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González MP, Scartascini C. Increasing the use of telemedicine: A field experiment. PNAS NEXUS 2024; 3:pgae239. [PMID: 38966011 PMCID: PMC11223656 DOI: 10.1093/pnasnexus/pgae239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/25/2024] [Indexed: 07/06/2024]
Abstract
Patients are reluctant to use telemedicine health services, compared to its substitute in-person visits. One reason is that telemedicine can be accurately evaluated and compared to its substitute only after the product has been adopted and experienced. As such, an intervention that increases the probability of a first experience can have lasting effects. This article reports the results of a randomized field experiment conducted in collaboration with a health insurance company. During the intervention, half of the households out of 3,469 in the sample received periodic e-mails with information about the available services. It effectively increased the take-up and demand for telemedicine. Within the first 8 months of the experiment, patients assigned to the treatment group were 6 percentage points more likely to have used the service at least once (and had about five times the odds of using telemedicine compared to those in the control group). Eight months after the start of the intervention, the number of virtual consultations by the treatment group was six times larger than that of the control group. These results, even if limited by the sample and context in which the intervention took place, provide additional evidence about how information interventions can increase technological take-up within the health sector and could serve as the stepping stone for evaluating the impact of telemedicine on health outcomes causally.
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Affiliation(s)
- Maria Patricia González
- Digital Inclusion Benchmarks, World Benchmarking Alliance, Prins Hendrikkade 25, 1012 TM Amsterdam, Netherlands
| | - Carlos Scartascini
- Research Department, Inter-American Development Bank, 1300 New York Ave., NW, Washington, DC 20577, USA
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Koenig R, Savani MM, Lee-Whiting B, McAndrews J, Banerjee S, Hunter A, John P, Loewen PJ, Nyhan B. Public support for more stringent vaccine policies increases with vaccine effectiveness. Sci Rep 2024; 14:1748. [PMID: 38242974 PMCID: PMC10798948 DOI: 10.1038/s41598-024-51654-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 01/06/2024] [Indexed: 01/21/2024] Open
Abstract
Under what conditions do citizens support coercive public policies? Although recent research suggests that people prefer policies that preserve freedom of choice, such as behavioural nudges, many citizens accepted stringent policy interventions like fines and mandates to promote vaccination during the COVID-19 pandemic-a pattern that may be linked to the unusually high effectiveness of COVID-19 vaccines. We conducted a large online survey experiment (N = 42,417) in the Group of Seven (G-7) countries investigating the relationship between a policy's effectiveness and public support for stringent policies. Our results indicate that public support for stringent vaccination policies increases as vaccine effectiveness increases, but at a modest scale. This relationship flattens at higher levels of vaccine effectiveness. These results suggest that intervention effectiveness can be a significant predictor of support for coercive policies but only up to some threshold of effectiveness.
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Affiliation(s)
- Richard Koenig
- Department of Political Economy, King's College London, London, WC2R 2LS, UK
| | - Manu Manthri Savani
- Department of Social and Political Sciences, Brunel University London, London, UB8 3PH, UK.
| | - Blake Lee-Whiting
- Munk School of Global Affairs and Public Policy, University of Toronto, Toronto, M5S 3K9, Canada
- Department of Political Science, University of Toronto, Toronto, M5S 3G3, Canada
| | - John McAndrews
- Digital Society Lab, McMaster University, Hamilton, L8S 4L8, Canada
| | - Sanchayan Banerjee
- Institute for Environmental Studies (IVM), Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, The Netherlands
| | - Andrew Hunter
- Department of Political Economy, King's College London, London, WC2R 2LS, UK
| | - Peter John
- Department of Political Economy, King's College London, London, WC2R 2LS, UK
| | - Peter John Loewen
- Munk School of Global Affairs and Public Policy, University of Toronto, Toronto, M5S 3K9, Canada
- Department of Political Science, University of Toronto, Toronto, M5S 3G3, Canada
| | - Brendan Nyhan
- Department of Government, Dartmouth College, Hanover, 03755, USA
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3
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Kaufman J, Steffens MS, Hoq M, King C, Marques MD, Mao K, Bullivant B, Danchin M. Effect of persuasive messaging about COVID-19 vaccines for 5- to 11-year-old children on parent intention to vaccinate. J Paediatr Child Health 2023; 59:686-693. [PMID: 36807943 DOI: 10.1111/jpc.16374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/20/2023]
Abstract
