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Jiboc NM, Paşca A, Tăut D, Băban AS. Factors influencing human papillomavirus vaccination uptake in European women and adolescents: A systematic review and meta-analysis. Psychooncology 2024; 33:e6242. [PMID: 37930064 DOI: 10.1002/pon.6242] [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: 05/19/2023] [Revised: 09/19/2023] [Accepted: 10/24/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE Cervical Cancer (CC) lingers as a severe public health issue due to low vaccination coverage and poor screening addressability. Hence, this systematic review explored psychological factors influencing the Human Papilloma Virus (HPV) vaccination uptake in European women. METHODS As of September 2022, PubMed, EMBASE, Scopus, and Web of Science were systematically searched to include English studies assessing diverse factors influencing vaccination uptake in European women. Only studies comparing vaccinated with unvaccinated women were included. Quality assessment, publication attrition assessment, and sensitivity analyses were performed. RESULTS Eighteen studies were included, totaling a population of 18,611 participants. Results indicated that knowledge about HPV infection could positively influence vaccination rates with an Odds Ratio (OR) of 1.82 and a confidence interval (CI) between 1.27 and 2.61, showing statistical significance at a Z value of 3.24 with a p-value of 0.001. Neither knowledge about HPV vaccination (OR = 1.39, CI: 0.73-2.65, Z = 1.01, p = 0.31) nor knowledge about CC screening (OR = 1.05, CI: 0.55-1.98, Z = 0,14, p = 0.89) seem to affect vaccination rates. Regardless, intention to undertake CC screening (CCS) showed an OR = 1.68 in favor of the group intending to perform it, with a CI between 1.37 and 2.07, showing statistical significance at a Z = 4.94 and p = 0.00001. Other aspects affecting vaccination uptake were fear of side effects, insufficient information, and belief that chances of being infected are low. CONCLUSIONS Results demonstrated that diverse aspects could affect the vaccination intent, while personalized interventions focusing on population and country characteristics need to be assembled to mitigate vaccination coverage.
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Affiliation(s)
| | - Andrei Paşca
- Department of Surgical Oncology and Gynaecological Oncology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Department of Surgical Oncology, "Prof. Dr. Ion Chiricuță" Institute of Oncology, Cluj-Napoca, Romania
| | - Diana Tăut
- Department of Psychology, Babeş-Bolyai University, Cluj-Napoca, Romania
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Damnjanović K, Ilić S, Kušić M, Lazić M, Popović D. Psychological Factors of Vaccination Intent among Healthcare Providers, Parents, and Laypeople. Vaccines (Basel) 2023; 11:1816. [PMID: 38140220 PMCID: PMC10748119 DOI: 10.3390/vaccines11121816] [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: 10/01/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/24/2023] Open
Abstract
The interrelatedness of social-structural aspects and psychological features with vaccination intention provides the context to explore personal psychological features related to vaccination. Specifically, we focused on general decision making and vaccine-related dispositions, and their contribution to the intention to vaccinate, within post-pandemic circumstances, after the imposed possibility of choosing a vaccine brand. Our study aimed to map the function (promotive, protective, risk, vulnerability) of a set of personal psychological aspects in the intention to vaccinate among people holding different social roles regarding the vaccination. We surveyed three samples of people: healthcare providers (HPs), parents, and laypeople, within the post-pandemic context. Negative vaccine attitudes lower intention to vaccinate in all regression models (all βs ranging from -0.128 to -0.983, all ps < 0.01). The main results indicate that, regardless of the sample/social role, there is a shared attitudinal core for positive vaccination intention. This core consists of [high] trust in large corporations, government, and healthcare systems, as well as perceived consensus on vaccine safety/efficacy and experience of freedom (protective factors), and [low] vaccination conspiracy beliefs, trust in social media, and choice overload (risk and vulnerability factors, respectively). There are no common promotive factors of intention to vaccinate: for parents, perceived consensus on vaccines, and trust in corporations and the healthcare system, play such roles; for HPs, the experience of freedom is obtained as a unique promotive factor. In contrast, for laypeople, no unique promotive factors were found. Our findings provide insights into the function of psychological factors of vaccination intention across different social roles, particularly healthcare providers, parents, and laypeople, and emphasize the need for tailored immunization interventions in the post-pandemic landscape.
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Affiliation(s)
- Kaja Damnjanović
- Laboratory for Experimental Psychology, Department of Psychology, Institute of Philosophy, Faculty of Philosophy, University of Belgrade, 11000 Beograd, Serbia
| | - Sandra Ilić
- Laboratory for Experimental Psychology, Department of Psychology, Faculty of Philosophy, University of Belgrade, 11000 Beograd, Serbia;
| | - Marija Kušić
- Laboratory for Research of Individual Differences, Department of Psychology, Faculty of Philosophy, University of Belgrade, 11000 Beograd, Serbia;
| | - Milica Lazić
- Faculty of Philosophy, University of Novi Sad, 21000 Novi Sad, Serbia;
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Choi DH, Noh GY. The Impact of Social Media on Preventive Behavior During the COVID-19 Outbreak in South Korea: The Roles of Social Norms and Self-Efficacy. SAGE OPEN 2023; 13:21582440231184969. [PMID: 37456583 PMCID: PMC10333550 DOI: 10.1177/21582440231184969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Social media are important channels to propagate health information and influence preventive behavior during a public health crisis, as witnessed during the coronavirus pandemic (COVID-19). This study explored the association between social media use and preventive behavior during the outbreak of COVID-19 in South Korea. Using the national survey data (N = 1,500), the study examined the mediating role of social norms in the association between social media use for news and information about COVID-19 and preventive behavior. In addition, the study tested the moderating effect of self-efficacy on the mediating path of social media use for preventive behavior via social norms. Conducting a moderated mediation analysis method, this study found that social norms mediated the relationship between social media use and preventive behavior (b = 0.046). Moreover, the study revealed that the indirect relationship between social media use and preventive behavior through social norms becomes stronger as an individual's level of self-efficacy decreases (low: b = 0.044, middle: b = 0.036, and high: b = 0.030). The study provides empirical evidence of the beneficial impact of social media use on preventive behavior. The findings of the study recommend promoting messages on social norms through social media for facilitating preventive behavior.
