jordan
| | - Suzan Matar
- Department of Clinical Laboratory Sciences, School of Science, The University of Jordan, Amman 11942, Jordan; (A.Y.); (S.M.)
| | - Azmi Mahafzah
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan; (H.H.); (A.M.)
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
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253
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Skjefte M, Ngirbabul M, Akeju O, Escudero D, Hernandez-Diaz S, Wyszynski DF, Wu JW. COVID-19 vaccine acceptance among pregnant women and mothers of young children: results of a survey in 16 countries. Eur J Epidemiol 2021; 36:197-211. [PMID: 33649879 PMCID: PMC7920402 DOI: 10.1007/s10654-021-00728-6] [Citation(s) in RCA: 322] [Impact Index Per Article: 107.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 01/21/2023]
Abstract
With the development of multiple effective vaccines, reducing the global morbidity and mortality of COVID-19 will depend on the distribution and acceptance of COVID-19 vaccination. Estimates of global vaccine acceptance among pregnant women and mothers of young children are yet unknown. An understanding of the challenges and correlates to vaccine acceptance will aid the acceleration of vaccine administration within these populations. Acceptance of COVID-19 vaccination among pregnant women and mothers of children younger than 18-years-old, as well as potential predictors, were assessed through an online survey, administered by Pregistry between October 28 and November 18, 2020. 17,871 total survey responses from 16 countries were obtained. Given a 90% COVID-19 vaccine efficacy, 52.0% of pregnant women (n = 2747/5282) and 73.4% of non-pregnant women (n = 9214/12,562) indicated an intention to receive the vaccine. 69.2% of women (n = 11,800/17,054), both pregnant and non-pregnant, indicated an intention to vaccinate their children. Vaccine acceptance was generally highest in India, the Philippines, and all sampled countries in Latin America; it was lowest in Russia, the United States and Australia. The strongest predictors of vaccine acceptance included confidence in vaccine safety or effectiveness, worrying about COVID-19, belief in the importance of vaccines to their own country, compliance to mask guidelines, trust of public health agencies/health science, as well as attitudes towards routine vaccines. COVID-19 vaccine acceptance and its predictors among women vary globally. Vaccination campaigns for women and children should be specific for each country in order to attain the largest impact.
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Affiliation(s)
- Malia Skjefte
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Michelle Ngirbabul
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Oluwasefunmi Akeju
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Daniel Escudero
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Sonia Hernandez-Diaz
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | | | - Julia W Wu
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.
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254
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Eguia H, Vinciarelli F, Bosque-Prous M, Kristensen T, Saigí-Rubió F. Spain's Hesitation at the Gates of a COVID-19 Vaccine. Vaccines (Basel) 2021; 9:170. [PMID: 33670621 PMCID: PMC7922768 DOI: 10.3390/vaccines9020170] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/11/2021] [Accepted: 02/15/2021] [Indexed: 02/07/2023] Open
Abstract
(1) Background: This study aims to delineate a pattern on vaccine hesitancy in a sample of the Spanish population, considering age groups and status as healthcare workers. (2) Methods: Participants were recruited using Twitter® as a dissemination tool to reach as many respondents as possible in different parts of the Spanish territory. The participants were recruited in a cross-sectional study, which included answering an online questionnaire. Data were collected from 10 September through 23 November 2020. Respondents answered questions asking whether they intended to be vaccinated and provided the main reason for their answers. To estimate associations between vaccination hesitancy and independent variables, we fit Poisson regression models with robust variance. (3) Results: One thousand and two responses were obtained, of which only 731 were validated. One hundred and sixty-four participants stated that they would not be vaccinated (22.43%), of which 20-24% were non-health workers or unemployed, 17.5% physicians, 31.5% other health workers, and almost 35% nurses. Concerns about lack of effectiveness of the vaccination, lack of safety when vaccinating and possibly dangerous adverse effects were the main causes provided. (4) Conclusions: This study indicates that more interventions are needed to achieve better communication with the population and health professionals. Receptiveness to the message of the importance and security of the COVID-19 vaccination could be an important strategy for improving these results.