AIM Uptake of COVID-19 vaccines for children aged 5-11 years old in Australia has plateaued. Persuasive messaging is an efficient and adaptable potential intervention to promote vaccine uptake, but evidence for its effectiveness is varied and dependent on context and cultural values. This study aimed to test persuasive messages to promote COVID-19 vaccines for children in Australia. METHODS A parallel, online, randomised control experiment was conducted between 14 and 21 January 2022. Participants were Australian parents of a child aged 5-11 years who had not vaccinated their child with a COVID-19 vaccine. After providing demographic details and level of vaccine hesitancy, parents viewed either the control message or one of four intervention texts emphasising (i) personal health benefits; (ii) community health benefits; (iii) non-health benefits; or (iv) personal agency. The primary outcome was parents' intention to vaccinate their child. RESULTS The analysis included 463 participants, of whom 58.7% (272/463) were hesitant about COVID-19 vaccines for children. Intention to vaccinate was higher in the community health (7.8%, 95% confidence interval (CI) -5.3% to 21.0%) and non-health (6.9%, 95% CI -6.4% to 20.3%) groups, and lower in the personal agency group (-3.9, 95% CI -17.7 to 9.9) compared to control, but these differences did not reach statistical significance. The effects of the messages among hesitant parents were similar to the overall study population. CONCLUSION Short, text-based messages alone are unlikely to influence parental intention to vaccinate their child with the COVID-19 vaccine. Multiple strategies tailored for the target audience should also be utilised.
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Affiliation(s)
- Jessica Kaufman
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Maryke S Steffens
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Monsurul Hoq
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Catherine King
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mathew D Marques
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Kevin Mao
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Bianca Bullivant
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Margie Danchin
- Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
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Pilch I, Turska-Kawa A, Wardawy P, Olszanecka-Marmola A, Smołkowska-Jędo W. Contemporary trends in psychological research on conspiracy beliefs. A systematic review. Front Psychol 2023; 14:1075779. [PMID: 36844318 PMCID: PMC9945548 DOI: 10.3389/fpsyg.2023.1075779] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/09/2023] [Indexed: 02/11/2023] Open
Abstract
Background The number of psychological studies on conspiracy beliefs has been systematically growing for about a dozen years, but in recent years, the trend has intensified. We provided a review covering the psychological literature on conspiracy beliefs from 2018 to 2021. Halfway through this period, the COVID-19 pandemic broke out, accompanied by an explosion of movements based on conspiracy theories, intensifying researchers' interest in this issue. Methods Adhering to PRISMA guidelines, the review systematically searched for relevant journal articles published between 2018 and 2021. A search was done on Scopus and Web of Science (only peer-reviewed journals). A study was included if it contained primary empirical data, if specific or general conspiracy belief(s) were measured and if its correlation with at least one other psychological variable was reported. All the studies were grouped for the descriptive analysis according to the methodology used, the participants' characteristics, the continent of origin, the sample size, and the conspiracy beliefs measurement tools. Due to substantial methodological heterogeneity of the studies, narrative synthesis was performed. The five researchers were assigned specific roles at each stage of the analysis to ensure the highest quality of the research. Results Following the proposed methodology, 308 full-text articles were assessed for eligibility and 274 articles (417 studies) meeting the inclusion criteria were identified and included in the review. Almost half of the studies (49.6%) were conducted in European countries. The vast majority of the studies (85.7%) were carried out on samples of adult respondents. The research presents antecedents as well as (potential) consequences of conspiracy beliefs. We grouped the antecedents of conspiracy beliefs into six categories: cognitive (e.g., thinking style) motivational (e.g., uncertainty avoidance), personality (e.g., collective narcissism), psychopathology (e.g., Dark Triad traits), political (e.g., ideological orientation), and sociocultural factors (e.g., collectivism). Conclusion and limitations The research presents evidence on the links between conspiracy beliefs and a range of attitudes and behaviors considered unfavorable from the point of view of individuals and of the society at large. It turned out that different constructs of conspiracy thinking interact with each other. The limitations of the study are discussed in the last part of the article.
