Different Culture or Different Mind? Perception and Acceptance of HPV Vaccine in China and in the U.S

The Influencing Role of Cultural Values on Attitudes of the Chinese Public Towards Traditional Chinese Medicine (TCM) for the Control of COVID-19

Purpose

The use of traditional Chinese medicine (TCM) for disease prevention and healthcare has been strongly supported by the Chinese government in recent years, but public perception of TCM remains controversial or resistant, especially in preventing and treating COVID-19. It is therefore crucial to understand the factors that influence public attitudes.

Methods

By applying a measure of attitudes towards TCM in epidemic prevention, this study conducted a nationwide survey (n=1192) on the relationships between attitudes towards TCM for the control of COVID-19 and trust, perceptions of risk, scientific literacy, policy endorsement, and cultural values.

Results

The results of the study showed surprisingly that scientific literacy and risk perception did not dominate the Chinese public's attitudes towards TCM for the control of COVID-19. Meanwhile, egalitarianism, policy endorsement, trust in scientist and healthcare personnel played a positive role. Moreover, egalitarianism positively regulates the relationship between trust in scientist and attitudes towards TCM epidemic prevention and control, while collectivism negatively regulates the relationship of the preceding variables.

Conclusion

All these findings suggest that attitudes towards the use of TCM are not based on rational cognition and logical reasoning, but are mainly influenced by emotional and cultural factors. This study will help researchers and practitioners understand the importance of cultural values, trust, policy endorsement, and attitudes towards TCM epidemic prevention and control to TCM's use in healthcare.

Psychological Distance, Construal Level, and Parental Vaccine Hesitancy for COVID-19, HPV, and Monkey Pox Vaccines

Building on the construal-level theory and the multi-dimensional model of behavioral barriers, this study examined whether psychological distance and construal level explain the association between behavioral intention and behavioral barriers that may lead to parental vaccine hesitancy. Results of multilevel structural equation models show that low vaccination intention, far distance perception, and abstract construal of vaccines led to more global concerns, such as vaccine safety and relevance. Such effects emerged when people considered specific vaccines, such as coronavirus disease 2019 (COVID-19), human papillomavirus (HPV), and monkeypox vaccines, and when they considered multiple vaccines in general.

Social media promotion, risk perception, and parental support for adolescent girls' HPV vaccination: Taking consideration of future consequences and sexual attitudes as moderators

HPV vaccine hesitancy in Asia is unique compared to western countries. Concerning whether social media promotion about HPV vaccine will be related with parental support for Chinese adolescent girls, we investigated the correlation among social media promotion, risk perception of HPV vaccine and parental support. Through the theoretical lens of Health Action Process Approach model (HAPA), we found that social media promotion could reduce the risk perception of HPV vaccine and promoted parental supportive decision, and risk perception played a mediation role between social media information exposure to vaccine and parental support. Consideration of future consequences has been found to play a moderating role between social media promotion and risk perception, and parents' sexual attitudes moderated the effect of social media promotion on parental support. Implications of the findings are discussed.

Trust in scientists on COVID-19 vaccine hesitancy and vaccine intention in China and the US

When we recognize various factors which influence vaccine willingness, it is unclear whether these factors work the same in different countries. This study explored how trust in scientists was related to COVID-19 vaccine hesitancies and vaccine willingness in China and the U.S. We attempted to understand the extent to which the perceived trustworthiness of scientists would predict vaccine hesitancies and intention to get vaccinated differently in these two countries. An online survey with participants in China (N = 391) and in the U.S. (N = 363) was conducted. Participants were asked about their view of scientists' competence, benevolence, and integrity as dimensions of trustworthiness, three types of vaccine hesitancies, as well as their willingness to get vaccinated. The results showed that trust in scientists was negatively related to individual vaccine hesitancy in both China and the U.S., and trust was negatively associated with the level of contextual hesitancy and vaccine-specific hesitancy in the U.S. Higher trust in scientists was also associated with the willingness to get vaccines in the U.S., rather than in China. Results yielded differences in China and the U.S. in how trust in scientists and vaccine hesitancies predicted individuals' willingness to get vaccinated.

