In the Wake of Scandals: How Media Use and Social Trust Influence Risk Perception and Vaccination Intention among Chinese Parents

Medication safety perceptions in China: Media exposure, healthcare experiences, and trusted information sources

OBJECTIVE

Amid ongoing medication safety concerns in China and limited research on public perceptions, this study investigates the correlations between media exposure, healthcare experiences, and individuals' perceptions of medication safety. It also examines individuals' reliance on information sources during safety crises.

METHODS

A multistage stratified random sampling was employed with the gross sample containing 3090 Chinese adults aged 18-60 years. Data were analyzed using multiple linear regression.

RESULTS

Social media exposure was found to negatively correlate with perceptions of current medication safety and its perceived improvement, while exposure to television and print media showed positive correlations. Positive healthcare experiences were associated with improved medication safety perceptions. Among various information sources, healthcare professionals were deemed most trustworthy during medication safety incidents.

CONCLUSIONS

Media exposure and personal healthcare experiences significantly shape individuals' perceptions of medication safety in China, with healthcare professionals playing a crucial role in this context. Practiceimplications: Effective health crisis communication in China needs to be multifaceted, integrating traditional media and social media platforms to disseminate accurate information broadly. Additionally, healthcare professionals should be actively involved in crisis communication. Their role as trusted sources can be leveraged to clarify misconceptions, and reassure the public during medication safety incidents.

Disappearing Negative Valence: A Content Analysis of HPV Vaccine Newspaper Coverage in China (2000-2018)

News coverage of the human papillomavirus (HPV) vaccine grew rapidly in China in 2016 when the vaccine was approved. Drawing upon framing theory, the present study analyzed the content of 491 Chinese newspaper reports on the HPV vaccine published between June 2000 and December 2018 to investigate what and how information and valence about the vaccine was relayed to the public. The results indicated that, while the Chinese media failed to provide comprehensive and accurate information about HPV and the HPV vaccine, they showed a positive evaluation of the HPV vaccine demand and market. In addition, there was a decline in negative coverage after the vaccine was approved. This study extended the literature on HPV vaccine coverage by combining issue-specific framing and valence framing, considering the Chinese-specific vaccine market for presentation and the value of such products, which is rare in previous studies. Practical implications of the findings for health promotion were also discussed.

Exploring how health-related advertising interference contributes to the development of cyberchondria: A stressor-strain-outcome approach

Objectives

Cyberchondria is increasingly recognized as the dark side of digital health, given the pervasive use of the internet as a main source of health information in people's daily lives. While previous studies have identified many factors contributing to cyberchondria, there is a dearth of research on the impact of health-related advertisements. Therefore, this study adopts the stressor-strain-outcome (SSO) model to investigate how health-related advertising interference is directly and indirectly related to cyberchondria.

Methods

To empirically validate the proposed research model, we conducted an online survey with 437 internet users with medical information seeking experience in China. Structural equation modeling (SEM) was employed to analyze the survey data.

Results

Our findings revealed a positive, direct association between health-related advertising interference and cyberchondria. Meanwhile, advertising interference was positively related to both information overload and information irrelevance, with the former further predicting cyberchondria. Moreover, doctor-patient communication weakened the positive effect of information overload on cyberchondria.

Conclusions

The study not only theoretically contributes to the literature by theorizing the relationship between health-related advertising interference and cyberchondria but also practically underlines the pivotal role of effective doctor-patient communication in reducing the development of cyberchondria.

"I am Young, Why Should I Vaccinate?" How empathetic and aggressive communication on social media impact young adults' attitudes toward COVID-19 vaccination

Introduction

To combat the current COVID-19 pandemic, high vaccination rates are of crucial value. However, young people in particular tend to be hesitant toward vaccination. On social media, young adults are often called to vaccinate in an aggressive tone, arguing that there is no choice than to vaccinate and that all else is wrong.

Methods

In an experimental study (N = 410), we investigated the effects of (a) empathetic vs. aggressive communication styles in social media postings and (b) the origin of the communicator on young adults' supportive attitudes toward COVID-19 vaccinations. We treated the gender of the communicator as a moderator, and expectancy violation, psychological distance as well as the perceived credibility of the communicator as mediators.

Results

Findings showed that an aggressive communication style generally had a negative impact on young adults' COVID-19 vaccination attitudes, fully mediated by expectancy violation and perceived credibility of the communicator. Gender and the origin of the communicator did not moderate this mediation processes.

Discussion

Further implications for online health communication strategies are discussed.