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Affiliation(s)
- Hans Eguia
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona 08018, Spain; (H.E.); (M.B.-P.)
- SEMERGEN New Technologies Working Group, 28009 Madrid, Spain;
| | - Franco Vinciarelli
- SEMERGEN New Technologies Working Group, 28009 Madrid, Spain;
- Emergency Hospital Clemente Álvarez, Rosario (Santa Fe) S2002, Argentina
| | - Marina Bosque-Prous
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona 08018, Spain; (H.E.); (M.B.-P.)
| | - Troels Kristensen
- Danish Centre for Health Economics, University of Southern (DaCHE), 5230 Odense, Denmark;
| | - Francesc Saigí-Rubió
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona 08018, Spain; (H.E.); (M.B.-P.)
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255
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Abstract
Utility of vaccine campaigns to control coronavirus 2019 disease (COVID-19) is not merely dependent on vaccine efficacy and safety. Vaccine acceptance among the general public and healthcare workers appears to have a decisive role in the successful control of the pandemic. The aim of this review was to provide an up-to-date assessment of COVID-19 vaccination acceptance rates worldwide. A systematic search of the peer-reviewed English survey literature indexed in PubMed was done on 25 December 2020. Results from 31 peer-reviewed published studies met the inclusion criteria and formed the basis for the final COVID-19 vaccine acceptance estimates. Survey studies on COVID-19 vaccine acceptance rates were found from 33 different countries. Among adults representing the general public, the highest COVID-19 vaccine acceptance rates were found in Ecuador (97.0%), Malaysia (94.3%), Indonesia (93.3%) and China (91.3%). However, the lowest COVID-19 vaccine acceptance rates were found in Kuwait (23.6%), Jordan (28.4%), Italy (53.7), Russia (54.9%), Poland (56.3%), US (56.9%), and France (58.9%). Only eight surveys among healthcare workers (doctors and nurses) were found, with vaccine acceptance rates ranging from 27.7% in the Democratic Republic of the Congo to 78.1% in Israel. In the majority of survey studies among the general public stratified per country (29/47, 62%), the acceptance of COVID-19 vaccination showed a level of ≥70%. Low rates of COVID-19 vaccine acceptance were reported in the Middle East, Russia, Africa and several European countries. This could represent a major problem in the global efforts to control the current COVID-19 pandemic. More studies are recommended to address the scope of COVID-19 vaccine hesitancy. Such studies are particularly needed in the Middle East and North Africa, Sub-Saharan Africa, Eastern Europe, Central Asia, Middle and South America. Addressing the scope of COVID-19 vaccine hesitancy in various countries is recommended as an initial step for building trust in COVID-19 vaccination efforts.
