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Karimi-Shahrbabak E, Di Chiara C, Farrar DS, Abu Fadaleh SM, Peresin J, Low B, Avelar-Rodriguez D, Orkin J, Science M, Piché-Renaud PP, Morris SK. COVID-19 vaccine acceptance and uptake among caregivers of children aged 5-11 years in Ontario, Canada: A cross-sectional survey. Vaccine 2024:S0264-410X(24)00553-X. [PMID: 38772834 DOI: 10.1016/j.vaccine.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 04/25/2024] [Accepted: 05/09/2024] [Indexed: 05/23/2024]
Abstract
INTRODUCTION Although COVID-19 vaccine safety in 5-11-year-old children has been documented, half of Ontarian children this age remain unvaccinated. This study aimed to assess caregivers' vaccine acceptance for 5-11-year-old children and identify factors associated with vaccine non-acceptance. METHODS A multi-language self-administered survey was sent to caregivers of 5-11-year-old children through schools and community health centers within the Greater Toronto Area from April-July 2022. Sociodemographic characteristics and immunization behaviours were collected for caregivers, their 5-11-year-old children, and any older siblings. The primary outcome, COVID-19 vaccine acceptance, was previous uptake of COVID-19 vaccine or caregiver intent to vaccinate for their 5-11-year-old child. Data were analyzed using descriptive statistics and multivariable logistic regression. RESULTS In total, 807 caregivers were included in analysis. Although 93 % of caregivers had received two doses of COVID-19 vaccine, 77 % had a 5-11-year-old child who received at least one dose of vaccine. Caregivers age was associated with vaccine acceptance (vs. < 40 years; adjusted odds ratio [aOR] 2.1, 95 % confidence interval [CI] 1.4-3.1 for ages 40-49; aOR 2.8, 95 % CI 1.1-7.1 for ages ≥50 years). Immunization factors associated with vaccine acceptance included caregiver COVID-19 vaccination (aOR 38.1 vs. unvaccinated caregivers; 95 % CI 15.8-92.3), older siblings COVID-19 vaccination (aOR 49.2 vs. unvaccinated siblings; 95 % CI 18.3-132.3), and recent influenza vaccination for the child (aOR 6.9 vs. no influenza vaccine; 95 % CI 4.6-10.5). Among 189 caregivers with unvaccinated 5-11-year-old children, the most common reasons for non-acceptance were concerns about long-term side effects (59 %), lack of experience vaccinating children (41 %), and concerns that vaccines were developed too quickly (39 %). CONCLUSION Acceptance of COVID-19 vaccination for 5-11-year-old children were associated with caregiver vaccine behaviors and sociodemographic factors. These findings highlight groups of caregivers that can be targeted for educational interventions and concerns that may be addressed to increase vaccine confidence.
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Affiliation(s)
- Elahe Karimi-Shahrbabak
- Child Health Evaluative Sciences, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada.
| | - Costanza Di Chiara
- Child Health Evaluative Sciences, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada; Division of Infectious Diseases, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G1X8, Canada.
| | - Daniel S Farrar
- Child Health Evaluative Sciences, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada.
| | - Sarah M Abu Fadaleh
- Child Health Evaluative Sciences, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada.
| | - Joelle Peresin
- Child Health Evaluative Sciences, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada.
| | - Brooke Low
- Child Health Evaluative Sciences, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada.
| | - David Avelar-Rodriguez
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, 555 University Avenue, Black Wing Room 1436, Toronto, ON M5G 1X8, Canada.
| | - Julia Orkin
- Child Health Evaluative Sciences, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada; Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, 555 University Avenue, Black Wing Room 1436, Toronto, ON M5G 1X8, Canada.
| | - Michelle Science
- Division of Infectious Diseases, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G1X8, Canada; Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, 555 University Avenue, Black Wing Room 1436, Toronto, ON M5G 1X8, Canada.
| | - Pierre-Philippe Piché-Renaud
- Division of Infectious Diseases, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G1X8, Canada; Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, 555 University Avenue, Black Wing Room 1436, Toronto, ON M5G 1X8, Canada.
| | - Shaun K Morris
- Child Health Evaluative Sciences, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada; Division of Infectious Diseases, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G1X8, Canada; Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, 555 University Avenue, Black Wing Room 1436, Toronto, ON M5G 1X8, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7, Canada; Division of Clinical Public Health and Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, 155 College Street, Toronto, ON M5T 3M7, Canada.