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Vriens E, Tummolini L, Andrighetto G. Vaccine-hesitant people misperceive the social norm of vaccination. PNAS NEXUS 2023; 2:pgad132. [PMID: 37168670 PMCID: PMC10165803 DOI: 10.1093/pnasnexus/pgad132] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 05/13/2023]
Abstract
Vaccine hesitancy is one of the main threats to global health, as became clear once more during the COVID-19 pandemic. Vaccination campaigns could benefit from appeals to social norms to promote vaccination, but without awareness of the social norm in place any intervention relying on social norms may backfire. We present a two-step approach of social norm diagnosis and intervention that identifies both whether a vaccination norm exists or develops over time and corrects misperceptions. In two studies (N = 887 and N = 412 ) conducted in Rome, Italy from June to August 2021 (during the first COVID-19 vaccination campaign), we show that vaccine-hesitant people strongly underestimated vaccine acceptance rates for COVID-19 despite increases in region-wide vaccination rates. This suggests a false consensus bias on the social norm of vaccination. We presented a subgroup of vaccine-hesitant people with the accurate vaccine acceptance rates (both planned uptake and vaccine approval) and tested if this social information would lower their vaccine hesitancy. We do not find clear effects, most likely because of the introduction of the COVID-19 health certificate (the "green pass") that was implemented during our data collection. The green pass reduced both misperceptions in the social norm and vaccine hesitancy, thus undermining our treatment effect. We conclude that to alleviate misperceptions on the social norm of vaccination in early stages of the vaccination campaign governments and media should report not just the current vaccination rate, but also about vaccination intentions and approval.
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Affiliation(s)
- Eva Vriens
- Institute of Cognitive Sciences and Technologies, Italian National Research Council, Via S. Martino della Battaglia 44, 00185 Rome, Italy
- Institute for Futures Studies, Holländargatan 13, 11136 Stockholm, Sweden
| | - Luca Tummolini
- Institute of Cognitive Sciences and Technologies, Italian National Research Council, Via S. Martino della Battaglia 44, 00185 Rome, Italy
- Institute for Futures Studies, Holländargatan 13, 11136 Stockholm, Sweden
| | - Giulia Andrighetto
- Institute of Cognitive Sciences and Technologies, Italian National Research Council, Via S. Martino della Battaglia 44, 00185 Rome, Italy
- Institute for Futures Studies, Holländargatan 13, 11136 Stockholm, Sweden
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Cavazos-Arroyo J, Pérez de Celis-Herrero C. [Severity, susceptibility and social norms perceived as antecedents of the intention to be vaccinated against COVID-19]. Rev Salud Publica (Bogota) 2023; 22:178-184. [PMID: 36753108 DOI: 10.15446/rsap.v22n2.86877] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 04/30/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To evaluate the effect of perceived risk and social norms on COVID-19 and on the intention to be vaccinated if a vaccine were available to prevent infection. METHODS A quantitative, explanatory and cross-sectional research was developed. The data was collected through a structured questionnaire applied electronically to inhabitants over 18 years of age in the state of Puebla in Mexico. An analysis with structural equations was used to identify the effects among the constructs studied. RESULTS The results showed that both the perceived severity and susceptibility of contracting COVID-19 had a positive effect on the perceived social norms about the virus. Also, while the perceived severity had a positive effect on the intention to vaccinate, the perceived susceptibility was not significant on the intention to vaccinate against COVID-19. CONCLUSION Intention to be vaccinated against COVID-19 is affected by the severity and perceived social norms of contracting the infection. However, the perceived susceptibility to the virus does not have an effect on the intention to be vaccinated.
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Affiliation(s)
- Judith Cavazos-Arroyo
- JC: Lic. Administración de Empresas. M. Sc. Administración. M. Sc. Mercadotecnia. Ph.D. Dirección y Mercadotecnia. Profesora-investigadora, Centro Interdisciplinario de Posgrados e Investigación, Universidad Popular Autónoma del Estado de Puebla. Puebla, México.
| | - Concepción Pérez de Celis-Herrero
- CP: Lic. Matemáticas. Especialidad en Informática, Opción Sistemas Informáticos. M. Sc. Salud Pública. Ph. D. 3éme Cycle en Informatique. Profesor-Investigador Titular B, Facultad de Ciencias de la Computación, Benemérita. Universidad Autónoma de Puebla. Puebla, México.
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Latkin C, Dayton L, Miller J, Yi G, Balaban A, Boodram B, Uzzi M, Falade-Nwulia O. A longitudinal study of vaccine hesitancy attitudes and social influence as predictors of COVID-19 vaccine uptake in the US. Hum Vaccin Immunother 2022; 18:2043102. [PMID: 35417302 PMCID: PMC9196649 DOI: 10.1080/21645515.2022.2043102] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/13/2022] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND In many countries with high levels of COVID-19 vaccine access, uptake remains a major issue. We examined prospective predictors of COVID-19 vaccine uptake in a United States longitudinal study. METHODS An online longitudinal study on COVID-19 and well-being assessed vaccine hesitancy attitudes, social norms, and uptake among 444 respondents who had completed both survey waves in March and June 2021. RESULTS The mean sample age was 41, with 55% female, 71% white, 13% Black, and 6% Latinx. In March 2021, 14% had received at least one COVID-19 vaccine dose. By June 2021, 64% reported receiving at least one dose. In prospectively assessing predictors of vaccine uptake, we found strong correlations among five different vaccine hesitancy questions. In multivariable logistic regression models, family and friends discouraging vaccination (adjusted odds ratios [aOR] = .26, 95% CI = .07, .98), not knowing whom to believe about vaccine safety (aOR = .51, 95% CI = .27, .95), and concerns that shortcuts were taken with vaccine development (aOR = .43, 95% CI = .23, .81) were all independent predictors of lower vaccine uptake. Political conservatism, gender, education, and income were also independent predictors of reduced uptake. Vaccine hesitancy items were also modeled as a scale, and the scale was found to be strongly predictive of vaccine uptake. CONCLUSIONS The findings highlight the importance of social norm interventions and suggest general and specific vaccine hesitancy attitudes, especially trust, should be considered in developing vaccine uptake programs.