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256
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Sallam M. COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates. Vaccines (Basel) 2021; 9:160. [PMID: 33669441 PMCID: PMC7920465 DOI: 10.3390/vaccines9020160] [Citation(s) in RCA: 1040] [Impact Index Per Article: 346.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 12/29/2022] Open
Abstract
Utility of vaccine campaigns to control coronavirus 2019 disease (COVID-19) is not merely dependent on vaccine efficacy and safety. Vaccine acceptance among the general public and healthcare workers appears to have a decisive role in the successful control of the pandemic. The aim of this review was to provide an up-to-date assessment of COVID-19 vaccination acceptance rates worldwide. A systematic search of the peer-reviewed English survey literature indexed in PubMed was done on 25 December 2020. Results from 31 peer-reviewed published studies met the inclusion criteria and formed the basis for the final COVID-19 vaccine acceptance estimates. Survey studies on COVID-19 vaccine acceptance rates were found from 33 different countries. Among adults representing the general public, the highest COVID-19 vaccine acceptance rates were found in Ecuador (97.0%), Malaysia (94.3%), Indonesia (93.3%) and China (91.3%). However, the lowest COVID-19 vaccine acceptance rates were found in Kuwait (23.6%), Jordan (28.4%), Italy (53.7), Russia (54.9%), Poland (56.3%), US (56.9%), and France (58.9%). Only eight surveys among healthcare workers (doctors and nurses) were found, with vaccine acceptance rates ranging from 27.7% in the Democratic Republic of the Congo to 78.1% in Israel. In the majority of survey studies among the general public stratified per country (29/47, 62%), the acceptance of COVID-19 vaccination showed a level of ≥70%. Low rates of COVID-19 vaccine acceptance were reported in the Middle East, Russia, Africa and several European countries. This could represent a major problem in the global efforts to control the current COVID-19 pandemic. More studies are recommended to address the scope of COVID-19 vaccine hesitancy. Such studies are particularly needed in the Middle East and North Africa, Sub-Saharan Africa, Eastern Europe, Central Asia, Middle and South America. Addressing the scope of COVID-19 vaccine hesitancy in various countries is recommended as an initial step for building trust in COVID-19 vaccination efforts.
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Affiliation(s)
- Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan; ; Tel.: +962-79-184-5186
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
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Szmyd B, Bartoszek A, Karuga FF, Staniecka K, Błaszczyk M, Radek M. Medical Students and SARS-CoV-2 Vaccination: Attitude and Behaviors. Vaccines (Basel) 2021; 9:vaccines9020128. [PMID: 33562872 PMCID: PMC7915119 DOI: 10.3390/vaccines9020128] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/22/2021] [Accepted: 02/03/2021] [Indexed: 12/11/2022] Open
Abstract
Since physicians play a key role in vaccination, the initial training of medical students (MS) should aim to help shape their attitude in this regard. The beginning of vaccination programs against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an excellent time to assess the attitudes held by both medical and non-medical students regarding vaccination. A 51- to 53-item questionnaire including the Depression, Anxiety and Stress Scale was administered to 1971 students (49.21% male; 34.86% MS); two career-related questions were also addressed to the MS. The majority of surveyed students indicated a desire to get vaccinated against SARS-CoV-2, with more medical than non-medical students planning to get vaccinated (91.99% vs. 59.42%). The most common concern about SARS-CoV-2 infection was the risk of passing on the disease to elderly relatives. While conspiracy theories regarding the COVID-19 vaccine are less popular among MS, both groups indicated concerns that vaccines may cause autism is equally common (~5%). Further studies exploring social attitudes towards the SARS-CoV-2 vaccine are a necessary first step to optimizing vaccination programs and achieving herd immunity.
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Affiliation(s)
- Bartosz Szmyd
- Department of Neurosurgery, Spine and Peripheral Nerves Surgery of Medical University of Lodz, 90-549 Łódź, Poland; (B.S.); (F.F.K.); (K.S.); (M.B.); (M.R.)
| | - Adrian Bartoszek
- Department of Neurosurgery, Spine and Peripheral Nerves Surgery of Medical University of Lodz, 90-549 Łódź, Poland; (B.S.); (F.F.K.); (K.S.); (M.B.); (M.R.)
- Department of Pathophysiology, Medical University of Lublin, 20-090 Lublin, Poland
- Correspondence:
| | - Filip Franciszek Karuga
- Department of Neurosurgery, Spine and Peripheral Nerves Surgery of Medical University of Lodz, 90-549 Łódź, Poland; (B.S.); (F.F.K.); (K.S.); (M.B.); (M.R.)