An empirical evaluation of technology acceptance model for Artificial Intelligence in E-commerce

Artificial Intelligence (AI) has become essential to Electronic-Commerce technology over the past decades. Its fast growth has changed the way consumers do online shopping. Using the Technology Acceptance Model (TAM) as a theoretical framework, this research examines how AI can be made more effective and profitable in e-commerce and how entrepreneurs can make AI technology to assist in achieving their business goals. In this regard, an online survey was conducted from the online purchasers of e-commerce firms. The Partial Least Square (PLS) Smart was used to examine the data. The broadly used TAM was identified as an appropriate hypothetical model for studying the acceptance of AI technology in e-commerce. The findings of this study show that Subjective Norms positively impact Perceived Usefulness (PU) and Pursued Ease of Use (PEU), trust has a positive effect on PEU, and PEU positively impacts PU and attitudes toward use. Similarly, PU also has a positive effect on attitudes toward use and intention to use. Furthermore, the findings do not support the impact of Trust on PU and attitudes towards behavioural intention to use. Lastly, behavioural intention to use positively impacted the actual use of AI technology. This study adds theoretical and practical knowledge for adopting the TAM model in the E-commerce sector. It helps entrepreneurs to implement the TAM model in their business to use AI in a better and more appropriate way.

Theoretical and practical aspects of risk communication in food safety: A review study

Currently, food safety hazards have introduced as one of the most important threats to public health worldwide. Considering numerous crises in the field of food safety at global, regional, and national levels, and their impact on the physical and mental health of consumers, it is very vital to evaluate risk communication strategies in each country. Food safety risk communication (FSRC) aims to provide the means for individuals to protect their health from food safety risks and make informed decisions about food risks. The purpose of this study is to present FSRC as one of the key parts of risk analysis, its importance considering the prevalence of food contamination and recent crises related to food. Additionally, the stages of implementation of FSRC are mentioned. In FSRC, it is essential to comply with the principles and prerequisites. There are various strategies for FSRC nowadays. Different platforms for FSRC are rapidly evolving. Choosing and evaluating the appropriate strategy according to the target group, consensus of stakeholders, cooperation and coordination of risk assessors and risk managers have a significant impact in order to improve and implement FSRC.

Impact of social media news on COVID-19 vaccine hesitancy and vaccination behavior

In order to take advantage of the power of social media to promote vaccination, this study reveals the mechanisms of positive and negative impacts of social media news on vaccine hesitancy and vaccination behavior. Based on the stimulus-organism-response (S-O-R) framework, we developed a research model to understand the effects of vaccine safety news and risk news from social media (external stimuli) on individuals' psychological organism (i.e., safety perception and risk perception) and consequent behavioral response, vaccine hesitancy and vaccination behavior. The proposed model was tested by partial least square structural equation modeling (PLS-SEM) on a sample gathered in China from September 2021 to November 2021 and from February 2022 to April 2022 (valid responses = 1579). The results found that the relationship between vaccine risk news from social media and risk perception was higher than the relationship between vaccine safety news from social media and safety perception. Individuals are more sensitive to vaccine risk news than safety news on social media. Moreover, both safety perception and risk perception explained the critical psychological mechanisms behind vaccine hesitancy. Interestingly, ego network density mitigated the effect of safety news on safety perception and the effect of risk news on risk perception. The findings contribute to the S-O-R model, the research on social media effects, and the literature on vaccination attitudes and behaviors. This study also informs public health officials about leveraging the power of social media to motivate the public to accept the COVID-19 vaccines.

PFAS Contamination: Pathway from Communication to Behavioral Outcomes

ABSTRACTGuided by the risk information seeking and processing model, this study examines social cognitive variables that motivate individuals to actively seek and process information related to per- and polyfluoroalkyl substances (PFAS) contamination. Results indicate that information insufficiency, affective response, and informational subjective norms are positively related to information seeking and systematic processing, which are positively associated with policy support and intention to adopt risk mitigation behaviors. These findings suggest that when communicating the health risks of PFAS contamination to the general public, cognitive, affective, and normative factors are important initial steps to generate public interest in relevant information.