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Affiliation(s)
- Irena Pilch
- Faculty of Social Sciences, Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
| | - Agnieszka Turska-Kawa
- Faculty of Social Sciences, Institute of Political Science, University of Silesia in Katowice, Katowice, Poland,*Correspondence: Agnieszka Turska-Kawa,
| | - Paulina Wardawy
- Faculty of Social Sciences, Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
| | - Agata Olszanecka-Marmola
- Faculty of Social Sciences, Institute of Political Science, University of Silesia in Katowice, Katowice, Poland
| | - Wiktoria Smołkowska-Jędo
- Faculty of Social Sciences, Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
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Bjørkheim S, Sætrevik B. Manipulating risk of infection and appeal to public benefit increase compliance with infection control measures in a hypothetical pandemic scenario. PLoS One 2022; 17:e0274024. [PMID: 36413543 PMCID: PMC9681092 DOI: 10.1371/journal.pone.0274024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/19/2022] [Indexed: 11/23/2022] Open
Abstract
To limit an infectious outbreak, the public must be informed about the infection risk and be motivated to comply with infection control measures. Perceiving a situation as threatening and seeing benefits to complying may be necessary to motivate for compliance. The current study used a preregistered survey experiment with a 2-by-2 between-subject design to investigate if emphasizing high infection risk and appealing to societal benefits impacted intention to comply with infection control measures. The results from a representative Norwegian sample (N = 2533) show that describing a high (as opposed to low) personal risk scenario had a small main effect on compliance. Further, appealing to public (as opposed to self-interested) benefits also had a small main effect. There was no interaction between risk scenario and motivational emphasis. The results suggest that to maximize compliance, information about disease outbreak should emphasize the individual risk of contracting the disease, and could also underline the public value of limiting infection spread. These findings can inform health authorities about the motives underlying compliance with infection control measures during an infectious disease outbreak.
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Affiliation(s)
- Sebastian Bjørkheim
- Department for Psychosocial Science, Operational Psychology Research Group, Faculty of Psychology, University of Bergen, Bergen, Norway
- * E-mail:
| | - Bjørn Sætrevik
- Department for Psychosocial Science, Operational Psychology Research Group, Faculty of Psychology, University of Bergen, Bergen, Norway
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Barnes K, Colagiuri B. Drivers of the Intention to Receive a COVID-19 Booster Vaccine: Insights from the UK and Australia. Vaccines (Basel) 2022; 10:1730. [PMID: 36298595 PMCID: PMC9607201 DOI: 10.3390/vaccines10101730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/13/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022] Open
Abstract
As the global pandemic perpetuates, keeping the population vaccinated will be imperative to maintain societal protection from the SARS-CoV-2 (COVID-19) virus. However, while empirical evidence regarding predictors of the intention to receive a first COVID-19 vaccine has amassed, our understanding regarding the psychological and behavioral drivers of continued COVID-19 vaccination remains limited. In this pre-registered study (UK: AsPredicted#78370|Australia: AsPredicted#81667), factors predicting the intention to receive a COVID-19 booster vaccine were investigated in two adult samples from the UK (N = 1222) and Australia (N = 1197) that were nationally representative on factors of age, gender, and geographic location. High levels of booster intent were found (73% and 67%, respectively). Exploratory Structural Equation Modelling (ESEM) revealed three key predictors of the intention to receive a booster vaccine that emerged across both UK and Australian samples: concern regarding the COVID-19 virus, positive perceptions of the COVID-19 vaccines, and the perceived severity of side effects experienced to the last COVID-19 vaccine dose. Several additional factors (age, months since the last COVID-19 vaccine, familiarity with side effects, and regularly receiving the influenza vaccine) were present in the Australian dataset. These findings provide important evidence that targeting psychological perceptions of the COVID-19 vaccine and virus may serve to maintain participation in the COVID-19 vaccination programme, paving the way for future behavioural research in this area.