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Łódz, Poland
| | - Katarzyna Staniecka
- Department of Neurosurgery, Spine and Peripheral Nerves Surgery of Medical University of Lodz, 90-549 Łódź, Poland; (B.S.); (F.F.K.); (K.S.); (M.B.); (M.R.)
| | - Maciej Błaszczyk
- Department of Neurosurgery, Spine and Peripheral Nerves Surgery of Medical University of Lodz, 90-549 Łódź, Poland; (B.S.); (F.F.K.); (K.S.); (M.B.); (M.R.)
| | - Maciej Radek
- Department of Neurosurgery, Spine and Peripheral Nerves Surgery of Medical University of Lodz, 90-549 Łódź, Poland; (B.S.); (F.F.K.); (K.S.); (M.B.); (M.R.)
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258
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Pastorino R, Villani L, Mariani M, Ricciardi W, Graffigna G, Boccia S. Impact of COVID-19 Pandemic on Flu and COVID-19 Vaccination Intentions among University Students. Vaccines (Basel) 2021; 9:70. [PMID: 33498282 PMCID: PMC7909275 DOI: 10.3390/vaccines9020070] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/13/2021] [Accepted: 01/15/2021] [Indexed: 01/27/2023] Open
Abstract
Flu vaccination for the general population, and specifically for vulnerable subgroups, brings the potential to reduce the impact of the COVID-19 pandemic in terms of mobility, mortality, and hospitalizations. In Italy, flu vaccination is recommended to all ≥6 months of age, even if it is only free of charge for specific categories. We investigated the intentions towards flu and COVID-19 vaccinations from a sample of 436 Italian university students. Results of a web-based survey show that 77.52% of them were willing to get the flu vaccine and 94.73% were willing to be vaccinated against COVID-19 when available. We identified positive predictive factors to undertake flu vaccination as being a medical student, having undertaken a previous vaccination against flu, and having a high level of concern and perceived vulnerability to the COVID-19 pandemic. Reinforced public health activities might consider engaging university students a as possible "positive influencer" towards flu and COVID-19 vaccination programs.
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Affiliation(s)
- Roberta Pastorino
- Department of Woman and Child Health and Public Health—Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.P.); (W.R.); (S.B.)
| | - Leonardo Villani
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Marco Mariani
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Walter Ricciardi
- Department of Woman and Child Health and Public Health—Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.P.); (W.R.); (S.B.)
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Guendalina Graffigna
- Dipartimento di Psicologia—Università Cattolica del Sacro Cuore, 20123 Milan, Italy;
- EngageMinds HUB—Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, 26100 Cremona, Italy
| | - Stefania Boccia
- Department of Woman and Child Health and Public Health—Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.P.); (W.R.); (S.B.)
- Section of Hygiene, University Department of Life Sciences and Public Health—Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
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259
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Kanu S, James PB, Bah AJ, Kabba JA, Kamara MS, Williams CEE, Kanu JS. Healthcare Workers' Knowledge, Attitude, Practice and Perceived Health Facility Preparedness Regarding COVID-19 in Sierra Leone. J Multidiscip Healthc 2021; 14:67-80. [PMID: 33469299 PMCID: PMC7810694 DOI: 10.2147/jmdh.s287156] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/08/2020] [Indexed: 11/23/2022] Open
Abstract
Background Healthcare workers (HCWs) are known to spearhead the fight against the COVID-19 pandemic. As such, their knowledge, attitude, and practice (KAP) toward coronavirus disease 2019 (COVID-19) are considered critical to the success of the current COVID-19 response efforts. This study aims to determine HCWs’ KAP toward COVID-19 and assesses their perception of their healthcare facilities preparedness to respond appropriately to the ongoing COVID-19 pandemic in Sierra Leone. Methods We conducted an online cross-sectional study among HCWs (n=516) between 1st May 2020 and 30th June 2020. We collected our data using a self-administered structured questionnaire via email and online social media platforms. We analyzed our data using descriptive statistics and regression analysis (p<0.05). Results Close to three-fourth of HCWs (n=375, 72.7%) were knowledgeable regarding COVID-19. Doctors were more knowledgeable than community health workers and laboratory technicians (AOR= 2.48, 95% CI: 1.16–5.31, p=0.019) regarding COVID-19. Close to two-thirds of HCWs (n=301, 58.3%) HCWs show positive attitudes toward COVID-19. Being male (AOR=2.08, 95% CI: 1.36–3.20, p=0.001) and directly involved in COVID-19 patient care (AOR=3.21, 95% CI: 1.88–5.48, p<0.001) were identified as predictors of positive attitude towards COVID-19. HCWs are generally adhering to COVID-19 safe practices with majority indicating that they regularly wash or sanitize their hands (n=510, 98.8%) and used facemask at point of care (n=499, 96.7%). Majority of HCWs are of the view that their healthcare facilities are ill-prepared to adequately respond to COVID-19 with majority (n= 400, 77.5%) of them stating that their facilities lack enough personal protective equipment. Conclusion HCWs in Sierra Leone showed good knowledge, positive attitude and practice regarding COVID-19. However, HCWs are of the view that their healthcare facilities are ill-prepared to respond adequately to the COVID-19 outbreak. Health authorities and policymakers need to provide the necessary resources to allow HCWs to work in a safe environment.