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Affiliation(s)
- Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lauren Dayton
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jacob Miller
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Grace Yi
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ariel Balaban
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Basmattee Boodram
- Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
| | - Mudia Uzzi
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Oluwaseun Falade-Nwulia
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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de Vries M, Claassen L, Lambooij M, Leung KY, Boersma K, Timen A. COVID-19 Vaccination Intent and Belief that Vaccination Will End the Pandemic. Emerg Infect Dis 2022; 28:1642-1649. [PMID: 35797995 PMCID: PMC9328899 DOI: 10.3201/eid2808.212556] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
High vaccination coverage is considered to be key in dealing with the coronavirus disease (COVID-19) pandemic. However, vaccine hesitancy can limit uptake. We examined the specific coronavirus beliefs that persons have regarding COVID-19 and COVID-19 vaccines and to what extent these beliefs explain COVID-19 vaccination intentions. We conducted a survey among 4,033 residents of the Netherlands that examined COVID-19 vaccination intentions and various beliefs. Random forest regression analysis explained 76% of the variance in vaccination intentions. The strongest determinant in the model was the belief the COVID-19 crisis will only end if many persons get vaccinated. Other strong determinants were beliefs about safety of vaccines, specifically in relation to vaccine development and approval process; (social) benefits of vaccination; social norms regarding vaccination behavior; and effectiveness of vaccines. We propose to address these specific beliefs in communications about COVID-19 vaccinations to stimulate vaccine uptake.
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Morbée S, Waterschoot J, Yzerbyt V, Klein O, Luminet O, Schmitz M, Van den Bergh O, Van Oost P, De Craene S, Vansteenkiste M. Personal and contextual determinants of COVID-19 vaccination intention: a vignette study. Expert Rev Vaccines 2022; 21:1475-1485. [PMID: 35876102 DOI: 10.1080/14760584.2022.2105212] [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: 11/04/2022]
Abstract
BACKGROUND This vignette study explores which factors contribute to higher COVID-19 vaccination intentions. METHODS Between the 4th-11 January 2021, we recruited 15,901 Belgian citizens (Mage = 50.11 years, range 18-100) through convenience sampling to participate in a vignette study. In each vignette, we manipulated contextual determinants consisting of different factors. Each participant rated six vignettes in terms of the outcomes 'vaccination intention' and 'recommendation to others.' Finally, we explored the benefits of tailored communication by examining whether these ratings depended upon citizens' initial motives for vaccination. RESULTS Participants are most likely to accept a vaccine when they expect no or only small side effects, when the vaccine offers a 95% protection, and when people can no longer infect others (p < 0.001). The possibility to receive the vaccine at home or at the GP's office, highlighting that most citizens are willing to get vaccinated, and emphasizing the protective benefits for others yielded additional positive effects (p < 0.001). Results showed that tailored communication has a small but significant effect, especially for individuals high on distrust-based amotivation (p < 0.01). CONCLUSION In addition to vaccine characteristics, there is room for policymakers to respond to those determinants that fall under their control and can thus be highlighted within communication campaigns.
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Affiliation(s)
- Sofie Morbée
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Joachim Waterschoot
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Vincent Yzerbyt
- Institute for Research in Psychological Sciences, Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | - Olivier Klein
- Faculty of Psychological Sciences and Education, Université Libre de Bruxelles, Brussels, Belgium
| | - Olivier Luminet
- Institute for Research in Psychological Sciences, Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | - Mathias Schmitz
- Institute for Research in Psychological Sciences, Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | | | - Pascaline Van Oost
- Institute for Research in Psychological Sciences, Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | - Silke De Craene
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Maarten Vansteenkiste
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Nadarzynski T, Frost M, Miller D, Wheldon CW, Wiernik BM, Zou H, Richardson D, Marlow LAV, Smith H, Jones CJ, Llewellyn C. Vaccine acceptability, uptake and completion amongst men who have sex with men: A systematic review, meta-analysis and theoretical framework. Vaccine 2021; 39:3565-3581. [PMID: 34034949 DOI: 10.1016/j.vaccine.2021.05.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/16/2021] [Accepted: 05/04/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Due to an increased risk of sexually transmitted infections (STIs), gay, bisexual and other men who have sex with men (MSM) have been recommended to receive vaccinations against human papillomavirus, meningitis C and hepatitis A/B. This review aimed to compare the rates of vaccine acceptability, uptake and completion, and to identify determinants of vaccine outcomes specific to MSM to inform a theoretical framework. METHODS In January 2020 four databases were explored to identify vaccination behaviours and associated factors among MSM. A narrative systematic review and meta-analysis were performed. Data were synthesised for theoretical modelling. RESULTS Seventy-eight studies, mostly from the USA, were included. The average vaccine acceptability was 63% (median = 72%, range: 30%-97%), vaccine uptake 45% (median = 42%, range: 5%-100%) and vaccine completion 47% (median = 45%, range: 12%-89%). Six categories of factors associated with vaccination acceptability, uptake and completion were conceptualised: Individual (e.g., demographic and psychosocial); Interpersonal (e.g., peer education); Healthcare provider (e.g., vaccine recommendation); Organisational and practice setting (e.g., routine collection of patient sexual orientation information that is integrated into a clinical decision support system); Community environment (e.g., targeted health promotion campaigns); and National, state and local policy environment (e.g., public health guidelines targeting MSM). CONCLUSION Despite overall high levels of acceptability, uptake and completion rates were below targets predicted by cost-effectiveness modelling across all recommended vaccines. These parameters may need to be adjusted for more precise estimations of cost-effectiveness. Addressing the multiple levels of determinants, as outlined in our theoretical framework, will help guide interventions to increase vaccine completion among MSM.
