The role of race and scientific trust on support for COVID-19 social distancing measures in the United States

Fostering Responsible Conduct of Research for Early-Stage Investigators: Challenges and Opportunities

The rise of academic misconduct poses significant challenges to the integrity and credibility of scholarly research. Early-stage investigators (ESIs), particularly those representing marginalized groups, face unique pressures in navigating the "publish or perish" paradigm while establishing their careers. This commentary articulates strategies for cultivating research environments conducive to the responsible conduct of research (RCR) for ESIs. By establishing shared values, planning research meticulously, conducting research collaboratively, and reporting findings transparently, ESIs can foster a culture of prevention and accountability in research. Ultimately, navigating beyond traditional methodologies to support RCR necessitates a fundamental reimagining of academic culture, reconceptualizing productivity to prioritize quality over quantity, and to encompass "invisible" work often shouldered by investigators with marginalized identities. Addressing scientific misconduct challenges requires a whole-system approach, encompassing individual leadership, policy changes, and institutional accountability. By implementing concrete strategies and systemic reforms, academia can reaffirm its commitment to responsible research conduct and safeguard the integrity of scholarly endeavors.

Compliance in the public versus the private realm: Economic preferences, institutional trust and COVID-19 health behaviors

To what extent do economic preferences and institutional trust predict compliance with physical distancing rules during the COVID-19 pandemic? We reexamine this question by introducing the theoretical and empirical distinction between individual health behaviors in the public and in the private domain (e.g., keeping a distance from strangers vs. abstaining from private gatherings with friends). Using structural equation modeling to analyze survey data from Germany's second wave of the pandemic (N = 3350), we reveal the following major differences between compliance in both domains: Social preferences, especially (positive) reciprocity, play an essential role in predicting compliance in the public domain but are barely relevant in the private domain. Conversely, individuals' degree of trust in the national government matters predominantly for increasing compliance in the private domain. The clearly strongest predictor in this domain is the perception pandemic-related threats. Our findings encourage tailoring communication strategies to either domain-specific circumstances or factors common across domains. Tailored communication may also help promote compliance with other health-related regulatory policies beyond COVID-19.

Attitudes and perceptions toward the COVID-19 risk-mitigation strategies among racially and ethnically diverse older adults in the United States and Puerto Rico: a qualitative study

OBJECTIVES

There is limited qualitative research investigating how risk-mitigation strategies during the COVID-19 pandemic impacted the lives of diverse older adults, who met criteria for mild to severe generalized anxiety or depression and minor to moderate disability. This study aims to address this gap by examining how racially and ethnically diverse older adults with at least mild mental health symptoms and minor physical disability in the United States and Puerto Rico adapted to guidelines during COVID-19. It aims to inform the medical community and policymakers of potential threats to these older adults' well-being given the COVID-19 burden.

DESIGN

Based on descriptive qualitative inquiry and phenomenological perspectives, we conducted semi-structured interviews over the phone with a racially and ethnically diverse sample of older (age 60+), predominantly minoritized adults (N = 100) in four states and territories across the United States and Puerto Rico in 2021. Interviews were recorded, coded, and analyzed using a thematic analysis approach.

RESULTS

Findings centered on five themes: (1) Previous experiences with the healthcare system and cultural beliefs related to trust and distrust led to mixed attitudes toward COVID-19 risk-mitigation strategies; (2) Compliance with COVID-19 mitigation strategies ensured safety and addressed fear of illness; (3) Compliance led to isolation due to interrupted social relations; (4) Isolation and disrupted social networks negatively impacted mental health and finances, and (5) Coping strategies and embracing support reduced the effects of social isolation.

CONCLUSION

This study underscores the importance of increasing support and social connectedness during a pandemic and beyond to ensure the well-being of older adults in racially and ethnically diverse communities. It highlights the resiliency of older adults in identifying strategies to cope with negative impacts. We recommend safeguarding economic security through policy efforts toward financial safety nets during health crises and collaborative approaches with community-based organizations to mitigate social isolation.