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Affiliation(s)
- Kirsten Barnes
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia
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Factors Associated with Willingness to Receive a COVID-19 Vaccine in Adult Polish Population-A Cross-Sectional Survey. Vaccines (Basel) 2022; 10:vaccines10101715. [PMID: 36298579 PMCID: PMC9609836 DOI: 10.3390/vaccines10101715] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/23/2022] Open
Abstract
Vaccinations are proven to be the most efficient in preventing COVID-19 disease. Nonetheless, some people are skeptical and hesitant. The study aimed to determine factors associated with willingness to receive a COVID-19 vaccine in the Polish adult population. An online survey consisting of questions regarding (1) demographic information and (2) health issues (the status of vaccination, comorbidities, receiving the flu vaccine and usage of health monitoring apps) was distributed between 13 January and 14 February 2022. Of the 7018 participants who met the study conditions, 76.89% (n = 5396) were females, 22.44% (n = 1575) were males and 0.67% (n = 47) did not specify gender. The median age was 31 years. Among them, 81.82% (n = 5742) were vaccinated and 18.18% (n = 1276) were not. 46.87% (n = 3289) had no chronic co-morbidities. Factors associated with lower odds to receive the vaccine were: being men (p = 0.02; OR = 0.83), having lower education status (p = 0.001, OR = 0.56−0.77), living in a smaller residence area (p < 0.001, OR = 0.47−0.73.), not receiving flu vaccination (p < 0.001, OR = 24.51) and not using health monitoring applications (p < 0.001, OR = 1.56). Health education and communication strategies are needed to achieve large-scale vaccine acceptability and finally herd immunity.
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Mardi P, Djalalinia S, Kargar R, Jamee M, Esmaeili Abdar Z, Qorbani M. Impact of incentives on COVID-19 vaccination; A systematic review. Front Med (Lausanne) 2022; 9:810323. [PMID: 36160125 PMCID: PMC9492889 DOI: 10.3389/fmed.2022.810323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionAlthough vaccination is the most effective way to limit and overcome the COVID-19 pandemic, a considerable fraction of them are not intended to get vaccinated. This study aims to investigate the existing research evidence and evaluate the effectiveness and consequences of all incentives provided for increasing the uptake of COVID-19 vaccination.MethodsA systematic search in PubMed, Web of Science (WoS), and SCOPUS from 2020 until October 10, 2021, was conducted on experimental studies evaluating the effects of incentives including cash, lottery voucher, and persuasive messages on COVID-19 vaccination intention and uptake. The study selection process, data extraction, and quality assessment were conducted independently by two investigators using Consolidated Standards of Reporting Trials (CONSORT 2010) checklist.ResultsTwenty-four records were included in the qualitative analysis. Most of the included studies assessed the effect of financial incentives. In 14 studies (58%) the assessed outcome was vaccination uptake and in nine (37.5%) others it was vaccination intention. One study considered self-reported vaccination status as the outcome. This study shows that high financial incentives and the Vax-a-million lottery are attributed to a higher vaccination rate, while the low amount of financial incentives, other lotteries, and persuasive messages have small or non-significant effects.ConclusionPaying a considerable amount of cash and Vax-a-million lottery are attributed to a higher vaccination. Nevertheless, there is a controversy over the effect of other incentives including other lotteries, low amount of cash, and messages on vaccination. It is noteworthy that, inconsistency and imprecision of included studies should be considered.
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Affiliation(s)
- Parham Mardi
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Shirin Djalalinia
- Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Reza Kargar
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahnaz Jamee
- Pediatric Nephrology Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Esmaeili Abdar
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- *Correspondence: Mostafa Qorbani
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Hample J. An Investigation into Memorable Messages about COVID-19. JOURNAL OF HEALTH COMMUNICATION 2022; 27:615-623. [PMID: 36382869 DOI: 10.1080/10810730.2022.2147256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
COVID-19 has been one of the most talked-about health threats in recent memory. Of the many messages - both good and bad - to which people are exposed, which ones are actually remembered? This study reports results of 319 people who described the COVID-19 message they found most memorable. Results indicate that people find messages about the virus, masks, and dangers of the disease most memorable. The majority of the messages came from TV news or the internet, particularly from social media. Overall, participants felt relatively positively about the messages. Memorable messages came from well-liked or trusted sources and were messages that the participant broadly agreed with (either because they already agreed or because the message changed their mind). Participants were more likely to report agreeing with the message if it produced feelings of happiness or fear and if the source of the message was seen as credible and benevolent. Future messages should focus on creating messages that provoke fear; highlight the credentials and character of the source; and are disseminated via social media and television.