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Affiliation(s)
| | - Miles Frost
- The University of Southampton, Southampton, United Kingdom
| | - Danny Miller
- The University of Westminster, London, United Kingdom
| | | | | | - Huachun Zou
- Sun Yat-sen University, School of Public Health, Shenzhen, China
| | - Daniel Richardson
- Brighton & Sussex University Hospitals NHS Trust, Brighton; Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom
| | - Laura A V Marlow
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Helen Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | | | - Carrie Llewellyn
- Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom
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Latkin C, Dayton LA, Yi G, Konstantopoulos A, Park J, Maulsby C, Kong X. COVID-19 vaccine intentions in the United States, a social-ecological framework. Vaccine 2021; 39:2288-2294. [PMID: 33771392 PMCID: PMC7945864 DOI: 10.1016/j.vaccine.2021.02.058] [Citation(s) in RCA: 110] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/23/2020] [Accepted: 02/24/2021] [Indexed: 12/01/2022]
Abstract
Background COVID-19 vaccine hesitancy is a major obstacle for pandemic mitigation. As vaccine hesitancy occurs along multiple dimensions, we used a social-ecological framework to guide the examination of COVID-19 vaccine intentions. Methods Using an online survey in the US conducted in July 2020, we examined intentions to obtain a COVID-19 vaccine, once available. 592 respondents provided data, including measures of demographics, vaccine history, social norms, perceived risk, and trust in sources of COVID-19 information. Bivariate and multivariate multinomial models were used to compare respondents who intended to be vaccinated against COVID-19 to respondents who did not intend or were ambivalent about COVID-19 vaccination. Results Only 59.1% of the sample reported that they intended to obtain a COVID-19 vaccine. In the multivariate multinomial model, those respondents who did not intend to be vaccinated, as compared to those who did, had significantly lower levels of trust in the CDC as a source of COVID-19 information (aOR = 0.29, CI = 0.17–0.50), reported lower social norms of COVID-19 preventive behaviors (aOR = 0.67, CI 0.51–0.88), scored higher on COVID-19 Skepticism (aOR = 1.44, CI = 1.28–1.61), identified as more politically conservative (aOR = 1.23, CI = 1.05–1.45), were less likely to have obtained a flu vaccine in the prior year (aOR = 0.21, CI = 0.11–0.39), were less likely to be female (aOR = 0.51, CI = 0.29–0.87), and were much more likely to be Black compared to White (aOR = 10.70, CI = 4.09–28.1). A highly similar pattern was observed among those who were ambivalent about receiving a COVID-19 vaccine compared to those who intended to receive one. Conclusion The results of this study suggest several avenues for COVID-19 vaccine promotion campaigns, including social network diffusion strategies and cross-partisan messaging, to promote vaccine trust. The racial and gender differences in vaccine intentions also suggest the need to tailor campaigns based on gender and race.
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Affiliation(s)
- Carl Latkin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, United States; Division of Infectious Diseases, Johns Hopkins University School of Medicine, United States.
| | - Lauren A Dayton
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Grace Yi
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, United States
| | | | - Ju Park
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Catherine Maulsby
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - Xiangrong Kong
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, United States
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11
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Trust in a COVID-19 vaccine in the U.S.: A social-ecological perspective. Soc Sci Med 2021; 270:113684. [PMID: 33485008 PMCID: PMC7834519 DOI: 10.1016/j.socscimed.2021.113684] [Citation(s) in RCA: 201] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/27/2020] [Accepted: 01/03/2021] [Indexed: 01/12/2023]
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12
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Lee TK, Su LYF. When a Personal HPV Story on a Blog Influences Perceived Social Norms: The Roles of Personal Experience, Framing, Perceived Similarity, and Social Media Metrics. HEALTH COMMUNICATION 2020; 35:438-446. [PMID: 30719938 DOI: 10.1080/10410236.2019.1567440] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The current study examines how a personal health story on a blog can influence individuals' perceived social norms, adopting the notion that social norms are "group identity-based codes of conduct". For that, we tested the effects of story framing and personal experience on perceived similarity, which interacts with social media metrics in forming perceived social norms. In an online experiment, college students (N = 220) were recruited to read a blogger's story in either a gain-frame (the blogger received the HPV vaccine and, thus, prevented cancer) or a loss-frame (the blogger did not receive the vaccine and, thus, developed cancer) with either high or low social media metrics. Participants reported that they were more similar with the blogger in the gain-framed story than the one in the loss-framed story, especially among those who have received the HPV. This perceived similarity was positively associated with both descriptive and injunctive norms; however, the positive association between similarity and descriptive norms disappeared when the blog had low social media metrics. Theoretical and practical implications are discussed.
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Affiliation(s)
| | - Leona Yi-Fan Su
- Department of Advertising, University of Illinois at Urbana-Champaign
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Najafi-Sharjabad F, Rayani M. The Relationship between knowledge, Attitude and Acceptance of Human Papilloma Virus (HPV) Vaccination for Cervical Cancer Prevention among Students at Bushehr University of Medical Sciences, Iran. JOURNAL OF RESEARCH DEVELOPMENT IN NURSING AND MIDWIFERY 2019. [DOI: 10.29252/jgbfnm.16.2.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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14
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Cherven B, Castellino SM, Chen Y, Wong FL, York JM, Wasilewski-Masker K, Hudson MM, Bhatia S, Klosky JL, Landier W. Intent and subsequent initiation of human papillomavirus vaccine among young cancer survivors. Cancer 2019; 125:3810-3817. [PMID: 31291010 DOI: 10.1002/cncr.32379] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 05/06/2019] [Accepted: 05/31/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite an increased risk of subsequent human papillomavirus (HPV)-related malignancies, HPV vaccine initiation rates among cancer survivors remain critically low. The purpose of this study was to determine the relationship between HPV vaccine intent and subsequent vaccine initiation among cancer survivors by linking data from a cross-sectional survey with state-based immunization registry records. METHODS Cancer survivors who were 9 to 26 years old were surveyed 1 to 5 years after their treatment to assess their HPV vaccine initiation status, HPV vaccine intent, sociodemographic factors, and vaccine-related health beliefs. HPV vaccine doses/dates were abstracted from the Georgia Registry for Immunization Transactions for 3.5 years after survey participation. Logistic regression models identified factors associated with vaccine intent and subsequent vaccine initiation. RESULTS Among survivors who were HPV vaccine-naive at survey participation (n = 103), factors associated with vaccine intent included the following: 1) provider recommendation for the HPV vaccine (odds ratio [OR], 5.0; 95% confidence interval [CI], 1.4-18.1; P = .014), 2) positive general attitude toward vaccines (OR, 4.8; 95% CI, 2.0-11.2; P < .001), and 3) perceived severity of HPV disease (OR, 3.5; 95% CI, 1.2-9.9; P = .02). Of the vaccine-naive patients, 28 initiated the HPV vaccine at a median of 1.1 years after the survey. Initiation was more likely among survivors who had reported vaccine intent (OR, 3.9; 95% CI, 1.2-12.5; P = .02) and was less likely among older survivors (OR per year, 0.7; 95% CI, 0.6-0.9; P < .001). CONCLUSIONS These findings suggest that provider recommendation for the HPV vaccine plays a role in establishing intent, which then translates into subsequent initiation.