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Affiliation(s)
- Sulaiman Kanu
- University of Sierra Leone Teaching Hospital Complex, Connaught Hospital, Freetown, Sierra Leone
| | - Peter Bai James
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007, Australia
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - John Alimamy Kabba
- Department of Pharmacy Administration and Clinical Pharmacy, Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Musa Salieu Kamara
- University of Sierra Leone Teaching Hospital Complex, Connaught Hospital, Freetown, Sierra Leone
| | | | - Joseph Sam Kanu
- Directorate of Disease Prevention and Control, Ministry of Health and Sanitation, Freetown, Sierra Leone
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Serbezova A, Mangelov M, Zaykova K, Nikolova S, Zhelyazkova D, Balgarinova N. Knowledge and attitude toward COVID-19 vaccines amongst medical, dental and pharmacy students. A cross-sectional study from Bulgaria. BIOTECHNOL BIOTEC EQ 2021. [DOI: 10.1080/13102818.2022.2041097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Asena Serbezova
- Department of Health Policy and Management, Faculty of Public Health, Medical University of Sofia, Sofia, Bulgaria
| | - Martin Mangelov
- Faculty of Medicine, Medical University of Varna, Varna, Bulgaria
| | | | - Silviya Nikolova
- Department of Social Medicine and Organization of Healthcare, Faculty of Public Health, Medical University of Varna, Varna, Bulgaria
| | | | - Niya Balgarinova
- Faculty of Medicine, Medical University of Varna, Varna, Bulgaria
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261
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Campo-Arias A, Pedrozo-Pupo JC. COVID-19 vaccine distrust in Colombian university students: Frequency and associated variables. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021367. [PMID: 35075083 PMCID: PMC8823557 DOI: 10.23750/abm.v92i6.11533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIM OF THE WORK The frequency of distrust towards the COVID-19 vaccine varies widely depending on the context, way of measurement, and pandemic stage. However, little information is available about Colombian populations. The study aimed to know the frequency and variables associated with COVID-19 vaccine distrust in students of a Colombian university. METHODS A cross-sectional study was carried out which participated emerging adult students of a Colombian university. RESULTS A total of 1,136 students between 18 and 29 years (M= 22.0, SD = 3.0); most of participants were female (66.0%), non-health students (82.8%), low-income (79.0%), and residents of urban areas (84.9%). It was frequent low institutional trust (74.8%), low cognitive, social capital (27.9%), low fear of COVID-19 (49.5%), low perceived stress related to COVID-19 (83.5%), and high COVID-19 vaccine distrust (78.9%). Non-health carrier (Adjusted OR = 3.63, 95%CI 2.58-5.10), rural residence (AOR = 1.85, 95%CI 1.13-3.04), low income (AOR = 1.84, 95%CI 1.31-2.57), and perceived stress related to COVID-19 (AOR = 1.74, 95%CI 1.20-2.54) were related to high COVID-19 vaccine distrust. CONCLUSIONS COVID-19 vaccine distrust is high among emerging adult Colombian university students. The COVID-19 vaccine distrust is related to non-health science carriers, rural residents, low-income, and low-perceived stress related to COVID-19. The COVID-19 related health literacy should be improved in students of this university considering socio-cultural background.