Vaccine for yourself, your community, or your country? Examining audiences' response to distance framing of COVID-19 vaccine messages

OBJECTIVE

This study explored the effects of COVID-19 vaccine promotion messages highlighting the benefit at individual, community, and country levels. Based on the cultural theory of risks, we investigated how individuals' valuation of individualism vs. communitarianism and hierarchical vs. egalitarian social structure affect their responses to vaccine messages.

METHODS

An online experiment (N = 702) with four video message conditions (individual-centered, community-centered, country-centered, and no message) was conducted. Participants were asked about their cultural cognition worldview, then were randomly assigned to view one message. Participants also reported their willingness to receive COVID-19 vaccines and support for vaccine mandate.

RESULTS

Respondents were more likely to get vaccinated and support vaccine mandates after viewing an individual-centered message, less with a community-centered message. Individuals who value individualism were more likely to respond positively to individual-centered messages, but those who believe more in communitarianism value were less likely.

CONCLUSION

Results showed that individuals are motivated selectively to respond to certain claims that cohere with their worldview and therefore respond differently to vaccine benefit frames.

PRACTICE IMPLICATIONS

The results point to the importance of understanding audiences' worldviews. By identifying this process through hierarchical and individualistic values, properly designed health promotion messages can maximize the desired outcomes.

Factors influencing COVID-19 vaccination intention among overseas and domestic Chinese university students: a cross-sectional survey

To vaccinate the Chinese on a nationwide scale timely and effectively, it is necessary to assess the vaccination uptake intention of the public. University students are opinion leaders, who have an important impact on the vaccination uptake intention of others around them. As a group with strong population mobility, overseas university students have an extra influence on the spread of COVID-19 and the prevention and control of the pandemic. Thus, it is necessary to investigate the vaccination uptake intention of overseas and domestic university students to promote vaccination and control the pandemic globally. However, little is known about the COVID-19 vaccination uptake intention among overseas and domestic university students. This study aimed to explore the difference between overseas and domestic Chinese university students' COVID-19 vaccination uptake intentions and influencing factors using the Health Belief Model. A cross-sectional survey using an online questionnaire was conducted among 370 overseas university students and 463 domestic university students between January and February 2021. More than half of the respondents (536, 64.3%) reported vaccination uptake intentions, with overseas and domestic university students reporting similar vaccination uptake intentions (64.1% vs 64.6%, p > .05). Perceived benefits, perceived barriers, and cues to action were important factors that influenced the vaccination intention among overseas and domestic university students. It is worth trying to communicate the benefits of the vaccine, enhance the role of cues to action, and eliminate the potential barriers among overseas and domestic university students through creative propagation to further promote the COVID-19 vaccination.

How privacy concerns and cultural differences affect public opinion during the COVID-19 pandemic: a case study

Purpose

COVID-19, an infectious disease first identified in China, has resulted in an ongoing pandemic all over the world. Most of the countries have been experiencing a difficult period during the fighting of this pandemic. The purpose of this study is to explore the effect of privacy concerns and cultural differences on public opinion related to the pandemic. The authors conducted a comparative analysis of public opinion in the US and in China as a case study, in order to determine the results.

Design/methodology/approach

National policies on important issues faced during the COVID-19 pandemic in the US and in China were examined through a comparative analysis. The authors used text clustering and visualization to mine public opinion on two popular social media platforms, Twitter and Weibo. From the perspectives of concern for privacy and of national culture, this study combines qualitative and quantitative analysis to discover the acceptance level of national policies by the public in the two countries.

Findings

The anti-pandemic policies and measures of the US and China reflect the different characteristics of their respective political systems and national cultures. When considering the culture of the US, it is hard to establish and enforce a rigorous regulation on either mask wearing in public or home quarantine on the national level. The opinions of US people are diverse, regarding national COVID-19 policies, but they are rather unified on privacy issues. On the other hand, Chinese people show a high acceptance of national policies based on their mask-wearing customs and their culture of collectivism.

Originality/value

Prior studies have paid insufficient attention to the ways in which user privacy and cultural difference affect public opinion on national policies between the US and China. This case study that compares public opinion on current and topical issues which are closely bound up with public life shows originality, as it innovatively provides a cross-cultural perspective on the research of public opinion dissemination during emergencies by considering the ongoing COVID-19 pandemic.