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Affiliation(s)
- Brooke Cherven
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Yanjun Chen
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Jocelyn M York
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | | | | | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - James L Klosky
- Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.,St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Wendy Landier
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama.,Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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15
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Pelullo CP, Esposito MR, Di Giuseppe G. Human Papillomavirus Infection and Vaccination: Knowledge and Attitudes among Nursing Students in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101770. [PMID: 31109133 PMCID: PMC6572142 DOI: 10.3390/ijerph16101770] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 01/04/2023]
Abstract
This cross-sectional study assessed nursing students' knowledge and attitudes about Human papillomavirus (HPV) infection and vaccination in Italy. The survey was conducted among a sample of 556 nursing students. Almost all reported that they had heard about HPV infection, while only 36.5% knew the risk factors of HPV infection and that this could be prevented by the HPV vaccine. Those who had heard about HPV infection during their degree program were more likely to know risk factors of HPV infection and that this could be prevented by the HPV vaccine. The majority of students (65.3%) reported that they would be willing to receive the HPV vaccine. Moreover, 91.7% of participants reported that they were willing, as future health care operators, to recommend the HPV vaccine to others. Those who knew risk factors of HPV infection and that this could be prevented by the HPV vaccine, and those who knew that cervical cancer could be prevented by the HPV vaccine expressed this positive attitude about willingness to recommend the HPV vaccine. These results highlight the need to supplement nursing students' specific education, to improve their knowledge and awareness of HPV vaccination.
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Affiliation(s)
- Concetta Paola Pelullo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
| | | | - Gabriella Di Giuseppe
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
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16
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Damnjanović K, Graeber J, Ilić S, Lam WY, Lep Ž, Morales S, Pulkkinen T, Vingerhoets L. Parental Decision-Making on Childhood Vaccination. Front Psychol 2018; 9:735. [PMID: 29951010 PMCID: PMC6008886 DOI: 10.3389/fpsyg.2018.00735] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 04/26/2018] [Indexed: 11/13/2022] Open
Abstract
A growing number of parents delay vaccinations or are deciding not to vaccinate their children altogether. This increases the risk of contracting vaccine-preventable diseases and disrupting herd immunity, and also impairs the trust in the capacities of health care systems to protect people. Vaccine hesitancy is related to a range of both psychological and demographic determinants, such as attitudes toward vaccinations, social norms, and trust in science. Our aim is to understand those determinants in parents, because they are a special group in this issue-they act as proxy decision makers for their children, who are unable to decide for themselves. The fact that deciding to vaccinate is a socially forced choice that concerns a child's health makes vaccine-related decisions highly important and involving for parents. This high involvement might lead to parents overemphasizing the potential side effects that they know to be vaccine-related, and by amplifying those, parents are more focused on the potential outcomes of vaccine-related decisions, which can yield specific pattern of the outcome bias. We propose two related studies to investigate factors which promote vaccine hesitancy, protective factors that determine parental vaccination decisions, and outcome bias in parental vaccination intentions. We will explore demographic and psychological factors, and test parental involvement related to vaccine hesitancy using an online battery in a correlation panel design study. The second study is an experimental study, in which we will investigate the moderating role of parents' high involvement in the specific domain of vaccination decision making. We expect that higher involvement among parents, compared to non-parents, will shape the pattern of the proneness to outcome bias. The studies will be conducted across eight countries in Europe and Asia (Finland, Germany, Hong Kong, the Netherlands, Serbia, Slovenia, Spain, and the United Kingdom), rendering findings that will aid with understanding the underlying mechanisms of vaccine hesitancy and paving the way for developing interventions custom-made for parents.
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Affiliation(s)
- Kaja Damnjanović
- Laboratory for Experimental Psychology, Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Johanna Graeber
- Department of Psychology, Faculty of Philosophy, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Sandra Ilić
- Laboratory for Experimental Psychology, Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Wing Y. Lam
- Faculty of Social Sciences, School of Psychology, University of Kent, Canterbury, United Kingdom
| | - Žan Lep
- Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia
| | - Sara Morales
- Faculty of Psychology, University of Basque Country, Bilbao, Spain
| | - Tero Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Loes Vingerhoets
- Department of Psychology, Faculty of Psychology and Neuroscience, University of Maastricht, Maastricht, Netherlands
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17
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Rosen BL, Shew ML, Zimet GD, Ding L, Mullins TLK, Kahn JA. Human Papillomavirus Vaccine Sources of Information and Adolescents' Knowledge and Perceptions. Glob Pediatr Health 2017; 4:2333794X17743405. [PMID: 29204462 PMCID: PMC5703096 DOI: 10.1177/2333794x17743405] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 10/15/2017] [Indexed: 11/17/2022] Open
Abstract
Understanding where adolescents obtain information about human papillomavirus (HPV) vaccines may be helpful in designing public health interventions promoting HPV vaccination. This study assessed the following: (1) exposure to specific sources of information about HPV vaccines, (2) self-reported helpfulness of these sources of information, and (3) whether the specific source of information was associated with knowledge and perceptions about HPV vaccines among adolescent girls. There were 339 adolescent girls (mean age = 16.8 years) recruited into the study. Television advertisements, the Internet, doctors/nurses, and mothers were the most frequently reported sources of vaccine information; more than 90% of participants who received information from these sources reported they were helpful. Adolescents who received information about HPV vaccines from television advertisements, the Internet, clinicians, and mothers had higher knowledge about HPV vaccines and more positive perceptions. Assuring the accuracy of messages from these sources will be essential, given their importance in influencing adolescents' knowledge and perceptions about HPV vaccines.
