Filipinos' health information-seeking behaviors and their implications for COVID-19 vaccination

Bridging the Gap: Reducing Health Inequities in Access to Preventive Health Care Services in Rural Communities in the Philippines

INTRODUCTION

We used an implementation science framework to investigate perceived health inequities in preventive health care initiatives in rural communities in the Philippines. We also identified health equity-focused quality improvement strategies.

METHODS

Three health care providers and 12 barangay clinic patients were interviewed.

RESULTS

Patient interviews showed that social determinants of health, respect, and attitudes toward health care providers affected patient empowerment to engage in self-management for noncommunicable diseases (NCDs). Health care providers identified six challenges in managing NCDs: (a) inefficient work processes; (b) staffing shortages; (c) insufficient access to low-cost medications; (d) inadequate primary preventive health education from the schools; (e) health care not considered a priority; and (f) lack of local government support.

DISCUSSION

Inadequate preventive health care and education intensify health access and resource inequities in rural communities in the Philippines. A multi-sectoral plan may improve rural health infrastructure and education toward improving health care access and decreasing care disparities.

Implications of information heard about Dengvaxia on Filipinos' perception on vaccination

Issues that arose from the Dengvaxia vaccination program in the Philippines in 2017 were followed by a remarkable decline in immunization coverage in the country. This study intended to describe the Filipinos' perceptions about vaccination after hearing about the Dengvaxia vaccine and the vaccination program and determine its potential relationship with selected demographic factors and other variables such as: health literacy, sources of information on Dengvaxia, information heard about the vaccine, healthcare visits, and perceived health status. The study utilized secondary data derived from a national health literacy survey in the Philippines. A total of 1992 respondents were included in the analysis. Majority were females, had reached college, residing in urban areas, and were unemployed. Most obtained information about Dengvaxia from media, particularly the television and heard that it caused death and prevents dengue. Seventy-one per cent had negative vaccination perception upon obtaining information about Dengvaxia. Sex, residence type, and income were found to be associated with vaccination perception. Females and those living in rural areas were more likely to have a negative vaccination perception while those with the highest income were less likely to have negative vaccination perception. Respondents who heard that Dengvaxia prevents dengue, those who obtained Dengvaxia information from health professionals, and those who visited both public and private health facilities in the last 12 months were less likely to have negative vaccination perception. On the other hand, those with inadequate functional health literacy were more likely to have negative vaccination perception. The study presents the implications of information heard about Dengvaxia on Filipinos' perception on vaccination through selected variables and other factors. The findings are important in designing strategies in communicating health information, building public trust, and in reinforcing policies to improve vaccination uptake.

Nursing students' clinical practice education experience during the COVID-19 pandemic: a qualitative study

BACKGROUND

Nursing education, including some elements of clinical practice, has largely been conducted online during the coronavirus disease 2019 (COVID-19) pandemic. Numerous studies have examined the experiences of nursing students in academia during the pandemic. However, research on nursing students' clinical practice experiences is limited. This study aimed to analyze nursing students' clinical practice experiences during the COVID-19 pandemic.

METHODS

This study used a qualitative research design and performed thematic analysis. Participants comprised 13 nursing university students with clinical practice experience at a hospital during the COVID-19 pandemic. Interviews were conducted either online or face-to-face. Data were collected during June‒July 2021.

RESULTS

Four themes and eight subthemes were generated through thematic analysis. Theme 1 was "Nursing students' anxiety and strict adherence to quarantine practices," with the subthemes of "Fear of infection" and "Protecting themselves." Theme 2 was "Nursing students' belief that their organization is protecting them," with the subthemes of "Strict quarantine rules at hospitals and universities" and "The nursing students regretted the limited scope of practice but felt safe." Theme 3 was "Learning through valuable practice," with the subthemes of "Recognizing the importance of practice" and "Realizing the benefits of practice." Theme 4 was "A sense of duty as a prospective nurse," with the subthemes of "Accepting a sense of duty as a nurse" and "Establishing the expanded role of a nurse."

CONCLUSIONS

The nursing students recognized the importance of nursing practice during the pandemic and worked harder. A better understanding of the experiences of nursing university students who completed their clinical practice during the COVID-19 pandemic can help nursing professors and managers more effectively train students during times of high stress.