Communicating Per- and Polyfluoroalkyl Substances (PFAS) Contamination to the Public Through Personal Relevance

It is important to understand people's risk perception to identify effective pathways for risk communication about per- and polyfluoroalkyl substances (PFAS) because they present emerging environmental health risks. Guided by dual-process theories of information processing, this study focuses on personal relevance as a key variable that influences risk perception, systematic processing, and information seeking intention. Through an experimental survey, we found that participants in the high personal relevance condition (n = 497) were more likely to process information systematically compared to those in the low personal relevance condition (n = 486). Results also revealed that personal relevance influenced systematic processing through risk judgment and emotional response. Message-specific systematic processing was positively associated with information seeking intention. Lastly, trust in government and trust in science had different relationships with systematic processing, demonstrating the importance of distinguishing different types of institutional trust in future research.

What attributes influence rural household's willingness to get vaccinated for COVID-19? Perspectives from six Chinese townships

Since the onset of the COVID-19 pandemic, vaccinations have been identified as the most effective mitigation strategy against the deadly virus. This has led developed nations to accelerate research and shorten the licensure process for COVID-19 vaccines, but these changes have caused widespread concerns about vaccine safety. Research literature has long indicated that citizens' perceptions of protective actions will determine their behaviors, and thus, the relationship between vaccine perception and vaccination intention needs to be assessed. To better understand vaccination willingness, especially in rural populations, this study surveyed 492 households from six townships in the Ya'an region of China's Sichuan Province in November 2020. The survey followed the Protective Action Decision Model (PADM) framework for collecting perceptions about the influenza and COVID-19 vaccines as protective actions, information sources, emergency preparedness, emotional response, and demographic characteristics. The results showed that influenza vaccine perceptions significantly affected people's COVID-19 vaccination perceptions and intentions. Unlike previous vaccination willingness and other COVID-19 studies, this study found that perceptions of resource-related attributes and health-related attributes both affected COVID-19 vaccination intentions, but the former were slightly stronger than the latter. Moreover, these effects were strongest among respondents who had the most positive perceptions of their influenza vaccine experience. This study's findings will benefit local authorities in designing appropriate policies and measures (e.g., hazard education, risk communication, vaccination convenience enhancement) for increasing vaccination compliance for the current and future pandemics.

Healthcare Workers and Nonhealthcare Workers Pro-Vaccination Attitude and Its Associated Factors towards COVID-19 Vaccine Globally: A Systematic Review and Meta-Analysis

Introduction

Coronavirus disease 2019 (COVID-19) pandemic has not been managed and controlled globally. The aim of this systematic review and meta-analysis were to determine the global pro-vaccination attitude and associated factors towards COVID-19 vaccine among healthcare workers (HCWs) and nonhealthcare workers (non-HCWs).

Methods

Different databases such as PubMed, Scopus, EMBASE, and Google Scholar were used. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 flowchart diagram and PRISMA checklist were used for study screening, selection, and inclusion into this systematic review and meta-analysis. Newcastle-Ottawa Scale (NOS) quality assessment criteria for cross-sectional studies were used to assess the included articles.

Results

A total of 51 studies were included into this systematic review and meta-analysis. The meta-analysis revealed that the global pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine among both HCWs and non-HCWs was 61.30% (95%CI: 56.12, 66.47, I 2 = 99.8%: p=0.000). Subgroup analysis showed that the global pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine was the lowest (59.77%, 95%CI (51.56, 67.98); I 2 = 99.6%, p=0.000) among the HCWs participants and the highest (62.53%, 95%CI (55.39, 69.67); I 2 = 99.8%, p=0.000) among the non-HCWs participants and the lowest (54.31%, 95%CI (43, 65.63); I 2 = 99.5%, p=0.000) for sample size <700 and the highest (66.49%, 95%CI (60.01, 72.98); I 2 = 99.8%, p=0.000) for sample size >700; the lowest (60.70%, 95%CI (54.08, 67.44); I 2 = 93.0%, p=0.000) for studies published in 2020 year and the highest (61.31%, 95%CI (55.93, 66.70); I 2 = 99.8%, p=0.000) for the studies published after 2020 years. From this systematic review, factors significantly associated with pro-vaccination attitude towards COVID-19 vaccine among HCWs were such as age, gender, race, work experience, home location, having no fear of injections, being a non-smoker, profession, presence of chronic illnesses, allergies, confidence in pharmaceutical companies, history of taking influenza vaccine, vaccine recommendation, perceived risk of new vaccines, perceived utility of vaccine, receiving a seasonal flu vaccination in the last 5 years, working in a private hospital, a high perceived pandemic risk index, low vaccine harm index, high pro-socialness index, being in close contact with a high-risk group, knowledge about the virus, confidence in and expectations about personal protective equipment, and behaviors. The level of positive attitude towards COVID-19 vaccine among non-HCWs ranged from 21.40% to 91.99%. Factors associated with the attitude towards COVID-19 vaccine among non-HCWs were such as age, gender, educational level, occupation, marital status, residency, income, ethnicity, risk for severe course of COVID-19, direct contact with COVID-19 at work, being a health profession, being vaccinated against seasonal flu, perceived benefits, cues to actions, having previous history of vaccination, fear of passing on the disease to relatives, and the year of medical study, studying health-related courses, COVID-19 concern, adherence level to social distancing guidelines, history of chronic disease, being pregnant, perceived vaccine safety, having more information about vaccine effectiveness, mandatory vaccination, being recommended to be vaccinated, lack of confidence in the healthcare system to control epidemic, and belief in COVID-19 vaccines protection from COVID-19 infection.