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Affiliation(s)
| | | | | | - Lili Ding
- University of Cincinnati, Cincinnati, OH, USA.,Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tanya L K Mullins
- University of Cincinnati, Cincinnati, OH, USA.,Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jessica A Kahn
- University of Cincinnati, Cincinnati, OH, USA.,Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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18
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Seanehia J, Treibich C, Holmberg C, Müller-Nordhorn J, Casin V, Raude J, Mueller JE. Quantifying population preferences around vaccination against severe but rare diseases: A conjoint analysis among French university students, 2016. Vaccine 2017; 35:2676-2684. [PMID: 28408120 DOI: 10.1016/j.vaccine.2017.03.086] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/21/2017] [Accepted: 03/30/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Several concepts are available to explain vaccine decision making by individual and inter-individual factors, including risk perception, social conformism and altruism. However, only a few studies have quantified the weight of these determinants in vaccine acceptance. Using a conjoint analysis tool, we aimed at eliciting preferences in a student population regarding vaccination against a rare, severe and rapidly evolving hypothetical disease, similar to meningococcal serogroup C meningitis or measles. METHODS During March-May 2016, we conducted an emailing survey among university students aged 18-24years (N=775) in Rennes, France. Participants were asked to decide for or against immediate vaccination in 24 hypothetical scenarios, containing various levels of four attributes: epidemic situation, adverse events, information on vaccination coverage, and potential for indirect protection. Data were analysed using random effect estimator logit models. RESULTS Participants accepted on average 52% of scenarios and all attributes significantly impacted vaccination acceptance. The highest positive effects were seen with an epidemic situation (OR 3.81, 95%-CI 3.46-4.19), 90% coverage in the community (3.64, 3.15-4.20) and potential for disease elimination from the community (2.87, 2.53-3.26). Information on "insufficient coverage" was dissuasive (vs. none of friends vaccinated: 0.65, 0.56-0.75). Controversy had a significantly greater negative effect than a confirmed risk of severe adverse events (OR 0.05 vs. 0.22). In models including participant characteristics, preference weights were unchanged, while trust in health authorities and vaccination perceptions strongly influenced acceptance themselves. The greatest significant variation of preference weights between subgroups was observed with controversy among students using alternative medicine daily (OR 0.28) and among students relying on scientific vaccine information (OR 0.02). CONCLUSIONS Among young adults, potential for indirect protection and factual information on coverage in the community and potential side effects positively impact theoretical vaccine acceptance. Conjoint analyses should be conducted to understand vaccine hesitancy in specific vaccination programs.
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Affiliation(s)
- Joy Seanehia
- EHESP French School of Public Health, Sorbonne Paris Cité, Paris, France.
| | - Carole Treibich
- Aix-Marseille Université, CNRS, EHESS, Centrale Marseille, AMSE, France.
| | - Christine Holmberg
- Institute for Public Health, Charité-Universitätsmedizin Berlin, Germany.
| | | | - Valerie Casin
- Service inter-universitaire de médecine préventive et de promotion de la santé, Rennes, France.
| | - Jocelyn Raude
- EHESP French School of Public Health, Sorbonne Paris Cité, Paris, France; UMR 190 EPV "Emergence des Pathologies Virales" (Aix-Marseille University, IRD 190, INSERM 1207, EHESP), Marseille, France; UMR "Processus Infectieux en Milieu Insulaire Tropical" (INSERM 1187, CNRS 9192, IRD 249, Université de La Réunion), Réunion, France.
| | - Judith E Mueller
- EHESP French School of Public Health, Sorbonne Paris Cité, Paris, France; Institut Pasteur, Paris, France.
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19
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Fadda M, Depping MK, Schulz PJ. Addressing issues of vaccination literacy and psychological empowerment in the measles-mumps-rubella (MMR) vaccination decision-making: a qualitative study. BMC Public Health 2015; 15:836. [PMID: 26328551 PMCID: PMC4556054 DOI: 10.1186/s12889-015-2200-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/27/2015] [Indexed: 11/16/2022] Open
Abstract
Background Whether or not to vaccinate one’s child is one of the first health-related decisions parents have to make after their child’s birth. For the past 20 years, the share of parents choosing not to immunize their children has increased in many countries, for various reasons. Among these, rumors affirming that vaccinations contain dangerous chemicals or might trigger severe chronic diseases have negatively affected parental attitudes towards pediatric immunizations, particularly the vaccination against measles, mumps and rubella (MMR), raising a number of public health concerns. The primary aim of this qualitative study is to understand what drives parents’ decision, giving special attention to vaccination literacy and psychological empowerment in such a context. Methods Twenty individual semi-structured interviews were conducted in the Canton of Ticino (Switzerland) between January and June 2014. Participants were either mothers or fathers of children less than 1 year old living in Switzerland. An inductive thematic analysis was performed to identify the main themes with regard to vaccination literacy and psychological empowerment in the MMR vaccination decision-making. Results Parents’ reports yielded four main themes: (a) the paradox of the free choice, referring to the misinterpretation of current vaccination policies; (b) giving up the power, pointing at the outcomes of a low perceived competence; (c) a far-reaching decision, reflecting the importance attributed to the MMR choice and the different levels of impact the decision can have; (d) the demand for shared-decision making, referring to the parental needs in relation to the child’s healthcare provider. Conclusion Understanding what drives parents’ management of their children’s immunization schedule in terms of vaccination literacy and psychological empowerment can help health professionals to communicate more effectively with parents in order to facilitate an informed decision, and stakeholders to design tailored health education programs and materials. This can ultimately help increase the coverage of the MMR vaccination. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2200-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marta Fadda
- Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano, Via G. Buffi 13, 6900, Lugano, Switzerland.
| | - Miriam K Depping
- Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano, Via G. Buffi 13, 6900, Lugano, Switzerland.
| | - Peter J Schulz
- Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano, Via G. Buffi 13, 6900, Lugano, Switzerland.
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20
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Gu C, Niccolai LM, Yang S, Wang X, Tao L. Human papillomavirus vaccine acceptability among female undergraduate students in China: the role of knowledge and psychosocial factors. J Clin Nurs 2015; 24:2765-78. [PMID: 26179945 DOI: 10.1111/jocn.12871] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2015] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To examine young women's perceptions and acceptability of human papillomavirus vaccination and factors influencing acceptability in mainland China. BACKGROUND In the light of current concepts, human papillomavirus vaccines serve as new paradigms in cervical cancer prevention programme for young women. However, knowledge and acceptability of human papillomavirus vaccination and factors influencing acceptability among young Chinese women are not known. DESIGN We implemented a cross-sectional descriptive study in the Hunan province of China. METHODS One hundred and seventeen female undergraduate students completed confidential surveys in 2012. The questionnaire included five parts: background information, awareness and knowledge of human papillomavirus vaccine and cervical cancer, attitudes towards the vaccine and intentions to be vaccinated, psychosocial burden of human papillomavirus infection, and human papillomavirus-related sexual stigma. RESULTS Only 44% of the participants were willing to be vaccinated in the future. Young women demonstrated low awareness and knowledge about human papillomavirus vaccine and cervical cancer. Their intention to receive future vaccination was associated with the high levels of knowledge about risk factors for cervical cancer and perceptions that infected women are responsible for their own infection of human papillomavirus. CONCLUSION The results of this study suggest low awareness and knowledge among young Chinese women about the preventive nature and value of human papillomavirus vaccination. Social and cultural factors including moral obligation and STD-related stigma may influence young women's intention to future vaccination. RELEVANCE TO CLINICAL PRACTICE Educational interventions are necessary to promote public awareness and deliver information about human papillomavirus vaccination and cervical cancer prevention. Results of this study can help health care practitioners develop appropriate programmes for the promotion of human papillomavirus vaccination among this population.
