Vaccines - but not as we know them: an ethical evaluation of HPV vaccination policy in Australia

COVID-19 vaccine hesitancy and patient self-advocacy: a statistical analysis of those who can and can't get vaccinated

Background

This study applies the Patient Self-Advocacy scale to investigate vaccine hesitancy in New Zealand. Due to New Zealand’s very limited tertiary hospital system and vulnerable populations, the Government’s strategy to address COVID-19 has been to prevent the virus from entering the nation and to eliminate it when it does cross the border. Therefore, there is no opportunity for the nation to generate any acquired immunity through exposure. To transition from closed borders, New Zealand will need to run a highly successful national vaccination programme and this needs to have the ability to drive influential public health messaging to the targeted places within the communities where vaccine hesitancy most exists.

Methods

This study employed statistical methods. A nationally representative survey of adults in New Zealand (n = 1852) was collected via Qualtrics. Independent samples t-tests, and multiple regression were used to explore the research questions.

Results

Those who identify as medically able to be vaccinated expressed significantly higher confidence in the COVID-19 vaccine than those who identified as unable to be vaccinated. Patient-self advocacy had a positive effect on vaccine confidence. Individuals who identify as able to be vaccinated have less hesitancy. Demographics had various effects on vaccine hesitancy.

Conclusion

The research highlights particularly important insights into vaccine hesitancy related to patient self-advocacy behaviours, and various demographic variables such as political affiliation. In addition, the research adds further clarity on how and why New Zealanders have responded to the COVID-vaccine. Finally, the importance of vaccine literacy is discussed.

Framework for Selecting Best Practices in Public Health: A Systematic Literature Review

Evidence-based public health has commonly relied on findings from empirical studies, or research-based evidence. However, this paper advocates that practice-based evidence derived from programmes implemented in real-life settings is likely to be a more suitable source of evidence for inspiring and guiding public health programmes. Selection of best practices from the array of implemented programmes is one way of generating such practice-based evidence. Yet the lack of consensus on the definition and criteria for practice-based evidence and best practices has limited their application in public health so far. To address the gap in literature on practice-based evidence, this paper hence proposes measures of success for public health interventions by developing an evaluation framework for selection of best practices. The proposed framework was synthesised from a systematic literature review of peer-reviewed and grey literature on existing evaluation frameworks for public health programmes as well as processes employed by health-related organisations when selecting best practices. A best practice is firstly defined as an intervention that has shown evidence of effectiveness in a particular setting and is likely to be replicable to other situations. Regardless of the area of public health, interventions should be evaluated by their context, process and outcomes. A best practice should hence meet most, if not all, of eight identified evaluation criteria: relevance, community participation, stakeholder collaboration, ethical soundness, replicability, effectiveness, efficiency and sustainability. Ultimately, a standardised framework for selection of best practices will improve the usefulness and credibility of practice-based evidence in informing evidence-based public health interventions. Significance for public healthBest practices are a valuable source of practice-based evidence on effective public health interventions implemented in real-life settings. Yet, despite the frequent branding of interventions as best practices or good practices, there is no consensus on the definition and desirable characteristics of such best practices. Hence, this is likely to be the first systematic review on the topic of best practices in public health. Having a single widely accepted framework for selecting best practices will ensure that the selection processes by different agencies are fair and comparable, as well as enable public health workers to better appreciate and adopt best practices in different settings. Ultimately, standardisation will improve the credibility and usefulness of practice-based evidence to that of research-based evidence.