Conclusion

This meta-analysis revealed that the global estimated pooled prevalence of pro-vaccination attitude towards COVID-19 vaccine among both HCWs and non-HCWs was unsatisfactory. Globally, there is a need for a call for action to cease the crisis of this pandemic.

Exploring factors that influence COVID-19 vaccination intention in China: Media use preference, knowledge level and risk perception

Vaccine is one of the most effective means to deal with the COVID-19 pandemic in many countries, but vaccine hesitancy has been always widespread among people due to individual differences in access to vaccine information. This research aims to empirically investigate the relationship between media use preference (video-based and text-based), knowledge level, risk perception and willingness to vaccinate among Chinese residents. A cross-sectional survey of a Chinese sample (N = 885) was carried out to explore factors that influence the COVID-19 vaccination intention of Chinese residents. The empirical results show that the knowledge level and risk perception of Chinese residents positively contribute to vaccination intention. People with video-usage preference have lower levels of knowledge about the COVID-19 vaccine than those with text-usage preference. People’s risk perception of the COVID-19 pandemic is not influenced by their media use preference or knowledge level, as COVID-19 is a global pandemic and a significant social risk. The current study yields health-related implications for the role of media use preference in vaccination intention.

Opt-out policy and its improvements promote COVID-19 vaccinations

Rationale

Vaccination uptake is a major strategy to prevent infection with SARS-CoV-2 and curb the transmission of COVID-19. However, many people remain unwilling to receive the COVID-19 vaccine.

Objective

Using default nudges, the present study examines (a) whether opt-out policy and its improvements could increase intention and attitude to get vaccinated and (b) whether these default effects differ across diverse risk-perception groups.

Method

An online experiment with 1926 unvaccinated Chinese respondents was conducted in February 2021. We measured willingness to be vaccinated after informing opt-in policy, standard opt-out policy, and its five improvements (opt-out education, opt-out opportunity, opt-out social norm, opt-out feedback, and opt-out opportunity). Risk perception of the pandemic of COVID-19 and vaccination were also measured.

Results

(a) Opt-out policy and its improvement (except the opt-out transparency) increased intentions to be vaccinated. Policies with a vaccination default did not weaken people's attitude toward policy and policymakers compared with the opt-in policy, but participants in the transparent improvement group reported lower freedom of choice than those in the opt-out group. (b) Further latent profile analysis revealed four classes underlying risk perception: risk exaggerators, risk deniers, disease-specific risk perceivers, and vaccine-specific risk perceivers. But there was no conclusive evidence that the effect of risk perception differs as a function of defaults.

Conclusions

These findings provide new psychological evidence for formulating more targeted vaccination policies and highlight the importance of risk perception to understand vaccination intentions.

Understanding Chinese international students' perception of flu vaccination on U.S. college campuses

Objective: This study examines Chinese international students' underlying beliefs and overall perception of the flu vaccination to inform effective health promotion efforts on U.S. college campuses. Participants: Data were collected in March 2020. Participants (N = 189) were recruited via email at a southeastern university in the U.S. Methods: Incorporating theory recommendations and recent vaccine-related research findings, this study designs a Four-Factor Measurement Model through confirmatory factor analysis (CFA) to examine Chinese international students' perception of flu vaccination. Results: Chinese international students' health beliefs, particularly their perceived susceptibility of the influenza virus, was the most important factor to explain their perception of flu vaccination. While normative beliefs were the least influential factor to account for Chinese international students' perception of flu vaccination, these students valued healthcare providers' opinions immensely. Conclusions: This study suggests the Four-Factor Measurement Model will help measure Chinese international students' perception of flu vaccination and can be applied to future vaccine-related research.