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Affiliation(s)
- Can Gu
- Department of Medicine, Xiang-Ya Hospital, Central South University, Changsha, China.,Xiang-Ya School of Nursing, Central South University, Changsha, China
| | | | - Shengbo Yang
- Department of Dermatology, Third Xiang-Ya Hospital, Central South University, Changsha, China
| | - Xiuhua Wang
- Xiang-Ya School of Nursing, Central South University, Changsha, China
| | - Lijian Tao
- Department of Medicine, Xiang-Ya Hospital, Central South University, Changsha, China
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21
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Coles VAH, Patel AS, Allen FL, Keeping ST, Carroll SM. The association of human papillomavirus vaccination with sexual behaviours and human papillomavirus knowledge: a systematic review. Int J STD AIDS 2014; 26:777-88. [PMID: 25300588 DOI: 10.1177/0956462414554629] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 09/15/2014] [Indexed: 11/15/2022]
Abstract
Since the 2008 introduction of the human papillomavirus (HPV) vaccination programme for adolescent girls in the UK, parents and other groups have expressed fears that immunisation condones sexual activity, promotes promiscuity and encourages risky sexual behaviour. This study aimed to explore whether HPV vaccination programmes have increased knowledge surrounding HPV and associated disease and whether uptake has influenced sexual behaviour. MEDLINE, Embase, Cochrane Library and PsycINFO electronic databases were interrogated. Studies of behaviour, attitudes and knowledge associated with HPV vaccination (or vaccination intent) in subjects of any age and gender in programmes reflective of UK practice were included in the review (n = 58). The evidence regarding the association of HPV vaccination with high-risk sexual behaviour was varied, primarily due to the heterogeneous nature of the included studies. Young females typically exhibited better knowledge than males, and vaccinated respondents (or those with vaccination intent) had higher levels of knowledge than the unvaccinated. However, knowledge surrounding HPV and genital warts was generally poor. This review highlights the need to provide effective education regarding the HPV vaccine and HPV-associated disease to adolescents of vaccination age, nurses, teachers, parents and guardians to ultimately allow informed decisions to be made regarding receipt of the HPV vaccine.
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22
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Blumenthal-Barby JS, Krieger H. Cognitive biases and heuristics in medical decision making: a critical review using a systematic search strategy. Med Decis Making 2014; 35:539-57. [PMID: 25145577 DOI: 10.1177/0272989x14547740] [Citation(s) in RCA: 288] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 07/26/2014] [Indexed: 12/23/2022]
Abstract
BACKGROUND The role of cognitive biases and heuristics in medical decision making is of growing interest. The purpose of this study was to determine whether studies on cognitive biases and heuristics in medical decision making are based on actual or hypothetical decisions and are conducted with populations that are representative of those who typically make the medical decision; to categorize the types of cognitive biases and heuristics found and whether they are found in patients or in medical personnel; and to critically review the studies based on standard methodological quality criteria. METHOD Data sources were original, peer-reviewed, empirical studies on cognitive biases and heuristics in medical decision making found in Ovid Medline, PsycINFO, and the CINAHL databases published in 1980-2013. Predefined exclusion criteria were used to identify 213 studies. During data extraction, information was collected on type of bias or heuristic studied, respondent population, decision type, study type (actual or hypothetical), study method, and study conclusion. RESULTS Of the 213 studies analyzed, 164 (77%) were based on hypothetical vignettes, and 175 (82%) were conducted with representative populations. Nineteen types of cognitive biases and heuristics were found. Only 34% of studies (n = 73) investigated medical personnel, and 68% (n = 145) confirmed the presence of a bias or heuristic. Each methodological quality criterion was satisfied by more than 50% of the studies, except for sample size and validated instruments/questions. Limitations are that existing terms were used to inform search terms, and study inclusion criteria focused strictly on decision making. CONCLUSIONS Most of the studies on biases and heuristics in medical decision making are based on hypothetical vignettes, raising concerns about applicability of these findings to actual decision making. Biases and heuristics have been underinvestigated in medical personnel compared with patients.
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Affiliation(s)
- J S Blumenthal-Barby
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX (JSBB)
| | - Heather Krieger
- Department of Social Psychology, University of Houston, Houston, TX (HK)
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23
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Frew PM, Saint-Victor DS, Owens LE, Omer SB. Socioecological and message framing factors influencing maternal influenza immunization among minority women. Vaccine 2014; 32:1736-44. [PMID: 24486366 DOI: 10.1016/j.vaccine.2014.01.030] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/18/2013] [Accepted: 01/14/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE A suboptimal level of seasonal influenza vaccination among pregnant minority women is an intractable public health problem, requiring effective message resonance with this population. We evaluated the effects of randomized exposure to messages which emphasize positive outcomes of vaccination ("gain-frame"), or messages which emphasize negative outcomes of forgoing vaccination ("loss-frame"). We also assessed multilevel social and community factors that influence maternal immunization among racially and ethnically diverse populations. STUDY DESIGN Minority pregnant women in metropolitan Atlanta were enrolled in the longitudinal study and randomized to receive intervention or control messages. A postpartum questionnaire administered 30 days postpartum evaluated immunization outcomes following baseline message exposure among the study population. We evaluated key outcomes using bivariate and multivariate analyses. RESULTS Neither gain- [OR=0.5176, (95% CI: 0.203,1.322)] nor loss-framed [OR=0.5000, 95% CI: (0.192,1.304)] messages were significantly associated with increased likelihood of immunization during pregnancy. Significant correlates of seasonal influenza immunization during pregnancy included healthcare provider recommendation [OR=3.934, 95% CI: (1.331,11.627)], use of hospital-based practices as primary source of prenatal care [OR=2.584, 95% CI: (1.091,6.122)], and perceived interpersonal support for influenza immunization [OR=3.405, 95% CI: (1.412,8.212)]. CONCLUSION Dissemination of vaccine education messages via healthcare providers, and cultivating support from social networks, will improve seasonal influenza immunization among pregnant minority women.