Predictive factors of hesitancy to vaccination against SARS-CoV-2 virus in young adults in Spain: Results from the PSY-COVID study

Widespread population vaccination against the SARS-CoV-2 virus is a matter of great interest to public health as it is the main pharmacological measure to contain the COVID-19 pandemic. Hesitancy/reluctance to vaccination has become a main barrier to containing the pandemic. Young adults are the age group with the greatest resistance to vaccination, even in countries with the highest vaccination rates during this pandemic. The objective of this study was to identify the main predictive factors of vaccination intention and profile people with hesitancy/reluctance to vaccinate against SARS-CoV-2 virus in young adults living in Spain during the pandemic. A cross-sectional study was conducted based on the administration of an online survey (PSY-COVID-2) that evaluated the intention of vaccination together with a wide range of sociodemographic, social, cognitive, behavioral and affective variables in a sample of 2210 young adults. 14% of the sample showed hesitancy/reluctance to vaccination at the beginning of their vaccination campaign. A total of 35 factors were associated (small to medium effect sizes) with the intention to get vaccinated. A reduced set of 4 attitudinal and social variables explained 41% of the variability in vaccination intention: attitude to the vaccination, trust in health staff/scientists, conspiracy beliefs about SARS-CoV-2 and time spent being informed about COVID-19. These variables showed good sensitivity/specificity for classifying people as reluctant/not reluctant to vaccination, properly classifying 86% of people. Psychosocial processes related to attitudes, trust and information are the main predictors of vaccination intention in a highly reluctant group such as the young adult population.

Characterizing discourses about COVID-19 vaccines on Twitter: a topic modeling and sentiment analysis approach

BACKGROUND

Evidence-based health communication is crucial for facilitating vaccine-related knowledge and addressing vaccine hesitancy. To that end, it is important to understand the discourses about COVID-19 vaccination and attend to the publics' emotions underlying those discourses.

METHODS

We collect tweets related to COVID-19 vaccines from March 2020 to March 2021. In total, 304,292 tweets from 134,015 users are collected. We conduct a Latent Dirichlet Allocation (LDA) modeling analysis and a sentiment analysis to analyze the discourse themes and sentiments.

RESULTS

This study identifies seven themes of COVID-19 vaccine-related discourses. Vaccine advocacy (24.82%) is the most widely discussed topic about COVID-19 vaccines, followed by vaccine hesitancy (22.29%), vaccine rollout (12.99%), vaccine facts (12.61%), recognition for healthcare workers (12.47%), vaccine side effects (10.07%), and vaccine policies (4.75%). Trust is the most salient emotion associated with COVID-19 vaccine discourses, followed by anticipation, fear, joy, sadness, anger, surprise, and disgust. Among the seven topics, vaccine advocacy tweets are most likely to receive likes and comments, and vaccine fact tweets are most likely to receive retweets.

CONCLUSIONS

When talking about vaccines, publics' emotions are dominated by trust and anticipation, yet mixed with fear and sadness. Although tweets about vaccine hesitancy are prevalent on Twitter, those messages receive fewer likes and comments than vaccine advocacy messages. Over time, tweets about vaccine advocacy and vaccine facts become more dominant whereas tweets about vaccine hesitancy become less dominant among COVID-19 vaccine discourses, suggesting that publics become more confident about COVID-19 vaccines as they obtain more information.

Factors Influencing the Adoption of Voluntary Nonpharmaceutical Interventions to Control COVID-19 in Japan: Cross-sectional Study

Background

Trust in government is seen to facilitate crisis management and policy instrument adoption across numerous studies. However, in Japan, public support for government handling of the COVID-19 pandemic and trust in the government is low, yet the adoption of voluntary nondigital nonpharmaceutical interventions (NPIs) is high. This is an important tension this study seeks to unravel.

Objective

The aim of this study is to understand the antecedents of nondigital NPI and tracking app adoption in the COVID-19 pandemic in Japan.

Methods

A commercial company was contracted to deliver an online survey of 1248 Japanese citizens in December 2020. A quota technique was used to deliver a sample representative in terms of gender, age, residence, income, and education.

Results

The adoption of voluntary nondigital NPIs is predicted by confidence in public health scientists and a favoring of infection control over reducing economic and social costs. A novel and unexpected finding is that trust in government does not predict nondigital NPI use. Perceived risk and knowledge of infection did not increase the use of nondigital NPIs. Education and income were not significant factors, although female and older respondents demonstrated greater compliance. For the adoption of a phone tracking app, trust in government is important, as is urban residence, albeit with a lower use of the app compared to nondigital NPIs.