COVID-19 vaccine uptake and associated factors among pregnant women attending antenatal care in Debre Tabor public health institutions: A cross-sectional study

Background

Vaccination is the best means of reducing the increased risk of severe COVID-19 during pregnancy. Data on COVID-19 vaccine uptake among pregnant women in Ethiopia is scarce. Thus, this study aimed to assess COVID-19 vaccine uptake and associated factors among pregnant women.

Method

An institution-based cross-sectional study was conducted among 634 pregnant women attending antenatal care in Debre Tabor public health institutions from March 14 to 30, 2022. Participants were recruited using a multistage sampling technique and data were collected via face-to-face interviews using a pre-tested structured questionnaire. Stata version 16.0 software was used for data analysis. Multiple logistic regression analysis was used to assess factors associated with COVID-19 vaccine uptake, with a p-value&lt; 0.05 considered statistically significant.

Result

Only 14.4% (95% CI: 11.7%-17.3%) of participants had received at least one dose of COVID-19 vaccines. The main reasons for declining vaccination were fear that the COVID-19 vaccine may have harmful side effects on the fetus or the mother. Being 45 or older (AOR: 1.75, 95%CI: 1.01–2.95), being married (AOR: 1.26, 95%CI: 1.12, 2.96), having good knowledge (AOR:3.52, 95%CI:1.83–3.87), and a positive attitude (AOR:4.81, 95% CI: 1.42–7.33) were positive predictors of COVID-19 vaccine uptake. But attaining a college or university education (AOR: 0.43, 95%CI: 0.12–0.69) was found to be a barrier to vaccine uptake by pregnant women.

Conclusion

COVID-19 vaccination among pregnant women was substantially low. Old age, being married, low education, good knowledge, and a positive attitude were significant predictors of COVID-19 vaccine uptake. To enhance the COVID-19 vaccine uptake, the government should improve the knowledge and attitude of pregnant women toward the COVID-19 vaccine.

Chinese Consumers’ Trust in Food Safety Surveillance Sampling of Commonly Consumed Foods

In China, food has become safer over the past five years, especially commonly consumed foods. Food supervision sampling has played an important role in improving food safety. However, consumer acceptance of the results of food safety supervision have not kept pace. Communicating actual food safety risks to consumers and improving the public trust in food safety supervision sampling inspection has become an important issue. This study focused on food safety surveillance sampling of commonly consumed foods. In total, 4408 adult consumers were surveyed between August and October 2021. Structural equation modeling was performed for data analysis. This study found significant differences along gender lines and across different cities and levels of education with respect to evaluating competence trust and care trust on food supervision sampling inspection. This study identified the public’s competence trust, care trust, and perception of food safety as factors that significantly affect one’s attitude toward supervision sampling inspection. Care trust showed a more pronounced effect on trust enhancement than competence trust. The present study also provides some practical measures for food safety supervisors to improve public trust in the national food inspection. Specifically, the sampling process should be open and transparent.

Belief in the importance of socially responsible behaviors - the significance of trust and personal experiences with Covid-19

A vast number of studies have shown that trust is related to socially desirable traits and behaviors. In the present research we have investigated the relationship between generalized trust and beliefs about the importance of socially responsible behaviors (SRB) during the pandemic - namely, following the sanitary regime and getting vaccinated. Basing on the previous findings we assumed that trustful people would be more convinced of the benefits of complying with the pandemic restrictions and getting vaccinated. The hypothesis stated that people with high levels of trust who had COVID-19 or whose close persons had been infected would be the most likely to believe in socially responsible behaviors. We recruited 405 people from the general population (age range 18-65) to participate in an online study conducted via a research platform. The analysis using linear regression has shown that people, whose close persons had suffered from COVID-19 were more inclined to believe in the importance of SRB. The level of trust also predicted the beliefs about the importance of socially responsible behaviors in mitigating the pandemic. Trust was positively related to SRB, except for people whose close persons had been infected with COVID-19. Regardless of the level of trust, people with such experience tended to assess SRB as important to combat the pandemic. These results have shed light on the importance of trust in developing the strategy of fighting the COVID-19 pandemic.