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Affiliation(s)
- Paula M Frew
- Emory University School of Medicine, Department of Medicine, Division of Infectious Diseases, Decatur, GA, United States; Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA, United States.
| | - Diane S Saint-Victor
- Emory University School of Medicine, Department of Medicine, Division of Infectious Diseases, Decatur, GA, United States; Emory University, Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA, United States
| | - Lauren E Owens
- Emory University School of Medicine, Department of Medicine, Division of Infectious Diseases, Decatur, GA, United States; Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, United States
| | - Saad B Omer
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, United States
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24
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Kivuti-Bitok LW, McDonnell G, Abdul R, Pokhariyal GP. System dynamics model of cervical cancer vaccination and screening interventions in Kenya. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2014. [DOI: 10.1186/1478-7547-12-26] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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25
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Bowyer HL, Forster AS, Marlow LAV, Waller J. Predicting human papillomavirus vaccination behaviour among adolescent girls in England: results from a prospective survey. ACTA ACUST UNITED AC 2013; 40:14-22. [PMID: 23902714 DOI: 10.1136/jfprhc-2013-100583] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND To maximise the benefits of human papillomavirus (HPV) vaccination, uptake needs to be high. We examined psychosocial predictors of HPV vaccine uptake and the association between vaccine intention and uptake 1 year later in adolescent girls (aged 16-17 years) in England. METHOD Adolescent girls in the catch-up cohort were recruited from colleges in the South East of England in 2009 and 2010. Participants completed a questionnaire 6 months before (n=606) and 6 months after (n=214) being offered the vaccine, which assessed vaccine intention, vaccine uptake, demographics and attitudes based on the Health Belief Model and Theory of Planned Behaviour. RESULTS A number of demographic and psychological factors, including intention, showed associations with vaccine uptake in uni-variable analyses. In multi-variable analyses, only ethnicity was independently associated with vaccine uptake. Participants from Black or 'Other' ethnic backgrounds were less likely to have received the HPV vaccine than White participants. CONCLUSIONS More research is needed to help understand variation in vaccine coverage between ethnic groups.
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Affiliation(s)
- Harriet L Bowyer
- Research Assistant, Research Department of Epidemiology and Public Health, Cancer Research UK Health Behaviour Research Centre, University College London, London, UK
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26
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Cohen EL, Head KJ. Identifying knowledge-attitude-practice gaps to enhance HPV vaccine diffusion. JOURNAL OF HEALTH COMMUNICATION 2013; 18:1221-34. [PMID: 23767775 DOI: 10.1080/10810730.2013.778357] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
To examine differences in knowledge, attitudes, and related practices among adopters and nonadopters of the human papillomavirus (HPV) vaccine, the researchers conducted 83 in-depth interviews with 18- to 26-year-old women. The study identified knowledge-attitude-practice gaps in the context of the HPV vaccine to explain why diffusion of a preventive innovation (such as the HPV vaccine) requires targeted risk communication strategies in order to increase demand. Salient findings included similarities between vaccinated and unvaccinated women's lack of knowledge and uncertainties about HPV and cervical cancer. Vaccinated women who had no knowledge of HPV or no-risk/low-risk perceptions of HPV reported receiving vaccination, indicating HPV risk protection behavior could precede knowledge acquisition for vaccinated women. These vaccinated women identified an interpersonal network supportive of vaccination and reported supportive social influences. Among unvaccinated women, unsupportive vaccination attitudes included low perceived personal risk of HPV. In contrast, unvaccinated women often cited erroneous beliefs that HPV could be avoided by abstinence, monogamy, and knowledge of their partners' sexual history as reasons that the vaccine was not personally relevant. Unvaccinated women cited interpersonal influences that activated short- and long-term vaccination safety and efficacy concerns. Different levels of fear regarding the HPV vaccine may underlie (a) attitudinal differences between vaccinated and unvaccinated women in perceived vaccination value and (b) attitude-practice gaps.
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Affiliation(s)
- Elisia L Cohen
- a Department of Communication , College of Communication and Information, University of Kentucky , Lexington , Kentucky , USA
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27
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Abstract
PURPOSE OF REVIEW Despite recommendations from the Advisory Committee on Immunization Practices (ACIP) for routine vaccination of adolescents with the human papillomavirus (HPV) vaccine, U.S. coverage among women remains less than 50%, with that of adolescent men below 2%. RECENT FINDINGS Ongoing studies document the efficacy and safety of the HPV vaccine. Nevertheless, misconceptions and negative attitudes persist and serve as barriers to vaccine uptake. Additionally, other factors such as age, insurance status, poverty status, and racial or ethnic background have been associated with diminished vaccine uptake and poor completion rates. Internationally, HPV vaccination programs and school-based programs have achieved increased rates of uptake and series completion. HPV vaccination coverage may also be facilitated by improving communication between physicians, parents, and adolescents as well as by addressing common misconceptions about the vaccine. SUMMARY This review highlights significant findings of recent literature on HPV vaccination of adolescent women with a special focus on uptake, series completion, communication, disparities in vaccine coverage, and other health outcomes associated with HPV vaccination.
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Reimer RA, Houlihan AE, Gerrard M, Deer MM, Lund AJ. Ethnic differences in predictors of HPV vaccination: comparisons of predictors for Latina and non-Latina White women. JOURNAL OF SEX RESEARCH 2012; 50:748-756. [PMID: 23030843 DOI: 10.1080/00224499.2012.692406] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The purpose of this study was to examine how social and behavioral factors such as age of first intercourse, mother-daughter communication, and perceived norms are associated with human papillomavirus (HPV) vaccination behaviors, and whether ethnicity moderates those associations (non-Latina White versus Latina participants). From June through December 2009, we surveyed a community sample of 309 White and Latina women, ages 15 to 30. We recruited participants from local health care clinics in Des Moines, Iowa. Vaccination status was not significantly different for Whites versus Latinas. The effects of age at first intercourse, mother-daughter communication about values related to sex, and descriptive norms of HPV vaccine uptake were all significantly moderated by ethnicity. The current findings reveal that sociocultural and behavioral factors that affect HPV vaccine uptake do not affect White and Latina women in the same fashion. In the future, public health campaigns about HPV and the HPV vaccine may be more effective if their messages are sensitive to these differences.
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