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262
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Leelavathy M, Messaline S, Ramachandran D, Sukumaran A, Jose R, Noufel A. Attitude towards COVID-19 vaccination among the public in Kerala: A cross sectional study. J Family Med Prim Care 2021; 10:4147-4152. [PMID: 35136781 PMCID: PMC8797121 DOI: 10.4103/jfmpc.jfmpc_583_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/11/2021] [Accepted: 07/12/2021] [Indexed: 11/10/2022] Open
Abstract
Context: As COVID-19 spread across the world, vaccines were developed to fight against the spread of the new disease. Negative attitude and unwillingness to vaccinate when available may be a major hurdle in attaining effective vaccination coverage. Aims: The aim of this study was to assess the attitudes towards the COVID-19 vaccine and identify the predictors of negative attitudes towards the vaccine and identify groups most at risk of uncertainty and unwillingness to receive a COVID-19 vaccine. Settings and Design: General public of Kerala, cross-sectional survey. Methods and Material: The study was conducted in Kerala during the period from 16 January 2021 to 22 February 2021. An online semi-structured questionnaire was sent via google forms with a consent form appended to it. Attitude towards vaccination was measured using a 20-item scale. Statistical Analysis Used: Collected data were analysed using SPSS software version 16. Ordinary least-squares (OLS) regressions were carried out to examine socio-demographic predictors of attitude towards vaccination. Multinomial logistic regression model was fitted to examine associations of socio-demographic with uncertainty and disagree to vaccinate against COVID-19. Results: In this study, 1345 subjects participated. Mean attitude score was 48.68 with SD 13.55. Most of the study subjects were agreeable to take the vaccine once it is available (88.8%). Religion, occupation, and monthly income were found to be the predictors of attitude towards vaccination. Conclusions: The willingness for vaccine uptake was found to be high in our study. However, other aspects such as doubt regarding its safety, effectiveness and duration of protection are considerable and need to be addressed.
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263
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Qiao S, Tam CC, Li X. Risk exposures, risk perceptions, negative attitudes toward general vaccination, and COVID-19 vaccine acceptance among college students in South Carolina. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020. [PMID: 33269360 DOI: 10.1101/2020.11.26.20239483] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Growing attention has been paid to vaccination in control of the COVID-19 pandemic and young adults is one of the key populations for vaccination. Advanced understanding of young adults' willingness to take a COVID-19 vaccine and the potential factors influencing their vaccine intention will contribute to the development and implementation of effective strategies to promote COVID-19 vaccine uptake among this group. The current study investigated how risk exposures and risk perceptions of COVID-19 (e.g., perceived susceptibility, severity, and fear of COVID-19) as well as negative attitudes toward general vaccination were related to COVID vaccine acceptance among college students based on online survey data from 1062 college students in South Carolina . Hierarchical linear regression was used to examine the association of these factors with COVID-19 vaccine acceptance controlling for key demographics. Results suggested that perceived severity and fear of COVID-19 were positively associated with vaccine acceptance, while higher level of risk exposures (work/study place exposure) and negative attitude toward general vaccination were associated with low vaccine acceptance. Our findings suggested that we need tailored education messages for college students to emphasize the severity of COVID-19, particularly potential long-term negative consequences on health, address the concerns of side effects of general vaccines by dispelling the misconception, and target the most vulnerable subgroups who reported high level of risk exposures while showed low intention to take the vaccine. Efforts are warranted to increase college students' perceived susceptibility and severity and promote their self-efficacy in health management and encourage them to take protective behaviors including vaccine uptake.