The risk perception of nanotechnology: evidence from twitter

Nanotechnology governance, particularly in relation to human and environmental concerns, remains a contested domain. In recent years, the creation of both a risk governance framework and council has been actively pursued. Part of the function of a governance framework is the communication to external stakeholders. Existing descriptions on the public perceptions of nanotechnology are generally positive with the attendant economic and societal benefits being forefront in that thinking. Debates on nanomaterials' risk tend to be dominated by expert groupings while the general public is largely unaware of the potential hazards. Communicating via social media has become an integral part of everyday life facilitating public connectedness around specific topics that was not feasible in the pre-digital age. When civilian passive stakeholders become active their frustration can quickly coalesce into a campaign of resistance, and once an issue starts to develop into a campaign it is difficult to ease the momentum. Simmering discussions with moderate local attention can gain international exposure resulting in pressure and it can, in some cases, quickly precipitate legislative action and/or economic consequences. This paper highlights the potential of such a runaway, twitterstorm. We conducted a sentiment analysis of tweets since 2006 focusing on silver, titanium and carbon-based nanomaterials. We further examined the sentiment expressed following the decision by the European Food Safety Authority (EFSA) to phase out the food additive titanium dioxide (E 171). Our analysis shows an engaged, attentive public, alert to announcements from industry and regulatory bodies. We demonstrate that risk governance frameworks, particularly the communication aspect of those structures must include a social media blueprint to counter misinformation and alleviate the potential impact of a social media induced regulatory and economic reaction.

The number of positive, negative and neutral tweets relating to silver, carbon and titanium nanoparticles since 2006. Over a quarter of a million tweets were analyzed using a sentiment analysis methodology.

Predicting the COVID-19 vaccine receive intention based on the theory of reasoned action in the south of Iran

Background

Vaccination against Covid 19 disease was based on rational practice theory.

One of the most effective methods to control the COVID-19 pandemic is extensive vaccination coverage in the shortest time. The relevant beliefs and predictors of COVID-19 vaccine and the barriers to and facilitators of receiving COVID-19 vaccine should be identified. Individuals’ intention to receive COVID-19 and the effective factors are of an utmost importance. This study aimed to predict intention to receive COVID-19 vaccine in the South of Iran.

Methods

This cross-sectional study was performed over a period of 2 months (May 2021 to July 2021) in 4 southern provinces in Iran. The study population of this study included people over 18 years of age who did not receive the COVID-19 vaccine. The online questionnaire was used to collect data. We recruited participants through a self-selection sampling method and posted the online survey link. The questionnaire had two parts: demographic information and Theory of Reasoned Action (TRA) questions. All statistical calculations and hypotheses tests were performed using SPSS21 and Amos21 software and the significance level was considered 0.05.

Results

A total number of 2556 people participated in this study with a mean age of 37.76 (10.7) of years (Age Range = 18–75). The findings showed that attitudes and subjective norms and the use of social media predict the intention to receive COVID-19 vaccine. SEM showed that attitude (β = 0.596, P < 0.001), subjective norms (β = 0.265, P < 0.001) were significant predictors of vaccination intention. In this study, 78% of people were willing to receive the vaccine when they were officially allowed to.

Conclusion

According to the results of the study, it is suggested to strengthen positive attitudes and subjective norms about the importance of COVID-19 vaccination as well as using social media to inform the community in order increase the intention to vaccinate COVID-19 and increase vaccine coverage.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12517-1.

Factors influencing COVID-19 vaccination intention: The roles of vaccine knowledge, vaccine risk perception, and doctor-patient communication

OBJECTIVE

This study aims to investigate factors influencing COVID-19 vaccination intention in the United States.

METHODS

A cross-sectional survey was conducted with 800 respondents recruited from an online panel managed by a survey company. Path analysis was employed to examine the relationships between the study variables.

RESULTS

First, perceived susceptibility to COVID-19 vaccine side effects was negatively associated with vaccination intention whereas perceived severity did not show any significant impact. Second, vaccine-related knowledge was not directly related to vaccination intention, but it had an indirect and positive effect on vaccination intention via decreasing perceived susceptibility. Third, doctor-patient communication strengthened the negative effect of vaccine knowledge on perceived susceptibility and severity.

CONCLUSION

The results of this study offer insights on how to increase people's vaccination intention and reduce their psychological concerns when making COVID-19 vaccine-related decisions.

PRACTICE IMPLICATIONS

Government agencies should actively promote the effectiveness and importance of vaccination, while addressing concerns about vaccine safety in the public; Health initiatives also need to enhance the level of knowledge about COVID-19 vaccines through various media channels; Doctors can start the conversations about COVID-19 vaccination with their patients at the point of care and/or via online communication platforms.

