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McCollum G, Allgood A, Agne A, Cleveland D, Gray C, Ford E, Baral S, Mugavero M, Hall AG. Associations Between Social Networks and COVID-19 Vaccine Uptake in 4 Rural Alabama Counties: Survey Findings. Public Health Rep 2024:333549241250223. [PMID: 38780015 DOI: 10.1177/00333549241250223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVES The COVID-19 pandemic demonstrated how vaccination decisions are influenced by misinformation, disinformation, and social pressures, leading to varied and inequitable uptake rates. In this study, we examined how COVID-19 vaccine messages received via social networks were associated with vaccine uptake in rural Alabama. METHODS From November 2021 through March 2022, we collected 700 responses to a telephone survey administered in 4 rural Alabama counties. We asked respondents to indicate whether certain social relationships (eg, family, businesses) tried to influence them to (1) obtain or (2) avoid a COVID-19 vaccine. We used χ2 tests, Kruskal-Wallis tests, Mantel-Haenszel χ2 tests, and Fisher exact tests to examine the associations between vaccination status and survey responses. RESULTS Respondents in majority-African American counties were significantly more likely than those in majority-White counties to have received ≥1 dose of COVID-19 vaccine (89.8% vs 72.3%; P < .001). Respondents who received ≥1 dose had a significantly higher mean age than those who had not (58.0 vs 39.0 years; P < .001). Respondents who were encouraged to get vaccinated by religious leaders were more likely to have received ≥1 dose (P = .001), and those who were encouraged to avoid vaccination by family (P = .007), friends (P = .02), coworkers (P = .003), and health care providers (P < .001) were less likely to have received ≥1 dose. Respondents with more interpersonal relationships that encouraged them to avoid vaccination were more likely to be unvaccinated (P < .001). CONCLUSIONS Interpersonal relationships and demographic characteristics appeared to be important in COVID-19 vaccine decision-making in rural Alabama. Further research needs to identify how to facilitate vaccine-positive interpersonal relationships, such as peer mentoring and trusted messenger interventions.
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Affiliation(s)
- Greer McCollum
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ashleigh Allgood
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - April Agne
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dave Cleveland
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Cicily Gray
- Community Health Program, Department of Health and Human Services, School of Education, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eric Ford
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stefan Baral
- Department of Epidemiology, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA
| | - Michael Mugavero
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allyson G Hall
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
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Zhao W, Russell CM, Jankovsky A, Cannon TD, Pittenger C, Pushkarskaya H. Information processing style and institutional trust as factors of COVID vaccine hesitancy. Sci Rep 2024; 14:10416. [PMID: 38710827 PMCID: PMC11074285 DOI: 10.1038/s41598-024-60788-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 04/26/2024] [Indexed: 05/08/2024] Open
Abstract
This study investigates the factors contributing to COVID vaccine hesitancy. Vaccine hesitancy has commonly been attributed to susceptibility to misinformation and linked to particular socio-demographic factors and personality traits. We present a new perspective, emphasizing the interplay between individual cognitive styles and perceptions of public health institutions. In January 2020, before the COVID-19 pandemic, 318 participants underwent a comprehensive assessment, including self-report measures of personality and clinical characteristics, as well as a behavioral task that assessed information processing styles. During 2021, attitudes towards vaccines, scientists, and the CDC were measured at three time points (February-October). Panel data analysis and structural equation modeling revealed nuanced relationships between these measures and information processing styles over time. Trust in public health institutions, authoritarian submission, and lower information processing capabilities together contribute to vaccine acceptance. Information processing capacities influenced vaccination decisions independently from the trust level, but their impact was partially mediated by authoritarian tendencies. These findings underscore the multifactorial nature of vaccine hesitancy, which emerges as a product of interactions between individual cognitive styles and perceptions of public health institutions. This novel perspective provides valuable insights into the underlying mechanisms that drive this complex phenomenon.
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Affiliation(s)
- Wanchen Zhao
- Department of Psychology, Yale University, 100 College St, New Haven, CT, 06510, USA.
| | - Catherine Maya Russell
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, 3rd Floor, New Haven, CT, 06519, USA
| | - Anastasia Jankovsky
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, 3rd Floor, New Haven, CT, 06519, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, 100 College St, New Haven, CT, 06510, USA
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, 3rd Floor, New Haven, CT, 06519, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Christopher Pittenger
- Department of Psychology, Yale University, 100 College St, New Haven, CT, 06510, USA
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, 3rd Floor, New Haven, CT, 06519, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Yale Center for Brain and Mind Health, Yale School of Medicine, New Haven, CT, USA
| | - Helen Pushkarskaya
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, 3rd Floor, New Haven, CT, 06519, USA.