Understanding Vaccination Among Hesitant Adopters of the COVID-19 Vaccine Using the Increasing Vaccination Model

The coronavirus disease (COVID-19) was the third leading cause of death in 2021 in the United States and has led to historic declines in life expectancy for Americans. While vaccination is an effective mitigation strategy for COVID-19, vaccine hesitancy remains a major barrier to individual and population-level protection. An emerging literature on hesitant adopters of COVID-19 vaccines highlights co-occurrence of hesitancy and vaccine uptake as an understudied phenomenon, with the potential to provide insight into factors that lead hesitant individuals to become vaccinated despite their hesitancy. We use qualitative interviews among hesitant adopters in Arkansas to examine vaccine hesitancy among this understudied group. Drawing on the Increasing Vaccination Model, we find that the most frequently reported motivations of hesitant adopters were within the domain of social processes, pointing to a critical focal point for targeted health communications intervening in this domain (e.g. social norms, social networks, and altruistic behavior). We find that recommendations from health care workers (HCWs) other than physicians/providers may serve as an effective influence to vaccinate. We also demonstrate negative effects of low provider and HCW confidence and weak recommendations on motivations to vaccinate among individuals expressing vaccine hesitancy. Additionally, we find individual information-seeking behaviors among hesitant adopters bolstered confidence in the efficacy of the COVID-19 vaccine. Based on these findings, clear, accessible, and authoritative health communication has a role in combatting the COVID-19 misinformation/disinformation infodemic.

Determinants of COVID-19 vaccination decision among Filipino adults

BACKGROUND

With a number of vaccines against COVID-19 now widely available globally, it is opportune to determine what tips the decision to get vaccinated. In most countries like the Philippines where the government provides these vaccines for free to all its citizens, their COVID-19 vaccine awareness and COVID-19 information sources as well as their socio-demographic profile were considered as primary factors that could possibly affect vaccination decisions. Participants' income level was considered as a possible financial consideration that can affect vaccination decision as transport to vaccination sites might entail costs to them.

METHODS

This study used a cross sectional survey design wherein participants came from all regions of the Philippines. An online questionnaire was voluntarily answered by Filipinos aged 18-80 years of age.

RESULTS

A total of 2,268 participated in the survey with 1,462 having complete responses which were included in the analysis. Those who are younger, with higher educational attainment, with public health insurance, with employers requiring vaccination, high awareness about COVID-19 vaccination, and high vaccine confidence are more likely to get vaccinated. On the other hand, those with long-standing illness and those residing outside the national capital region are less likely to get vaccinated.

CONCLUSION

Vaccination decisions among Filipinos are determined by their age, educational attainment, health insurance, employer requirement, high awareness of the disease, and a high level of vaccine confidence.

Adherence to COVID-19 health protocols in an online news context in the Philippines: A manifest content analysis

OBJECTIVES

Globally, adherence to COVID-19 health and safety protocols played a crucial role in preventing the spread of the virus. Thus, this study analyzed online news articles reporting adherence to COVID-19 health and safety protocols in the Philippines.

DESIGN

Manifest content analysis.

SAMPLE

News articles (n = 192) from three major online news portals in the Philippines.

MEASUREMENT

Published online news articles were collected during the peak of the COVID-19 pandemic (March 2020 to March 2021). Bengtsson's content analysis approach was used to analyze the data. Member-checking and intercoder reliability validated the study's results.

RESULTS

Three main themes emerged: (a) adherence, (b) non-adherence, and (c) partial adherence. The subthemes were labeled who, what, when, where, and why. The same behavior, social distancing, was the most adhered to and non-adhered COVID-19 health protocol. This protocol has the highest occurrences in political protest, religious-related activities, and self-initiated quarantine. Leisure activities both showed non-adherence and partial adherence.

CONCLUSIONS

Online news articles depicted Filipinos' adherence to health and safety protocols. Their adherence was primarily determined by one's group or community, social norms, and values. The government and its public health agencies should strengthen current efforts and continuously re-evaluate existing policies to modify ineffective and confusing safety health protocols.

Human monkeypox infection knowledge in the Philippines: An online cross-sectional survey

Background

In July 2022, human monkeypox (Mpox) was declared by the World Health Organization public health emergency of global concern. Assessing people's knowledge about Mpox will help the government and healthcare workers create policies to prevent the spread of the virus. To the best of my knowledge, this is the first study that assessed Filipinos' Mpox knowledge. Thus, this study investigated the Filipinos' Mpox knowledge and determined the demographic variables that predicted it.

Methods

A descriptive cross-sectional design study participated by 557 Filipinos. This study used a 21-item Mpox knowledge survey questionnaire to collect data from July to September 2022. Logistic regression analysis was used to analyze the data.