Social Capital, Technological Empowerment, and Resilience in Rural China

In the post-pandemic era, the need for resilient and flexible COVID-19 prevention strategies in rural areas has become increasingly prominent. Based on a sample of 2229 rural residents nationwide, the Structural Equation Model was adopted to analyze the influence of social capital and technological empowerment on pandemic resilience in rural areas. The proportion of diversity, adequacy, and effectiveness of pandemic prevention measures taken by communities was about 57%. Social capital (0.667) and technological empowerment (0.325) had a significant positive impact on rural resilience and pandemic prevention. Social capital plays a mediating role between technological empowerment and pandemic resilience in rural areas. The risk of disease in society stimulates the inherent social capital factors in villages, with the individual social network generating strong social support. Technological empowerment can not only provide new methods for the connection of social capital, but also bring new means for rural authorities to improve their governance capabilities. Social trust in social capital plays an important role in rural resilience and pandemic prevention. The indirect effect of technological empowerment through social capital on pandemic resilience is greater than its direct effect. Social capital construction is the key to rural resilience and pandemic prevention.

The Paradox of Conspiracy Theory: The Positive Impact of Beliefs in Conspiracy Theories on Preventive Actions and Vaccination Intentions during the COVID-19 Pandemic

This study aims to analyze the direct and indirect impact of beliefs in conspiracy theories on COVID-19-related preventive actions and vaccination intentions. The dominant theory in the literature is that beliefs in conspiracy theories have negative consequences. In particular, strong beliefs in conspiracy theories lower people’s intentions to engage in preventive actions and get vaccinated. Previous studies indicated that this dominant theory applies in Korea as well. However, we find that this dominant theory does not apply in Korea. Based on an analysis of survey data, we find that beliefs in conspiracy theories have positive impact on preventive actions and vaccination intentions. In addition, beliefs in conspiracy theories play indirect roles in these two responses to COVID-19. Specifically, when perceived benefits and trust in the government or science enhance preventive actions or increase vaccination intentions, strong beliefs in conspiracy theories promote this effect. This positive role of conspiracy theories is paradoxical because they are generally viewed as negative.

Knowledge and Attitude Towards Second COVID-19 Vaccine Dose Among Health Professionals Working at Public Health Facilities in a Low Income Country

Background

Several vaccines have been approved in a lot of countries to combat coronavirus disease and distributed throughout the world. Health professional’s knowledge and attitude towards a second COVID-19 vaccine dose were poorly implemented and understood in Ethiopia's health facilities. The main purpose of conducting this study was to investigate health professionals’ knowledge and attitude towards the second COVID-19 vaccine dose at public hospitals in Ethiopia.

Methods

A cross-sectional study design was conducted from January to March, 2021 to assess the knowledge and attitude towards second COVID-19 vaccine dose among health professionals working at public health facilities in Ethiopia. A multivariable logistic regression was performed to identify predictors that correlate with knowledge and attitude towards a second COVID-19 vaccine dose with a P-value<0.05 as a cut-off point for statistical significance at 95% confidence interval (CI).

Results

Four hundred and nine study subjects participated, with a response rate of 96.7%. In this study, more than half of the respondents had high knowledge towards second COVID-19 vaccine doses. Similarly, 95.6% of respondents had a favorable attitude towards second COVID-19 vaccine doses. Educational status (AOR=1.82, 95% CI=1.1–2.2), age (AOR=2.01, 95% CI=1.76–3.01), and profession (AOR=2.32, 95% CI=1.42–3.01) were variables associated with knowledge towards second COVID-19 vaccine doses. Educational status (AOR=5.42, 95% CI=4.1–6.7), age (AOR=12.4, 95% CI=10.54–15.8), professionals (AOR=4.33, 95% CI=2.32–6.87), working experience (AOR=4.33, 95% CI=2.32–6.87), marital status (AOR=2.47, 95% CI=1.33–5.95), risk degree (AOR=2.33, 95% CI=1.31–4.11) and gender (AOR=3.42, 95% CI=2.91–4.98) were determinant factors of attitude towards the second COVID-19 vaccine dose.

Conclusion

Addressing problems related with risk degree, educational status, and socio-demographic factors will help to increase the overall knowledge and attitude towards second COVID-19 vaccine doses.