Conclusions

Voluntary compliance in the adoption of nondigital NPIs—if skillfully led by trusted scientific experts and in accord with societal norms—can be effectively achieved. We provide evidence that trust in government is effective in encouraging the use of the Japanese tracking app. Moreover, the technical efficacy of digital initiatives and perceptions of such will unsurprisingly affect citizen support and use of digital tools.

A cross-sectional international study shows confidence in public health scientists predicts use of COVID-19 non-pharmaceutical interventions

BACKGROUND

We examine the antecedents of COVID-19 phone tracking applications use, social distancing, and mask use, in the United States, Hong Kong and Japan.

METHODS

We draw on online panel surveys of over 1000 respondents each in the USA, Hong Kong and Japan, using broadly representative quota sample selections. Results are tested by ordinal logistic regression for the two ordinal dependent variables and logistic regression for phone app use.

RESULTS

Confidence in public health scientists predicts use of phone tracking applications, social distancing, and mask use, albeit statistically insignificant for tracer phone application use in Hong Kong. Trust in government predicts the use of a phone tracking application. Counterintuitively, trust in government is negatively and significantly associated with mask use and social distancing in Hong Kong and Japan. Women are more likely to wear masks and practice social distancing. Government employees are more likely to use a phone tracking application, but less likely to mask and social distance. Voting and civic participation are positively associated with trust in government and confidence in public health scientists, in all three countries. There are interesting variations across all three countries on other antecedents and controls.

CONCLUSIONS

Building and maintaining confidence in public health scientists provides a key tool to manage pandemics. Credible, effectively communicative - and independent - medical and scientific leaders may be central to pandemic control success. For digital measures, trust in government and privacy protection is central. Political and social factors are important to understand successful public health policy implementation.

Does ethnicity affect pain management for people with advanced disease? A mixed methods cross-national systematic review of 'very high' Human Development Index English-speaking countries

BACKGROUND

Racial disparities in pain management have been observed in the USA since the 1990s in settings such as the emergency department and oncology. However, the palliative care context is not well described, and little research has focused outside of the USA or on advanced disease. This review takes a cross-national approach to exploring pain management in advanced disease for people of different racial and ethnic groups.

METHODS

Mixed methods systematic review. The primary outcome measure was differences in receiving pain medication between people from different racial and ethnic groups. Five electronic databases were searched. Two researchers independently assessed quality using JBI checklists, weighted evidence, and extracted data. The quantitative findings on the primary outcome measure were cross-tabulated, and a thematic analysis was undertaken on the mixed methods studies. Themes were formulated into a conceptual/thematic matrix. Patient representatives from UK ethnically diverse groups were consulted. PRISMA 2020 guidelines were followed.

RESULTS

Eighteen papers were included in the primary outcome analysis. Three papers were rated 'High' weight of evidence, and 17/18 (94%) were based in the USA. Ten of the eighteen (56%) found no significant difference in the pain medication received between people of different ethnic groups. Forty-six papers were included in the mixed methods synthesis; 41/46 (89%) were based in the USA. Key themes: Patients from different ethnically diverse groups had concerns about tolerance, addiction and side effects. The evidence also showed: cultural and social doctor-patient communication issues; many patients with unmet pain management needs; differences in pain assessment by racial group, and two studies found racial and ethnic stereotyping.

CONCLUSIONS

There was not enough high quality evidence to draw a conclusion on differences in receiving pain medication for people with advanced disease from different racial and ethnic groups. The mixed methods findings showed commonalities in fears about pain medication side effects, tolerance and addiction across diverse ethnic groups. However, these fears may have different foundations and are differently prioritised according to culture, faith, educational and social factors. There is a need to develop culturally competent pain management to address doctor-patient communication issues and patients' pain management concerns.

TRIAL REGISTRATION

PROSPERO- CRD42020167890 .