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Denny A, Day AS, Vernon-Roberts A. Association between Paediatric Complementary and Alternative Medicine Use and Parental Health Literacy, Child Health, and Socio-Economic Variables: A Prospective Study. Pediatr Rep 2024; 16:368-384. [PMID: 38804375 PMCID: PMC11130825 DOI: 10.3390/pediatric16020032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 04/30/2024] [Accepted: 04/30/2024] [Indexed: 05/29/2024] Open
Abstract
Complementary and Alternative Medicines (CAMs) constitute products and practices not considered allopathic medicine. CAM use is high in children, but little is known about factors that may influence parents using CAM with their child. This study aimed to determine the variables associated with CAM use in children with a prospective study among children and their parents attending a tertiary care hospital in New Zealand (NZ). Outcomes included current CAM use, parental opinions on CAM, parental health literacy and child well-being. This study was completed by 130 parents (85% female), and the mean child age was 6.7 years. CAM use was reported for 59 (45%) children, the most common being oral supplements and body manipulation. Children were more likely to use CAM if their parent had higher health literacy (p = 0.001), and if they had previously attended the emergency department within 12 months (p = 0.03). There was no association between child well-being and CAM use. Parental opinion of using CAM only if a doctor recommended it was associated with CAM use for their child (p = 0.01). Only 40% of parents disclosed their child's CAM use to the medical team. This study highlights that parental health literacy influences the use of CAM for children in NZ, providing insight for translational research to improve CAM safety and disclosure rates in NZ.
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Affiliation(s)
- Abida Denny
- Otago Medical School, University of Otago, Dunedin 9016, New Zealand
| | - Andrew S. Day
- Department of Paediatrics, University of Otago, Christchurch 8011, New Zealand;
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Nakajima R, Komoriya M, Watanabe F. Is health literacy of adolescent athletes' parents whose children belonged to sports clubs related to their children's intention to receive medications, vaccines, supplements, and energy drinks? A cross-sectional study. BMC Public Health 2024; 24:257. [PMID: 38254028 PMCID: PMC10804555 DOI: 10.1186/s12889-024-17746-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Adolescent athletes' values regarding health behaviors, including their attitudes toward doping, are largely derived from those of their parents. Therefore, clarifying the factors that affect parents' intentions regarding their children's medicine intake and nutrition can help elucidate the process of forming values of healthy behaviors in young athletes. METHODS Between March 8 and March 9, 2021, an online questionnaire survey was conducted via an Internet research company; data from 2,000 residents in Japan were collected. Participants were male and female residents aged 30-59 years with children in elementary or high school and belonging to sports clubs. The survey items included respondent's and child's basic information, respondent's health literacy, and level of sports in which the respondent and child were (or are) engaged. Respondents were also asked if they would like their children to receive prescription drugs, over-the-counter drugs, herbal medicines, vaccines, supplements, or energy drinks. Logistic regression analysis was performed to analyze the relationship between respondents' basic information and health literacy and their intention to receive prescription and over-the-counter drugs, herbal medicines, vaccines, supplements, and energy drinks. RESULTS Higher parental health literacy was associated with higher children's willingness to receive prescription drugs (odds ratio [OR] = 1.025, 95% confidence interval [CI]: 1.016-1.035), over-the-counter drugs (OR = 1.012, 95% CI: 1.003-1.021), prescription herbal medicines (OR = 1.021, 95% CI: 1.021-1.030), over-the-counter herbal medicines (OR = 1.012, 95% CI: 1.003-1.021), and vaccines (OR = 1.025, 95% CI: 1.016-1.035). Conversely, the children's intention to receive energy drinks (OR = 0.990, 95% CI: 0.980-1.000) decreased significantly. As the child's athletic level increased, parents' willingness for their children to receive oral prescription medicines decreased (OR = 0.886, 95% CI: 0.791-0.992) and that to receive supplements (OR = 1.492, 95% CI: 1.330-1.673) and energy drinks significantly increased (OR = 1.480, 95% CI: 1.307-1.676). CONCLUSION Health literacy of adolescent athletes' parents is associated with their children's willingness to receive medicines. Healthcare providers should counsel parents of adolescent athletes to allow their children to receive necessary drug treatments and prevent doping violations caused by supplement intake.