Results

Most participants (53.74%) were above 30 years old, females (68.87%), residing in Luzon (54.96%), college graduates (61.04%), Catholics (78.61%), and employed (68%). Social media, particularly Facebook (57.91%), is the common source of Mpox-related information (78.61%). Participants' age (>30 years old) is the only predictor of Mpox infection knowledge (aOR: 3.13; 95%CI: 1.25-7.87, p = 0.015). They are three times more likely to be knowledgeable than those under 30.

Conclusion

The findings highlight the importance of evidence-based strategies for increasing public knowledge and awareness. The government, healthcare workers, and the public should adopt proactive preventive measures against Mpox to prevent future pandemics.

Undergraduate Students' Knowledge, Attitudes and Willingness to Receive COVID-19 Vaccines: A Survey of Convenience Sample in Namibia

Introduction

The global consequences of the COVID-19 pandemic cannot be overstated. Vaccinations are one of the leading strategies to protect against the virus, and it is likely that students' understanding and desire to be vaccinated can be major factors in helping contain the pandemic. Nonetheless, no studies looked into the vaccine attitude, knowledge and willingness in Namibia.

Objectives

To assess and describe the association between knowledge, attitudes, and willingness of undergraduate students to receive COVID-19 vaccines in the school of education, nursing and economics and management science at the university campus in Namibia.

Methods

The study employed a cross-sectional descriptive study from 200 undergraduate university students using a convenience sampling. Data analysis was done using SPSSv28 and descriptive statistics were used to depict trends in data while a Pearson's correlation determined the relationship between the study variables.

Results

The data showed that 54.2% (1.54  ±  0.49) of the participants had adequate knowledge concerning the vaccine, while 57.1% and 58.6% had a negative outlook and were unwilling to get vaccinated. A moderate positive correlation was observed between attitudes and willingness to take COVID-19 vaccines (r  =  .546, P  =<.001), while a negative relation existed between knowledge and attitudes (r  =  -.017, P  =>.001).

Conclusions

This study has provided valuable insight into the knowledge, attitudes, and willingness of undergraduate students to receive COVID-19 vaccines. Despite more than half of the participants having appropriate knowledge, they had an unfavourable outlook toward COVID-19 vaccination. It is recommended that further studies focus on how factors such as incentives, religion and cultural values affect their desires to be vaccinated.

Filipinos' COVID-19 vaccine hesitancy comments in TikTok videos: A manifest content analysis

OBJECTIVES

Vaccine hesitancy is one of the top 10 threats to world health. The ongoing pandemic highlighted this health threat. The COVID-19 vaccine hesitancy remains underreported in the Philippines. Thus, this study aimed to describe and analyze the comments of Filipinos in TikTok videos about COVID-19 vaccine hesitancy.

DESIGN

Manifest content analysis.

SAMPLE

A total of 25 TikTok videos and their comments (n = 4564) were analyzed.

METHODS

We collected data between July 2021 and October 2021. Bengtsson's approach to content analysis was utilized to analyze the data. Data were validated using member-checking and intercoder reliability.

RESULTS

This study afforded three themes of COVID-19 vaccine hesitancy: (a) fear and mistrust (subthemes: influence of Dengvaxia vaccine, the influence of people who refuse to be vaccinated, lack of trust in the government, lack of trust in healthcare workers, doubts on vaccines' effectiveness), (b) misinformation and disinformation (subthemes: misbeliefs, insufficient knowledge), and (c) adamant attitudes (subthemes: unwillingness to be vaccinated, picky on vaccine brand).

CONCLUSION

Our study established Filipinos' diverse reasons for COVID-19 vaccine hesitancy. TikTok, as a social media platform, is used for COVID-19 vaccine discussions and the dissemination of misinformation. To prepare for the next pandemic or public health disaster, the government, HCWs, and the public must efficiently convey timely, accurate health information and dispel misinformation on social media platforms.

The Content of COVID-19 Information Searches and Vaccination Intention: An Implication for Risk Communication

OBJECTIVE

The main objective of this study was to examine the association between COVID-19 information search activities and vaccination intention.

METHODS

Cross-sectional data were collected using online surveys. Independent variables included COVID-19 information search on the (1) science of viral effects of COVID-19 on the body, (2) origin of COVID-19, (3) symptoms and outcomes, (4) transmission and prevention, (5) future outbreak, and (6) policies/procedures to follow. The outcome variable was vaccination intention. A multivariable regression analysis was conducted.