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Affiliation(s)
- Jessica Hample
- Department of Communication, University of Nebraska at Kearney, Kearney, Nebraska, USA
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Eidelman S, Vance E, Blanchar JC, Kallodaychask K, Shimomoto Y, Yamasaki K. Perceived longevity of mRNA technology increases support for Covid-19 vaccines. SOCIAL INFLUENCE 2022. [DOI: 10.1080/15534510.2022.2116105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Scott Eidelman
- Department of Psychological Science, University of Arkansas, Akansas, AR, USA
| | - Emily Vance
- Department of Psychological Science, University of Arkansas, Akansas, AR, USA
| | - John C. Blanchar
- Department of Psychology, University of Minnesota Duluth, Swarthmore College, Swarthmore, PA, USA
| | | | - Yuna Shimomoto
- Department of Psychological Science, University of Arkansas, Akansas, AR, USA
| | - Kaori Yamasaki
- Department of Psychological Science, University of Arkansas, Akansas, AR, USA
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Andreas M, Iannizzi C, Bohndorf E, Monsef I, Piechotta V, Meerpohl JJ, Skoetz N. Interventions to increase COVID-19 vaccine uptake: a scoping review. Cochrane Database Syst Rev 2022; 8:CD015270. [PMID: 35920693 PMCID: PMC9347311 DOI: 10.1002/14651858.cd015270] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Vaccines are effective in preventing severe COVID-19, a disease for which few treatments are available and which can lead to disability or death. Widespread vaccination against COVID-19 may help protect those not yet able to get vaccinated. In addition, new and vaccine-resistant mutations of SARS-CoV-2 may be less likely to develop if the spread of COVID-19 is limited. Different vaccines are now widely available in many settings. However, vaccine hesitancy is a serious threat to the goal of nationwide vaccination in many countries and poses a substantial threat to population health. This scoping review maps interventions aimed at increasing COVID-19 vaccine uptake and decreasing COVID-19 vaccine hesitancy. OBJECTIVES To scope the existing research landscape on interventions to enhance the willingness of different populations to be vaccinated against COVID-19, increase COVID-19 vaccine uptake, or decrease COVID-19 vaccine hesitancy, and to map the evidence according to addressed populations and intervention categories. SEARCH METHODS We searched Cochrane COVID-19 Study Register, Web of Science (Science Citation Index Expanded and Emerging Sources Citation Index), WHO COVID-19 Global literature on coronavirus disease, PsycINFO, and CINAHL to 11 October 2021. SELECTION CRITERIA We included studies that assess the impact of interventions implemented to enhance the willingness of different populations to be vaccinated against COVID-19, increase vaccine uptake, or decrease COVID-19 vaccine hesitancy. We included randomised controlled trials (RCTs), non-randomised studies of intervention (NRSIs), observational studies and case studies with more than 100 participants. Furthermore, we included systematic reviews and meta-analyses. We did not limit the scope of the review to a specific population or to specific outcomes assessed. We excluded interventions addressing hesitancy towards vaccines for diseases other than COVID-19. DATA COLLECTION AND ANALYSIS Data were analysed according to a protocol uploaded to the Open Science Framework. We used an interactive scoping map to visualise the results of our scoping review. We mapped the identified interventions according to pre-specified intervention categories, that were adapted to better fit the evidence. The intervention categories were: communication interventions, policy interventions, educational interventions, incentives (both financial and non-financial), interventions to improve access, and multidimensional interventions. The study outcomes were also included in the mapping. Furthermore, we mapped the country in which the study was conducted, the addressed population, and whether the design was randomised-controlled or not. MAIN RESULTS We included 96 studies in the scoping review, 35 of which are ongoing and 61 studies with published results. We did not identify any relevant systematic reviews. For an overview, please see the interactive scoping map (https://tinyurl.com/2p9jmx24) STUDIES WITH PUBLISHED RESULTS Of the 61 studies with published results, 46 studies were RCTs and 15 NRSIs. The interventions investigated in the studies were heterogeneous with most studies testing communication strategies to enhance COVID-19 vaccine uptake. Most studies assessed the willingness to get vaccinated as an outcome. The majority of studies were conducted in English-speaking high-income countries. Moreover, most studies investigated digital interventions in an online setting. Populations that were addressed were diverse. For example, studies targeted healthcare workers, ethnic minorities in the USA, students, soldiers, at-risk patients, or the general population. ONGOING STUDIES Of the 35 ongoing studies, 29 studies are RCTs and six NRSIs. Educational and communication interventions were the most used types of interventions. The majority of ongoing studies plan to assess vaccine uptake as an outcome. Again, the majority of studies are being conducted in English-speaking high-income countries. In contrast to the studies with published results, most ongoing studies will not be conducted online. Addressed populations range from minority populations in the USA to healthcare workers or students. Eleven