Trust in the U.S. Government and Its Health Agencies in the Time of COVID-19

This article examines the factors affecting Americans' trust in their federal government and its health agencies during the COVID-19 public health crisis. More specifically, we examine the evolution of Americans' trust in their government and health system and how, in the context of the COVID-19 pandemic response, it has been affected by multiple factors. Several academic journals, government policy recommendations and public health polls were evaluated to understand the public's trust in the federal government and its health institutions. Public trust in institutions during a global pandemic is essential in influencing adherence to a pandemic response (both non-pharmaceutical and medical interventions). Americans' trust in institutions is built and maintained by a variety of factors. We focus on: political polarization and involvement, media influence and health communications, history of systemic racism and socioeconomic inequalities, and pandemic fatigue. Based on the interplay of these factors, we conclude with recommendations for future pandemic response strategies.

Factors Associated with Parental Acceptance of COVID-19 Vaccination: A Multicenter Pediatric Emergency Department Cross-sectional Analysis

Study objective

During the delta surge of the COVID-19 pandemic in 2021, we sought to identify characteristics and beliefs associated with COVID-19 vaccination acceptance in parents of pediatric emergency department (ED) patients.

Methods

We conducted a cross-sectional survey-based study of the parents of children aged 3 to 16 years presenting to 1 of 9 pediatric EDs from June to August 2021 to assess the parental acceptance of COVID-19 vaccines. Using multiple variable regression, we ascertained which factors were associated with parental and pediatric COVID-19 vaccination acceptance.

Results

Of 1,491 parents approached, 1,298 (87%) participated, of whom 50% of the parents and 27% of their children aged 12 years or older and older were vaccinated. Characteristics associated with parental COVID-19 vaccination were trust in scientists (adjusted odds ratio [aOR] 5.11, 95% confidence interval [CI] 3.65 to 7.15), recent influenza vaccination (aOR 2.66, 95% CI 1.98 to 3.58), college degree (aOR 1.97, 95% CI 1.36 to 2.85), increasing parental age (aOR 1.80, 95% CI 1.45 to 2.22), a friend or family member hospitalized because of COVID-19 (aOR 1.34, 95% CI 1.05 to 1.72), and higher income (aOR 1.60, 95% CI 1.27 to 2.00). Characteristics associated with pediatric COVID-19 vaccination (children aged ≥12 years) or intended COVID-19 pediatric vaccination, once approved for use, (children aged <12 years) were parental trust in scientists (aOR 5.37, 95% CI 3.65 to 7.88), recent influenza vaccination (aOR 1.89, 95% CI 1.29 to 2.77), trust in the media (aOR 1.68, 95% CI 1.19 to 2.37), parental college degree (aOR 1.49, 95% CI 1.01 to 2.20), and increasing parental age (aOR 1.26, 95% CI 1.01 to 1.57).

Conclusion

Overall COVID-19 vaccination acceptance was low. Trust in scientists had the strongest association with parental COVID-19 vaccine acceptance for both themselves and their children.

The social specificities of hostility toward vaccination against Covid-19 in France

Equal Access to the COVID-19 vaccine for all remains a major public health issue. The current study compared the prevalence of vaccination reluctance in general and COVID-19 vaccine hesitancy and social and health factors associated with intentions to receive the vaccine. A random socio-epidemiological population-based survey was conducted in France in November 2020, in which 85,855 adults participants were included in this study. We used logistic regressions to study being "not at all in favor" to vaccination in general, and being "certainly not" willing to get vaccinated against Covid-19. Our analysis highlighted a gendered reluctance toward vaccination in general but even more so regarding vaccination against COVID-19 (OR = 1.88 (95% CI: 1.79-1.97)). We also found that people at the bottom of the social hierarchy, in terms of level of education, financial resources, were more likely to refuse the COVID-19 vaccine (from OR = 1.22 (95% CI:1.10-1.35) for respondents without diploma to OR = 0.52 (95% CI:0.47-0.57) for High school +5 or more years level). People from the French overseas departments, immigrants and descendants of immigrants, were all more reluctant to the Covid-19 vaccine (first-generation Africa/Asia immigrants OR = 1.16 (95% CI:1.04-1.30)) versus OR = 2.19 (95% CI:1.96-2.43) for the majority population). Finally, our analysis showed that those who reported not trusting the government were more likely to be Covid-19 vaccine-reluctant (OR = 3.29 (95% CI: 3.13-3.45)). Specific campaigns should be thought beforehand to reach women and people at the bottom of the social hierarchy to avoid furthering social inequalities in terms of morbidity and mortality.