RESULTS

Participants (N = 501) had a mean age of 32.44 ± 11.94 years, were 55.3% female, and 67.9% were white. Most COVID-19 information searches were on symptoms and outcomes (77.7%) and policies/procedures to follow (69.9%). Intention to vaccinate against COVID-19 was higher among participants who searched for information on the science of viral effects of COVID-19 on the body (β = 0.23, 95% CI: 0.03-0.43; P = 0.03) and policies/procedures to follow (β = 0.24, 95% CI: 0.03-0.41; P = 0.02).

CONCLUSIONS

People who searched for information about (1) the science of viral effects of COVID-19 and (2) policies/procedures recommendations also reported higher vaccination intention. Risk communication seeking to increase vaccination should meet the consumers' information demand by prioritizing the scientific rationale for COVID-19 vaccination and by clarifying what policies/procedures are recommended.

What Drives Elderly People in China Away from COVID-19 Information?

Background: A worrying phenomenon has emerged in recent years: a growing number of people have stopped seeking coronavirus disease 2019 (COVID-19) information and have started deliberately avoiding it. Even though the virulence of COVID-19 has now weakened, the proportion of severe illnesses and deaths in elderly people is still much higher than in other age groups. However, no study has focused on this topic. This is the first study to explore the level of COVID-19 information avoidance among elderly people, and to identify the barriers and potential factors associated therewith. Methods: Convenience sampling was used to recruit 907 elderly people in Wuhan, China. Data collection measures included a sociodemographic questionnaire, health information avoidance scale, information overload scale, general self-efficacy scale, and health anxiety inventory. Results: A total of 72.3% of elderly participants reported COVID-19 information avoidance. Regarding COVID-19-related information reading habits, 44.5% of the elderly only read the title, 16.0% merely skimmed through the content, and 22.9% skipped all relevant information. The most common reasons for this result were information overload (67.5%), underestimation of the infection risk (58.1%), and uselessness of information (56.4%). The main factors associated with COVID-19 information avoidance were recorded as information overload, age, health anxiety, and children (p < 0.05). Conclusions: China should strengthen its health communication regarding COVID-19 in accordance with the characteristics of elderly people, adopt more attractive publicity methods on traditional media, improve censorship about health information, and pay more attention to the childless elderly and the elderly aged 80 and above.

Academic stress, COVID-19 anxiety, and quality of life among nursing students: The mediating role of resilience

AIM

This study investigated the mediating role of resilience in the relationship between academic stress, COVID-19 anxiety, and quality of life (QoL) among Filipino nursing students during the COVID-19 pandemic.

BACKGROUND

The COVID-19 pandemic has impacted the QoL of nursing students who are experiencing mental health issues. The mediating role of resilience in mitigating the effects of academic stress and COVID-19 anxiety on nursing students' QoL remains understudied.

METHODS

This study employed a correlational cross-sectional design, with a convenience sample of 611 Filipino nursing students. Data were collected using the scales Connor and Davidson Resilience, Brunnsviken Brief Quality of Life, COVID-19 Anxiety, and Perception of Academic Stress and analyzed using Pearson's r, bivariate analysis, and multistage regression analyses.

RESULTS

Academic stress and COVID-19 anxiety negatively correlated with QoL and resilience. Resilience was positively associated with QoL and reduced the effect of academic stress on QoL, indicating that resilience is a crucial mediating variable between academic stress and QoL. Finally, resilience had a significant mediating influence on QoL, as evidenced by a reduction in the effect of COVID-19 anxiety on QoL among nursing students.

CONCLUSIONS

Filipino nursing students' QoL was affected by academic stress and COVID-19-related anxiety. However, resilience mediated this impact, preserving QoL.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Nursing colleges and affiliated hospitals must collaborate to monitor academic stress and pandemic-related anxiety. Nursing students should be provided with programs such as seminars and team-building activities to enhance their resilience.

Quality of life and academic resilience of Filipino nursing students during the COVID-19 pandemic: a cross-sectional study

OBJECTIVES

Studies on quality of life (QoL) and academic resilience among nursing students during the Coronavirus disease (COVID-19) pandemic remain underreported. This study investigated the relationship between nursing students' QoL and academic resilience and their predictors during the COVID-19 pandemic.

METHODS

A descriptive survey, cross-sectional study that used two self-reported questionnaire scales to evaluate the QoL and academic resilience of Filipino nursing students (n=924). Chi-squared test and multiple regression were used to analyze the data.

RESULTS

There was no significant association between the QoL and academic resilience to participants' profile variables. Gender and year level of nursing students were significant predictors of QoL and academic resilience.

CONCLUSIONS

Our study concludes that a better understanding of the QoL and academic resilience, which are two distinct concepts critical in developing a student's mental well-being, will help stakeholders in nursing education establish effective psychoeducation programs for nursing students.