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Cordella B, Signore F, Andreassi S, De Dominicis S, Gennaro A, Iuso S, Mannarini T, Kerusauskaite S, Kosic A, Reho M, Rochira A, Rocchi G, Salvatore S. How socio-institutional contexts and cultural worldviews relate to COVID-19 acceptance rates: A representative study in Italy. Soc Sci Med 2023; 320:115671. [PMID: 36702028 PMCID: PMC9839458 DOI: 10.1016/j.socscimed.2023.115671] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/09/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
RATIONALE Despite its importance to counter the COVID-19 pandemic, vaccination has raised hesitation in large segments of the population. This hesitation makes it important to understand the mechanisms underlying vaccine acceptance. To this end, the study adopts the Semiotic Cultural Psychology Theory, holding that social behaviors - and therefore, vaccination acceptance - depend on the cultural meanings in terms of which people interpret the social world. OBJECTIVE The study aims at estimating the impact a) of the way people interpret the socio-institutional context of the pandemic and b) of the underlying cultural worldviews on vaccine acceptance. More particularly, the study tested the three following hypotheses. a) The meanings grounding the interpretation of the socio-institutional framework - that is, trust in institutions and political values - are an antecedent of vaccination acceptance. b) The impact of these meanings is moderated by the cultural worldviews (operationalized as symbolic universes). And c), the magnitude of the symbolic universes' moderator effect depends on the uncertainty to which the respondent is exposed. The exposure to uncertainty was estimated in terms of socioeconomic status - the lower the status, the high the exposure to uncertainty. METHODS An Italian representative sample (N = 3020) completed a questionnaire, measuring vaccination acceptance, the meanings attributed to the socio-institutional context - that is, political values and trust in institutions - and symbolic universes. RESULTS The findings were consistent with the hypotheses. a) Structural equation modelling proved that vaccine acceptance was predicted by trust in institutions. b) Multigroup analysis revealed that symbolic universes moderated the correlation between trust in institutions and vaccine acceptance. And c), the moderation effect of symbolic universes proved to occur only in the segment of lower socio-economic status (i.e., the group exposed to higher uncertainty). CONCLUSIONS Vaccination acceptance is not only a medical issue; it is also dependent upon the rationalization of the socio-institutional context. Implications for the promotion of vaccination acceptance are discussed.
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Affiliation(s)
- Barbara Cordella
- Department of Dynamic and Clinical Psychology, And Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00183, Rome, Italy
| | - Fulvio Signore
- Department of Human and Social Sciences, University of Salento, Via di Valesio 24, 73100, Lecce, Italy
| | - Silvia Andreassi
- Department of Dynamic and Clinical Psychology, And Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00183, Rome, Italy
| | | | - Alessandro Gennaro
- Department of Dynamic and Clinical Psychology, And Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00183, Rome, Italy
| | - Salvatore Iuso
- Department of Clinical and Experimental Medicine, University of Foggia, Via A. Gramsci, N. 89/91, 71122, Foggia, Italy
| | - Terri Mannarini
- Department of Human and Social Sciences, University of Salento, Via di Valesio 24, 73100, Lecce, Italy
| | - Skaiste Kerusauskaite
- Department of Dynamic and Clinical Psychology, And Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00183, Rome, Italy
| | - Ankica Kosic
- Department of Developmental and Social Psychology, Sapienza University of Rome, Via Dei Marsi, 78, 00185, Rome, Italy
| | - Matteo Reho
- Department of Dynamic and Clinical Psychology, And Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00183, Rome, Italy
| | - Alessia Rochira
- Department of Human and Social Sciences, University of Salento, Via di Valesio 24, 73100, Lecce, Italy
| | - Giulia Rocchi
- Department of Dynamic and Clinical Psychology, And Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00183, Rome, Italy
| | - Sergio Salvatore
- Department of Human and Social Sciences, University of Salento, Via di Valesio 24, 73100, Lecce, Italy.
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González-Cano M, Garrido-Peña F, Gil-Garcia E, Lima-Serrano M, Cano-Caballero MD. Sexual behaviour, human papillomavirus and its vaccine: a qualitative study of adolescents and parents in Andalusia. BMC Public Health 2021; 21:1476. [PMID: 34320959 PMCID: PMC8320038 DOI: 10.1186/s12889-021-11510-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 07/20/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) is one of the most common sexually transmitted infections and can be prevented by vaccination. The purpose of this study is to gain a better understanding, by analysing interview responses of adolescents and parents, of how adolescent sexual behaviour is approached in families, how widespread knowledge about HPV is in Andalusia, the autonomous region with the lowest vaccination rate in Spain, as well as to learn more about the interviewees' position regarding vaccination. METHODS A qualitative study by means of 15 focus groups of adolescents (N = 137, aged 14-17 years) and five focus groups of parents with children of those ages (N = 37) was conducted in the provinces of Granada, Seville and Jaén (Andalusia, Spain). The audio data were transcribed verbatim, coded and analysed thematically using NVIVO-10 software. RESULTS There were three major results: (1) There is a lack of communication between adolescents and parents regarding sexual behaviour; (2) In both groups, scarce knowledge about HPV and vaccination was found; (3) Parents mistrust vaccination due to a lack of qualified and verified information about its benefits. CONCLUSIONS Healthy adolescent sexual behaviour is aided by communication within the family. Families need more information based on the evidence about HPV and vaccination. Health professionals are a key element in this process.