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Affiliation(s)
- Rie Nakajima
- Department of Pharmacy Practice in Primary Care, Nihon University School of Pharmacy, 7-7-1 Narashinodai, 274-8555, Funabashi-shi, Chiba, Japan.
| | - Michihiro Komoriya
- Department of Pharmacy Practice in Primary Care, Nihon University School of Pharmacy, 7-7-1 Narashinodai, 274-8555, Funabashi-shi, Chiba, Japan
| | - Fumiyuki Watanabe
- Department of Pharmacy Practice in Primary Care, Nihon University School of Pharmacy, 7-7-1 Narashinodai, 274-8555, Funabashi-shi, Chiba, Japan
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Didem HY, Ülfiye Ç, Miraç Ç, Safiye TS, Pelin SS, Cem YA, Hatice U, Galip E. The frequency and determinants of vaccine hesitancy among parents of preschool and kindergarten students in Edirne central district. J Pediatr Nurs 2024; 74:e38-e44. [PMID: 37980235 DOI: 10.1016/j.pedn.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/02/2023] [Accepted: 11/04/2023] [Indexed: 11/20/2023]
Abstract
PURPOSES The aim of our study is to determine the frequency of vaccine hesitancy and the associated factors among parents with preschool children in a city center. DESIGN AND METHODS We conducted a cross-sectional study among parents of preschool children in the central district of Edirne. The cluster sampling method was applied. The data collection tools consisted of a questionnaire designed by the researchers and The Parent Attitudes about Childhood Vaccines (PACV) Scale. The correlations between vaccine hesitancy among parents factos such as the vaccine's content, adverse effects, religious beliefs, media coverage, reliance on community leaders, and the usage of complementary and alternative medical methods were examined. RESULTS The study group consisted of 315 individuals and the prevalence of vaccine hesitancy among participants was determined to be 13%. The mean PACV scale score of the parents was 29.76 ± 16.62. According to multivariate analyses, the odds ratios (%95 CI) of variables that were statistically significantly associated with parental vaccine hesitancy were as follows: being a mother 8.77 (1.02-75.07), vaccine side effects 2.91 (0.93-9.16), low/equal income level 6.80 (2.45-18.86), low/high income level 5.74 (1.65-20.0), religious reasons 3.33 (1.34-8.25), and media influence 9.53 (3.75-24.18). CONCLUSION Overall, vaccine hesitancy was observed at one in every 7 parents in the central district of Edirne province, and the main determinants of hesitancy were low-income status, media influence and religious beliefs, advers effects and being mother. Community-based intervention programs should be established to combat vaccine hesitancy. PRACTICAL IMPLICATIONS The PACV scale is recommended for detecting community-based vaccine hesitancy.
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Affiliation(s)
- Han Yekdeş Didem
- Department of Public Health, School of Medicine, Trakya University, Faculty of Medicine, Edirne, Türkiye.
| | - Çelikkalp Ülfiye
- Department of Public Health, School of Medicine, Trakya University, Faculty of Medicine, Edirne, Türkiye.
| | - Çağlayan Miraç
- Department of Public Health, School of Medicine, Trakya University, Faculty of Medicine, Edirne, Türkiye.
| | - Takır Stewart Safiye
- Department of Public Health, School of Medicine, Trakya University, Faculty of Medicine, Edirne, Türkiye.
| | - Sarı Serin Pelin
- Department of Public Health, School of Medicine, Trakya University, Faculty of Medicine, Edirne, Türkiye.
| | - Yekdeş Ali Cem
- Department of Public Health, School of Medicine, Trakya University, Faculty of Medicine, Edirne, Türkiye.
| | | | - Ekuklu Galip
- Department of Public Health, School of Medicine, Trakya University, Faculty of Medicine, Edirne, Türkiye.