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264
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Grech V, Gauci C. WITHDRAWN: Vaccine hesitancy in the University of Malta Faculties of Health Sciences, Dentistry and Medicine vis-à-vis influenza and novel COVID-19 vaccination. Early Hum Dev 2020:105258. [PMID: 33213966 PMCID: PMC7658558 DOI: 10.1016/j.earlhumdev.2020.105258] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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265
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Graffigna G, Palamenghi L, Barello S, Stefania B. "Cultivating" acceptance of a COVID-19 vaccination program: Lessons from Italy. Vaccine 2020; 38:7585-7586. [PMID: 33121655 PMCID: PMC7588171 DOI: 10.1016/j.vaccine.2020.10.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/04/2020] [Accepted: 10/06/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Guendalina Graffigna
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Lorenzo Palamenghi
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Serena Barello
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy.
| | - Boccia Stefania
- Section of Hygiene, University Department of Health Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Woman and Child Health and Public Health, Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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266
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Taylor S, Landry CA, Paluszek MM, Groenewoud R, Rachor GS, Asmundson GJG. A Proactive Approach for Managing COVID-19: The Importance of Understanding the Motivational Roots of Vaccination Hesitancy for SARS-CoV2. Front Psychol 2020; 11:575950. [PMID: 33192883 PMCID: PMC7604422 DOI: 10.3389/fpsyg.2020.575950] [Citation(s) in RCA: 186] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/01/2020] [Indexed: 01/24/2023] Open
Abstract
Importance Vaccination hesitancy—the reluctance or refusal to be vaccinated—is a leading global health threat (World Health Organization, 2019). It is imperative to identify the prevalence of vaccination hesitancy for SARS-CoV2 in order to understand the scope of the problem and to identify its motivational roots in order to proactively prepare to address the problem when a vaccine eventually becomes available. Objective To identify (1) the prevalence of vaccination hesitancy for a SARS-CoV2 vaccine, (2) the motivational roots of this hesitancy, and (3) the most promising incentives for improving the likelihood of vaccination uptake when a vaccine does become available. Design, Setting, and Participants A cross-sectional sample of 3,674 American and Canadian adults assessed during the COVID-19 pandemic in May 2020. Main Outcomes Measures of vaccination intention (i.e., “If a vaccine for COVID-19 was available, would you get vaccinated?”), attitudes toward vaccines in general and specific to SARS-CoV2 using the Vaccination Attitudes Examination Scale, and incentives for getting vaccinated for those who reported they would not get vaccinated. Results Many American (25%) and Canadian (20%) respondents said that they would not get vaccinated against SARS-CoV2 if a vaccine was available. Non-adherence rates of this magnitude would make it difficult or impossible to achieve herd immunity. Vaccine rejection was most strongly correlated with mistrust of vaccine benefit, and also correlated with worry about unforeseen future effects, concerns about commercial profiteering from pharmaceutical companies, and preferences for natural immunity. When asked about incentives for getting vaccinated, respondents were most likely to report that evidence for rigorous testing and safety of the vaccine were of greatest importance. Conclusions and Relevance Vaccination hesitancy is a major looming problem for COVID-19. To improve vaccine uptake, it is imperative that the vaccine is demonstrated to the public to be rigorously tested and not perceived as rushed or premature in its dissemination.