Review of Chinese young adults' human papillomavirus knowledge, attitudes, and vaccine acceptability

OBJECTIVE

The human papillomavirus (HPV) vaccine is effective in reducing HPV-related disease. The 2-, 4-, and 9-valent HPV vaccines have been approved by the Chinese FDA since 2016; however, factors associated with HPV vaccine acceptability and use in Chinese young adults remain unclear.

DESIGN AND SAMPLE

We conducted a systematic review to analyze factors affecting HPV vaccine acceptability and use in Chinese young adults. A comprehensive search of databases (e.g., PubMed, CINAHL, and PsycINFO) was conducted, and articles between 2011 and 2020 were included.

RESULTS

Seventeen studies were included in the final review, and eleven were conducted in mainland China and six in Hong Kong. All studies reported low level of HPV-related knowledge. Better knowledge, more concerns about HPV-associated diseases, and being female were found associated with higher vaccine acceptability. The vaccine cost and safety were the major concerns for vaccination.

CONCLUSIONS

Findings suggested a low level of HPV-related knowledge and suboptimal vaccination rate in Chinese young adults. Theory-based interventions addressing knowledge and other influencing factors and involving both males and females are urgently needed to increase vaccine acceptability and use in Chinese young adults.

Incorporating Message Framing into Narrative Persuasion to Curb E-Cigarette Use Among College Students

This study examines the interaction effect of message format (narrative vs. nonnarrative) and message framing (gain vs. loss) in e-cigarette prevention targeting young adults. Results of a two-way experiment (N = 439) revealed that transportation and discrete emotions mediated message effect on risk perception and behavioral intention. Compared to the gain-framed nonnarrative, the gain-framed narrative reduced feelings of guilt, and guilt was negatively related to risk perception and positively related to behavioral intention. Thus, the gain-framed narrative achieved desirable persuasive outcome through guilt-increasing risk perception and decreasing intention to use e-cigarette. Similarly, the loss-framed narrative evoked greater sadness, which also led to increased risk perception and decreased behavioral intention. Transportation and discrete emotions mediated message effect in a serial order. This research not only contributes to the literature on narrative persuasion and emotion, but also provides insight for health communication designed for e-cigarette prevention.

Exploring Chinese College Students' HPV Awareness, Knowledge, Attitudes, and Intent of HPV Vaccination: a Qualitative Study

Human papillomavirus (HPV) infection is the world's most prevalent sexually transmitted infection and causes cancers. In China, about 47,739 deaths occur annually from HPV-related cervical cancer, and this number continues to increase. HPV vaccines have shown promising results in preventing HPV-associated cancers; however, the vaccination rate in Chinese college students remains extremely low. This qualitative research explored Chinese college students' HPV-related awareness, knowledge, attitudes and beliefs, and their vaccination intention as well as the strategies promoting vaccination in China. We conducted four focus groups with 18 male and 20 female students; prompts were developed based on the health belief model (HBM). Discussions were audiotaped, transcribed, and translated from Chinese to English by three bilingual researchers. Content analysis of the data revealed eight themes addressing HBM. Participants demonstrated high awareness (71% had heard of HPV) with limited knowledge. They perceived very low risks of being infected but expressed high vaccination intention if the cost was covered by the government. Participants identified reasons that facilitate and prevent vaccination and proposed culturally and developmentally congruent strategies to promote vaccination in China. It is essential to address facilitators and barriers at individual, societal, political, and cultural levels to promote HPV vaccination in Chinese college students.

When we increase fear, do we dampen hope? Using narrative persuasion to promote human papillomavirus vaccination in China

This study examines the use of narrative persuasion in promoting human papillomavirus vaccination. Compared to non-narrative message, the narrative message increased perceived severity of human papillomavirus, which influenced vaccination intention through heightened fear. The narrative message also dampened hope and subsequently decreased vaccination intention. This research attests to the effectiveness of narrative persuasion in vaccination promotion, but also offers important caveat for message design-egocentric efficacy information is crucial in narrative persuasion designed to motivate preventive health behaviors.