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Lu Y, Wang Q, Zhu S, Xu S, Kadirhaz M, Zhang Y, Zhao N, Fang Y, Chang J. Lessons learned from COVID-19 vaccination implementation: How psychological antecedents of vaccinations mediate the relationship between vaccine literacy and vaccine hesitancy. Soc Sci Med 2023; 336:116270. [PMID: 37778145 DOI: 10.1016/j.socscimed.2023.116270] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/29/2023] [Accepted: 09/23/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Enhancing the public's vaccine literacy is critical for curbing vaccine hesitancy and enhancing society's pandemic preparedness, particularly in an era of infodemic. Evidence on vaccine literacy as an influencing factor of hesitancy is scarce. Lessons could be learned from COVID-19 vaccination implementation. Taking the COVID-19 vaccines as an example, the current study aimed to examine the relationship between vaccine literacy and hesitancy and the mediating role of psychological antecedents of vaccination on the relationship. METHODS A baseline online questionnaire survey among the general public in China based on quota sampling was conducted in April 2021 to measure participants' vaccine literacy, psychological antecedents of vaccination, COVID-19 vaccination status, and vaccine hesitancy. A follow-up online survey tracked the updated COVID-19 vaccination status among those who hadn't taken COVID-19 vaccines at the baseline survey. Structural equation modeling has been applied to examine the direct and indirect effect of vaccine literacy on vaccine hesitancy. Time-to-event analysis was used to explore the effect of vaccine hesitancy on vaccination behavior. RESULTS Lower vaccine hesitancy was associated with higher vaccine literacy. The "3Cs" psychological antecedents were important mediators between vaccine literacy and vaccine hesitancy. The pathway between critical/interactive vaccine literacy and vaccine hesitancy through the "3Cs" psychological antecedents played a more important role. Time-to-event analysis showed participants with a higher vaccine hesitancy were prone to have a longer delay in vaccination. CONCLUSIONS Improving the public's ability to obtain and evaluate vaccination information can fix the public's psychological determinants of vaccination, reducing vaccine hesitancy and promoting vaccination. Governments need to put more effort into guiding and regulating the media to disseminate evidence-based information, rectifying misinformation, and improving the public's vaccine literacy through education, especially the public's capability to critically discern mixed information.
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Affiliation(s)
- Yunshu Lu
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an, China
| | - Quanfang Wang
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shan Zhu
- Xi'an Municipal Health Commission, Xi'an, China
| | - Sen Xu
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an, China
| | - Muhtar Kadirhaz
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an, China
| | - Yushan Zhang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an, China
| | - Nan Zhao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an, China
| | - Jie Chang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an, China.
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Bíró É, Vincze F, Nagy-Pénzes G, Ádány R. Investigation of the relationship of general and digital health literacy with various health-related outcomes. Front Public Health 2023; 11:1229734. [PMID: 37588120 PMCID: PMC10426797 DOI: 10.3389/fpubh.2023.1229734] [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: 05/26/2023] [Accepted: 07/17/2023] [Indexed: 08/18/2023] Open
Abstract
Background Despite the growing number of health literacy surveys, we know little about the combined effect of the different dimensions of health literacy on various health-related outcomes. Objective Thus, our study aimed to examine the impacts of general and digital health literacy on health behaviour, confidence in vaccination, self-perceived health, and health care utilization. Methods Our research was part of the Health Literacy Population Survey 2019-2021, which was an international, multicentre, cross-sectional study. The data were collected via computer-assisted telephone interview in December 2020 in Hungary. Multiple multinomial logistic and multivariate linear regression models were used to analyse the separately effects of general and digital health literacy on the studied outcomes. Moreover, the combined effect of general and digital health literacy was also analysed via sensitivity analyses. In the last step, the interactions between general and digital health literacy were examined using the Johnson-Neyman procedure. Results The results did not reveal any associations between health literacy and health behaviour. Health care use was only affected by digital health literacy; however, this effect was inconsistent. Both dimensions of health literacy were positively associated with self-perceived health and vaccination confidence. Conclusion Our results suggest that increasing health literacy could promote health and vaccination confidence, while the potential effect of higher digital health literacy on more conscious use of the health care system should be investigated further.
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Affiliation(s)
- Éva Bíró
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ferenc Vincze
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gabriella Nagy-Pénzes
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Róza Ádány
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- National Laboratory for Health Security, Center for Epidemiology and Surveillance, Semmelweis University, Budapest, Hungary
- Department of Public Health, Semmelweis University, Budapest, Hungary
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