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Affiliation(s)
- Steven Taylor
- Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | | | | | - Rosalind Groenewoud
- Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
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Graffigna G, Palamenghi L, Boccia S, Barello S. Relationship between Citizens' Health Engagement and Intention to Take the COVID-19 Vaccine in Italy: A Mediation Analysis. Vaccines (Basel) 2020; 8:E576. [PMID: 33019663 PMCID: PMC7711984 DOI: 10.3390/vaccines8040576] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 12/18/2022] Open
Abstract
The actual effectiveness of the still-to-come vaccination against the coronavirus SARS-CoV-2 might be challenged by vaccine hesitancy, a rather common and known phenomenon whose psychological predictors are, nevertheless, still largely debated. Our study aims at understanding how adult citizens' health engagement, perceived COVID-19 susceptibility and severity, and general vaccine-related attitudes affect the willingness to vaccinate against COVID-19. To that end, on a sample of Italian citizens, we implemented a path model to test the impact of health engagement on the willingness to vaccinate against SARS-CoV-2, and whether this relationship is direct or mediated by the general attitude towards vaccines and the risk perception. Moreover, we tested the configural and weak invariance of the model across gender and three age groups. Results show that health engagement is positively related to the intention to vaccinate and that this relationship is partially mediated by the general attitude towards vaccines. The model appears invariant across genders and partially invariant across age groups, showing some differences in the role of perceived susceptibility. These findings vouch for the implementation of educational campaigns aimed at sustaining future vaccination programs that also include health engagement promotion.
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Affiliation(s)
- Guendalina Graffigna
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, 20123 Milan, Italy; (G.G.); (S.B.)
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20123 Milan, Italy
- Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, via Milano 24, 26100 Cremona, Italy
| | - Lorenzo Palamenghi
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, 20123 Milan, Italy; (G.G.); (S.B.)
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20123 Milan, Italy
- Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, via Milano 24, 26100 Cremona, Italy
| | - Stefania Boccia
- Section of Hygiene, Department of Health Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Woman and Child Health and Public Health, Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Serena Barello
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, 20123 Milan, Italy; (G.G.); (S.B.)
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20123 Milan, Italy
- Faculty of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
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268
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Graffigna G, Barello S, Savarese M, Palamenghi L, Castellini G, Bonanomi A, Lozza E. Measuring Italian citizens' engagement in the first wave of the COVID-19 pandemic containment measures: A cross-sectional study. PLoS One 2020; 15:e0238613. [PMID: 32915822 PMCID: PMC7485890 DOI: 10.1371/journal.pone.0238613] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 08/20/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In January 2020, the coronavirus disease 2019 (COVID-19) started to spread in Italy. The Italian government adopted urgent measures to slow its spread. Enforcing compliance with such measures is crucial in order to enhance their effectiveness. Engaging citizens in the COVID-19 preventive process is urgent today both in Italy and around the world. However, to the best of our knowledge, no previous studies have investigated the role of health engagement in predicting citizens' compliance with health emergency containment measures. METHOD An online survey was administered between February 28 and March 4, 2020 on a representative sample of 1000 Italians. The questionnaire included a measure of health engagement (Patient Health Engagement Scale), a 5-item Likert scale ranging from 1 to 7, resulting in 4 positions that describe the psychological readiness to be active in one's own health management, and a series of ad hoc items intended to measure citizens' perceived susceptibility and severity of the disease, orientation towards health management, trust in institutional bodies, health habits and food consumption. To investigate the relationship between health engagement and these variables, ANOVA analysis, logistic regression and contingency tables with Pearson's chi-squared analysis have been carried out. RESULTS Less engaged people show higher levels of perceived susceptibility to the virus and severity of the disease; they are less trustful of scientific and healthcare authorities, they feel less self-effective in managing their own health-both in normal conditions and under stress-and are less prone to cooperate with healthcare professionals. Low levels of health engagement also are associated with a change in the usual purchase behavior. CONCLUSIONS The Patient Health Engagement model (PHE) provides a useful framework for understanding how people will respond to health threats such as pandemics. Therefore, intervention studies should focus on raising their levels of engagement to increase the effectiveness of educational initiatives intended to promote preventive behaviors.
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Affiliation(s)
- Guendalina Graffigna
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agricultural, Nutrition and Environmental Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Serena Barello
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Mariarosaria Savarese
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agricultural, Nutrition and Environmental Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Lorenzo Palamenghi
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agricultural, Nutrition and Environmental Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Greta Castellini
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agricultural, Nutrition and Environmental Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Andrea Bonanomi
- Department of Statistical Science, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Edoardo Lozza
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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