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Affiliation(s)
| | - Francisco Garrido-Peña
- Department of Criminal Law, Philosophy of Law, Moral Philosophy and Philosophy, University of Jaen, Jaen, Spain
| | | | | | - María Dolores Cano-Caballero
- Department of Nursing, University of Granada, Granada, Spain
- Biosanitary Research Institute of Granada, Granada, Spain
- University Hospital Virgen de las Nieves, Granada, Spain
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Díaz Crescitelli ME, Ghirotto L, Sisson H, Sarli L, Artioli G, Bassi MC, Appicciutoli G, Hayter M. A meta-synthesis study of the key elements involved in childhood vaccine hesitancy. Public Health 2019; 180:38-45. [PMID: 31838344 DOI: 10.1016/j.puhe.2019.10.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 09/26/2019] [Accepted: 10/30/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Immunization is one of the most successful and cost-effective interventions to improve health outcomes. However, internationally, the phenomenon of parental vaccine hesitancy is increasing and presents a growing challenge for health professionals. This article summarizes the evidence surrounding childhood vaccine hesitancy from the perspective of parents. STUDY DESIGN We conducted a systematic review and meta-synthesis of qualitative studies. METHODS We searched for qualitative research articles in electronic databases from inception to March 2018. In addition, a manual search of the retrieved articles and their references was conducted to identify other potential articles. We used the Critical Appraisal Skills Programme to examine study validity, adequacy and potential applicability of the results. No articles were excluded for reasons of quality. By performing a meta-synthesis, we identified descriptive themes and, subsequently, the conceptual elements of vaccine hesitancy. RESULTS The review included 27 studies involving a total of 1557 parents who were hesitant about vaccinating their child. Five overarching categories were identified: (1) risk conceptualization; (2) mistrust towards vaccine-related institutions, pharmaceutical companies, researchers, health professionals and the information from media; (3) parental alternative health beliefs about childhood immunity, vaccine scheduling and the perceived toxicity of vaccinations; (4) philosophical views on parental responsibility; and (5) parents' information levels about vaccination. CONCLUSIONS Healthcare providers need to approach this difficult situation considering that parents desire to do what they feel right for the child. Understanding the core elements of hesitancy will allow health professionals to adopt effective communication and behavioural strategies.
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Affiliation(s)
| | - L Ghirotto
- Azienda USL - IRCCS di Reggio Emilia, Italy
| | - H Sisson
- Faculty of Health Sciences, University of Hull, UK
| | - L Sarli
- Department of Medicine and Surgery, University of Parma, Italy
| | - G Artioli
- Azienda USL - IRCCS di Reggio Emilia, Italy
| | - M C Bassi
- Azienda USL - IRCCS di Reggio Emilia, Italy
| | | | - M Hayter
- Faculty of Health Sciences, University of Hull, UK
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Cruz Piqueras M, Rodríguez García de Cortazar A, Hortal Carmona J, Padilla Bernáldez J. [Vaccine hesitancy: discourse analysis of parents who have not fully or partially vaccinated their children]. GACETA SANITARIA 2017; 33:53-59. [PMID: 28928056 DOI: 10.1016/j.gaceta.2017.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/07/2017] [Accepted: 07/11/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To analyse and understand vaccination hesitancy discourses, particularly those of people who have decided not to vaccinate their sons and daughters. METHODS Qualitative study of five individual interviews and two focus groups with people who chose not to vaccinate their children in the province of Granada (Spain). RESULTS Mothers and fathers manifest a system of health beliefs different to the biomedical paradigm. From an ethical point of view, they justify their position based on the right to autonomy and responsibility for their decisions. Alleged specific reasons: they doubt administration of several vaccines simultaneously at an early age in a systematic way and without individualising each case; they fear adverse effects and do not understand the variations of the vaccination schedule. CONCLUSIONS These vaccination hesitancy discourses respond to the individual vs collective conflict; parents defend their right to bring up their children without any interference from the state and focus their responsibility on the individual welfare of their sons and daughters, regardless of the consequences that their actions might have on the collective. In their management of risks, they consider those derived from vaccination more relevant than the individual or collective consequences of not doing so. The vaccines generating most doubts are the more controversial ones within the scientific world. Transparency in communication of adverse effects; authorities respect for other health/disease concepts; banishment of the term "anti-vaccines" from the media and scientific vocabulary, and developing spaces for dialogue are bridges to be built.
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