Disparities in national and state estimates of COVID-19 vaccination receipt and intent to vaccinate by race/ethnicity, income, and age group among adults ≥ 18 years, United States

INTRODUCTION

COVID-19 morbidity and mortality has disproportionately affected vulnerable populations such as minority racial/ethnic groups. Understanding disparities in vaccine intentions and reasons for vaccine hesitancy are important for developing effective strategies for ameliorating racial/ethnic COVID-19 inequities.

METHODS

Using six waves of the large, nationally representative Census Bureau's Household Pulse Survey data from January 6-March 29, 2021 (n = 459,235), we examined national and state estimates for vaccination intent, defined as receipt of ≥ 1 dose of the COVID-19 vaccine or definite intent to be vaccinated, by race/ethnicity with stratification by household income and age group. In separate logistic regression models, we also examined the interaction between race/ethnicity and household income, and race/ethnicity and age group, and its association with vaccination intent. Lastly, we examined reasons for not vaccinating by race/ethnicity.

RESULTS

Vaccination intent differed by racial/ethnic group, household income, and age group nationally and by Health and Human Services (HHS) region and state. A significant interaction was observed between race/ethnicity and household income (F(8,72) = 4.50, p < 0.001), and race/ethnicity and age group (F(8,72) = 15.66, p < 0.001). Non-Hispanic Black adults with lower income (<$35,000) and younger age (18-49 years) were least likely to intend to vaccinate. Similar disparities across racial/ethnic groups were seen across most HHS regions and states. Concerns about possible side effects and effectiveness were significantly higher among all minority groups compared to non-Hispanic White adults.

CONCLUSION

Disparities in vaccination intent by racial/ethnic groups underscore the need for interventions and recommendations designed to improve vaccination coverage and confidence in underserved communities, such as younger and lower income racial/ethnic minority groups. Efforts to reduce disparities and barriers to vaccination are needed to achieve equity in vaccination coverage, and ultimately, to curb COVID-19 transmission.

"Until I Know It's Safe for Me": The Role of Timing in COVID-19 Vaccine Decision-Making and Vaccine Hesitancy

Managing the COVID-19 pandemic-and other communicable diseases-involves broad societal uptake of vaccines. As has been demonstrated, however, vaccine uptake is often uneven and incomplete across populations. This is a substantial challenge that must be addressed by public health efforts. To this point, significant research has focused on demographic and attitudinal correlates with vaccine hesitancy to understand uptake patterns. In this study, however, we advance understandings of individual decision-making processes involved in vaccine uptake through a mixed-methods investigation of the role of timing in COVID-19 vaccine choices. In the first step, a survey experiment, we find the timing of vaccine rollout (i.e., when a vaccine becomes available to the respondent) has a significant impact on public decision-making. Not only is there a higher level of acceptance when the vaccine becomes available at a later time, but delayed availability is correlated with both lower levels of 'desire to wait' and 'total rejection' of the vaccine. In a second step, we explore associated qualitative data, finding that temporal expressions (i.e., professing a desire to wait) can serve as a proxy for underlying non-temporal rationales, like concerns around safety, efficacy, personal situations, or altruism. By identifying these patterns, as well as the complexities of underlying factors, through a mixed-methods investigation, we can inform better vaccine-related policy and public messaging, as well as enhance our understanding of how individuals make decisions about vaccines in the context of COVID-19.

Scientists, presidents, and pandemics-comparing the science-politics nexus during the Zika virus and COVID-19 outbreaks

Objective

We investigate how beliefs about scientists and presidents affect views about two pandemics, Zika virus (2016) and COVID-19 (2020).

Methods

Three New Hampshire surveys in 2016 and 2020 provide data to test how beliefs about scientists' practices and presidential approval relate to pandemic views.

Results

Support for presidents consistently predicts perceptions of scientists' integrity and trust in science agencies for information, but the directionality changes from 2016 to 2020-increased trust among Obama-supporters; decreased trust among Trump-supporters. Respondents who believe scientists lack objectivity are also less likely to trust science agencies during both Zika and COVID-19 and are less apt to be confident in the government's response in 2016. Assessments of pandemic responses become increasingly political during 2020; most notably, support for President Trump strongly predicts confidence in the government's efforts.

Conclusion

Results highlight how beliefs about scientists' practices and presidents are central to the science-politics nexus during pandemics.