Mistrust and Beliefs in Conspiracy Theories Differently Mediate the Effects of Psychological Factors on Propensity for COVID-19 Vaccine

Vaccination is considered a key factor in the sanitary resolution of the COVID-19 pandemic. However, vaccine hesitancy can undermine its diffusion with severe consequences on global health. While beliefs in conspiracy theories, mistrust in science and in policymakers, and mistrust in official information channels may also increment vaccine hesitancy, understanding their psychological causes could improve our capacity to respond to the pandemic. Thus, we designed a cross-sectional study with the aim of probing vaccine propensity in the Italian population and explored its relationship with sociodemographic and psychological variables, and with misbeliefs in COVID-19. A battery of questionnaires was administered to a sample of 374 Italian adults during the first national lockdown (April 2020). The materials included an original instrument—Beliefs in COVID-19 Inventory—and questionnaires measuring perceived stress, anxiety, death anxiety, psychological distress, psychoticism, paranoia, anger, and somatization. The exploratory factor analysis (EFA) on Beliefs in COVID-19 suggested the existence of three factors: belief in conspiracy theories, mistrust in medical information, and mistrust in medicine and science. These factors were positively correlated with female sex, age, religious beliefs, psychiatric conditions, and psychological variables, while negatively correlated with education levels. We conducted a mediation analysis by means of a structural equation model, including psychological factors as predictors, beliefs in COVID-19 scales as mediators, and vaccine propensity as an outcome. The model showed that death anxiety had a direct positive effect on the propensity to get vaccinated. It also showed that death anxiety reduced the propensity to get vaccinated through a mediated path in believing in conspiracy theories, whereas paranoia was linked to a reduction in vaccination adherence with the mediation effect of mistrust in medical science. Psychological distress reduced vaccination propensity by increasing both conspiracy beliefs and mistrust. On the other hand, anxiety increased the propensity to get vaccinated through a decrease in both belief in conspiracy theories and mistrust in science. Our results suggest that psychological dimensions are differentially related to belief in conspiracy theories, to mistrust in science, and to the propensity to get vaccinated. Based on this result, we propose an original interpretation of how conspiracy beliefs build on a paranoid and suspicious attitude. We also discuss the possible clinical implications of treatment for such pathological beliefs.

The Intention to Receive the COVID-19 Vaccine in China: Insights from Protection Motivation Theory

(1) Background: More coronavirus disease 2019 (COVID-19) vaccines are gradually being developed and marketed. Improving the vaccination intention will be the key to increasing the vaccination rate in the future; (2) Methods: A self-designed questionnaire was used to collect data on COVID-19 vaccination intentions, protection motivation and control variables. Pearson Chi-square test and multivariate ordered logistic regression models were specified to analyze the determinants of intention to receive COVID-19 vaccine; (3) Results: Although the vaccine was free, 17.75% of the 2377 respondents did not want, or were hesitant, to receive the COVID-19 vaccine. Respondents’ cognition of vaccine safety, external reward and response efficacy were positively related to COVID-19 vaccination intention, while age, income and response cost were negatively related to the intention to receive the COVID-19 vaccine. Professionals and people without medical insurance had the lowest intention to vaccinate; (4) Conclusions: The older aged, people without health insurance, those with higher incomes and professionals should be treated as the key intervention targets. Strengthening publicity and education about the safety and efficacy of COVID-19 vaccines, training vaccinated people and community leaders as propagandists for the vaccine, and improving the accessibility to the COVID-19 vaccine are recommended to improve COVID-19 vaccination intention.

COVID-19 Vaccination Willingness among Chinese Adults under the Free Vaccination Policy

(1) Background: China will provide free coronavirus disease 2019 (COVID-19) vaccinations for the entire population. This study analyzed the COVID-19 vaccination willingness rate (VWR) and its determinants under China’s free vaccination policy compared to a paid vaccine. (2) Methods: Data on 2377 respondents were collected through a nationwide questionnaire survey. Multivariate ordered logistic regression models were specified to explore the correlation between the VWR and its determinants. (3) Results: China’s free vaccination policy for COVID-19 increased the VWR from 73.62% to 82.25% of the respondents. Concerns about the safety and side-effects were the primary reason for participants’ unwillingness to be vaccinated against COVID-19. Age, medical insurance and vaccine safety were significant determinants of the COVID-19 VWR for both the paid and free vaccine. Income, occupation and vaccine effectiveness were significant determinants of the COVID-19 VWR for the free vaccine. (4) Conclusions: Free vaccinations increased the COVID-19 VWR significantly. People over the age of 58 and without medical insurance should be treated as the target intervention population for improving the COVID-19 VWR. Contrary to previous research, high-income groups and professional workers should be intervention targets to improve the COVID-19 VWR. Strengthening nationwide publicity and education on COVID-19 vaccine safety and effectiveness are recommended policies for decision-makers.