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Giannouchos TV, Li Z, Hung P, Li X, Olatosi B. Rural-Urban Disparities in Hospital Admissions and Mortality Among Patients with COVID-19: Evidence from South Carolina from 2021 to 2022. J Community Health 2023; 48:824-833. [PMID: 37133745 PMCID: PMC10154180 DOI: 10.1007/s10900-023-01216-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 05/04/2023]
Abstract
Although rural communities have been hard-hit by the COVID-19 pandemic, there is limited evidence on COVID-19 outcomes in rural America using up-to-date data. This study aimed to estimate the associations between hospital admissions and mortality and rurality among COVID-19 positive patients who sought hospital care in South Carolina. We used all-payer hospital claims, COVID-19 testing, and vaccination history data from January 2021 to January 2022 in South Carolina. We included 75,545 hospital encounters within 14 days after positive and confirmatory COVID-19 testing. Associations between hospital admissions and mortality and rurality were estimated using multivariable logistic regressions. About 42% of all encounters resulted in an inpatient hospital admission, while hospital-level mortality was 6.3%. Rural residents accounted for 31.0% of all encounters for COVID-19. After controlling for patient-level, hospital, and regional characteristics, rural residents had higher odds of overall hospital mortality (Adjusted Odds Ratio - AOR = 1.19, 95% Confidence Intervals - CI = 1.04-1.37), both as inpatients (AOR = 1.18, 95% CI = 1.05-1.34) and as outpatients (AOR = 1.63, 95% CI = 1.03-2.59). Sensitivity analyses using encounters with COVID-like illness as the primary diagnosis only and encounters from September 2021 and beyond - a period when the Delta variant was dominant and booster vaccination was available - yielded similar estimates. No significant differences were observed in inpatient hospitalizations (AOR = 1.00, 95% CI = 0.75-1.33) between rural and urban residents. Policymakers should consider community-based public health approaches to mitigate geographic disparities in health outcomes among disadvantaged population subgroups.
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Affiliation(s)
- Theodoros V Giannouchos
- Department of Health Services Policy & Management, Arnold School of Public Health, University of South Carolina, 915 Greene St, Columbia, SC, 29208, USA.
- Big Data Health Science Center, University of South Carolina, Columbia, SC, USA.
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Zhenlong Li
- Big Data Health Science Center, University of South Carolina, Columbia, SC, USA
- Geoinformation and Big Data Research Lab, Department of Geography, University of South Carolina, Columbia, SC, USA
| | - Peiyin Hung
- Department of Health Services Policy & Management, Arnold School of Public Health, University of South Carolina, 915 Greene St, Columbia, SC, 29208, USA
- Big Data Health Science Center, University of South Carolina, Columbia, SC, USA
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- Big Data Health Science Center, University of South Carolina, Columbia, SC, USA
- Department of Health Promotion Education and Behavior, University of South Carolina, Columbia, SC, USA
| | - Bankole Olatosi
- Department of Health Services Policy & Management, Arnold School of Public Health, University of South Carolina, 915 Greene St, Columbia, SC, 29208, USA
- Big Data Health Science Center, University of South Carolina, Columbia, SC, USA
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Ma J, Wang T, Lund B. Analyzing Public Libraries as Civic Agents in Advocating for COVID-19 Vaccine Uptake. PUBLIC LIBRARY QUARTERLY 2023. [DOI: 10.1080/01616846.2023.2197842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Affiliation(s)
- Jinxuan Ma
- School of Library and Information Management, Emporia State University, Emporia, Kansas, United States
| | - Ting Wang
- School of Library and Information Management, Emporia State University, Emporia, Kansas, United States
| | - Brady Lund
- College of Information, University of North Texas, Denton, Texas, United States
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Mattzela K, White CJ, Francis LA. Mobilizing the Community to Implement Mass Coronavirus Disease-2019 Vaccination Clinics: The Power of Free and Charitable Clinics. Nurs Clin North Am 2023; 58:11-23. [PMID: 36731956 PMCID: PMC9579184 DOI: 10.1016/j.cnur.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A free and charitable clinic successfully designed and implemented mass COVID-19 vaccination clinics in a semirural area in Central Pennsylvania. A total of 172 clinics were offered, approximately 500 volunteers were mobilized, and approximately 45,000 vaccine doses were administered. Partnering with local schools, universities, and recreation centers to offer mass vaccination clinics made it possible to expand the clinic's reach beyond its own patients. Findings provide evidence for the capacity of small community clinics to respond to major public health emergencies, such as a pandemic.
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Affiliation(s)
- Kristi Mattzela
- Centre Volunteers in Medicine, State College, 2520 Green Tech Drive, Suite D, State College, PA 16803, USA
| | - Cheryl Jo White
- Centre Volunteers in Medicine, State College, 2520 Green Tech Drive, Suite D, State College, PA 16803, USA
| | - Lori A. Francis
- Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA 16802, USA,Corresponding author
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Xu Y, Li L, Li X, Li H, Song Y, Liu Y, Chen C, Zhan H, Wang Z, Feng X, Liu M, Wang Y, Liu G, Qu Y, Li Y, Li Y, Sun Q. COVID-19 vaccination status, side effects, and perceptions among breast cancer survivors: a cross-sectional study in China. Front Public Health 2023; 11:1119163. [PMID: 37139378 PMCID: PMC10150050 DOI: 10.3389/fpubh.2023.1119163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/24/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Breast cancer is the most prevalent malignancy in patients with coronavirus disease 2019 (COVID-19). However, vaccination data of this population are limited. Methods A cross-sectional study of COVID-19 vaccination was conducted in China. Multivariate logistic regression models were used to assess factors associated with COVID-19 vaccination status. Results Of 2,904 participants, 50.2% were vaccinated with acceptable side effects. Most of the participants received inactivated virus vaccines. The most common reason for vaccination was "fear of infection" (56.2%) and "workplace/government requirement" (33.1%). While the most common reason for nonvaccination was "worry that vaccines cause breast cancer progression or interfere with treatment" (72.9%) and "have concerns about side effects or safety" (39.6%). Patients who were employed (odds ratio, OR = 1.783, p = 0.015), had stage I disease at diagnosis (OR = 2.008, p = 0.019), thought vaccines could provide protection (OR = 1.774, p = 0.007), thought COVID-19 vaccines were safe, very safe, not safe, and very unsafe (OR = 2.074, p < 0.001; OR = 4.251, p < 0.001; OR = 2.075, p = 0.011; OR = 5.609, p = 0.003, respectively) were more likely to receive vaccination. Patients who were 1-3 years, 3-5 years, and more than 5 years after surgery (OR = 0.277, p < 0.001; OR = 0.277, p < 0.001, OR = 0.282, p < 0.001, respectively), had a history of food or drug allergies (OR = 0.579, p = 0.001), had recently undergone endocrine therapy (OR = 0.531, p < 0.001) were less likely to receive vaccination. Conclusion COVID-19 vaccination gap exists in breast cancer survivors, which could be filled by raising awareness and increasing confidence in vaccine safety during cancer treatment, particularly for the unemployed individuals.
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Affiliation(s)
- Yali Xu
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Linrong Li
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaomeng Li
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- Department of Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Haolong Li
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yu Song
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yongmei Liu
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Chang Chen
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Haoting Zhan
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Zhe Wang
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinxin Feng
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Mohan Liu
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yingjiao Wang
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Guanmo Liu
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yang Qu
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuechong Li
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yongzhe Li
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- Yongzhe Li,
| | - Qiang Sun
- Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Qiang Sun,
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Barbieri V, Wiedermann CJ, Lombardo S, Plagg B, Gärtner T, Ausserhofer D, Wiedermann W, Engl A, Piccoliori G. Rural-Urban Disparities in Vaccine Hesitancy among Adults in South Tyrol, Italy. Vaccines (Basel) 2022; 10:1870. [PMID: 36366378 PMCID: PMC9692501 DOI: 10.3390/vaccines10111870] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND The demographic determinants of hesitancy in Coronavirus Disease-2019 (COVID-19) vaccination include rurality, particularly in low- and middle-income countries. In the second year of the pandemic, in South Tyrol, Italy, 15.6 percent of a representative adult sample reported hesitancy. Individual factors responsible for greater vaccination hesitancy in rural areas of central Europe are poorly understood. METHODS A cross-sectional survey on a probability-based sample of South Tyrol residents in March 2021 was analyzed. The questionnaire collected information on sociodemographic characteristics, comorbidities, COVID-19-related experiences, conspiracy thinking, and the likelihood of accepting the national vaccination plan. A logistic regression analysis was performed. RESULTS Among 1426 survey participants, 17.6% of the rural sample (n = 145/824) reported hesitancy with COVID-19 vaccination versus 12.8% (n = 77/602) in urban residents (p = 0.013). Rural residents were less likely to have post-secondary education, lived more frequently in households with children under six years of age, and their economic situation was worse than before the pandemic. Chronic diseases and deaths due to COVID-19 among close relatives were less frequently reported, and trust in pandemic management by national public health institutions was lower, as was trust in local authorities, civil protection, and local health services. Logistic regression models confirmed the most well-known predictors of hesitancy in both urban and rural populations; overall, residency was not an independent predictor. CONCLUSION Several predictors of COVID-19 vaccine hesitancy were more prevalent in rural areas than in urban areas, which may explain the lower vaccine uptake in rural areas. Rurality is not a determinant of vaccine hesitancy in the economically well-developed North of Italy.
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Affiliation(s)
- Verena Barbieri
- Institute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, Italy
| | - Christian J. Wiedermann
- Institute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, Italy
- Department of Public Health, Medical Decision Making and Health Technology Assessment, University of Health Sciences, Medical Informatics and Technology, 6060 Hall, Austria
| | - Stefano Lombardo
- Provincial Institute for Statistics of the Autonomous Province of Bolzano—South Tyrol (ASTAT), 39100 Bolzano, Italy
| | - Barbara Plagg
- Institute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, Italy
- Faculty of Education, Free University of Bolzano, 39100 Bolzano, Italy
| | - Timon Gärtner
- Provincial Institute for Statistics of the Autonomous Province of Bolzano—South Tyrol (ASTAT), 39100 Bolzano, Italy
| | - Dietmar Ausserhofer
- Institute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, Italy
| | - Wolfgang Wiedermann
- Department of Educational, School and Counseling Psychology, Missouri Prevention Science Institute, College of Education and Human Development, University of Missouri, Columbia, MO 65211, USA
| | - Adolf Engl
- Institute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, Italy
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, Italy
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