ongoing studies have estimated completion dates in 2022. AUTHORS' CONCLUSIONS: We were able to identify and map a variety of heterogeneous interventions for increasing COVID-19 vaccine uptake or decreasing vaccine hesitancy. Our results demonstrate that this is an active field of research with 61 published studies and 35 studies still ongoing. This review gives a comprehensive overview of interventions to increase COVID-19 vaccine uptake and can be the foundation for subsequent systematic reviews on the effectiveness of interventions to increase COVID-19 vaccine uptake. A research gap was shown for studies conducted in low and middle-income countries and studies investigating policy interventions and improved access, as well as for interventions addressing children and adolescents. As COVID-19 vaccines become more widely available, these populations and interventions should not be neglected in research. AUTHORS CONCLUSIONS We were able to identify and map a variety of heterogeneous interventions for increasing COVID-19 vaccine uptake or decreasing vaccine hesitancy. Our results demonstrate that this is an active field of research with 61 published studies and 35 studies still ongoing. This review gives a comprehensive overview of interventions to increase COVID-19 vaccine uptake and can be the foundation for subsequent systematic reviews on the effectiveness of interventions to increase COVID-19 vaccine uptake. A research gap was shown for studies conducted in low and middle-income countries and studies investigating policy interventions and improved access, as well as for interventions addressing children and adolescents. As COVID-19 vaccines become more widely available, these populations and interventions should not be neglected in research.
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Affiliation(s)
- Marike Andreas
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Claire Iannizzi
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Emma Bohndorf
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ina Monsef
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cochrane Haematology, Cologne, Germany
| | - Vanessa Piechotta
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Burger MN, Mayer M, Steimanis I. Repeated information of benefits reduces COVID-19 vaccination hesitancy: Experimental evidence from Germany. PLoS One 2022; 17:e0270666. [PMID: 35763537 PMCID: PMC9239477 DOI: 10.1371/journal.pone.0270666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background Many countries, such as Germany, struggle to vaccinate enough people against COVID-19 despite the availability of safe and efficient vaccines. With new variants emerging and the need for booster vaccinations, overcoming vaccination hesitancy gains importance. The research to date has revealed some promising, albeit contentious, interventions to increase vaccination intention. However, these have yet to be tested for their effectiveness in increasing vaccination rates. Methods & results We conducted a preregistered survey experiment with N = 1,324 participants in Germany in May/June 2021. This was followed by a series of emails reminding participants to get vaccinated in August and concluded with a follow-up survey in September. We experimentally assess whether debunking vaccination myths, highlighting the benefits of being vaccinated, or sending vaccination reminders decreases hesitancy. In the survey experiment, we find no increase in the intention to vaccinate regardless of the information provided. However, communicating vaccination benefits over several weeks reduced the likelihood of not being vaccinated by 9 percentage points, which translates into a 27% reduction compared to the control group. Debunking vaccination myths and reminders alone also decreased the likelihood, yet not significantly. Discussion Our findings suggest that if soft governmental interventions such as information campaigns are employed, highlighting benefits should be given preference over debunking vaccination myths. Furthermore, it seems that repeated messages affect vaccination action while one-time messages might be insufficient, even for increasing vaccination intentions. Our study highlights the importance of testing interventions outside of survey experiments that are limited to measuring vaccination intentions—not actions—and immediate changes in attitudes and intentions—not long-term changes.
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Affiliation(s)
| | - Matthias Mayer
- Department of Economics, Philipps University Marburg, Marburg, Germany
| | - Ivo Steimanis
- Department of Economics, Philipps University Marburg, Marburg, Germany
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Hing NYL, Woon YL, Lee YK, Kim HJ, Lothfi NM, Wong E, Perialathan K, Ahmad Sanusi NH, Isa A, Leong CT, Costa-Font J. When do persuasive messages on vaccine safety steer COVID-19 vaccine acceptance and recommendations? Behavioural insights from a randomised controlled experiment in Malaysia. BMJ Glob Health 2022; 7:bmjgh-2022-009250. [PMID: 35906015 PMCID: PMC9344599 DOI: 10.1136/bmjgh-2022-009250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/21/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Vaccine safety is a primary concern among vaccine-hesitant individuals. We examined how seven persuasive messages with different frames, all focusing on vaccine safety, influenced Malaysians to accept the COVID-19 vaccine, and recommend it to individuals with different health and age profiles; that is, healthy adults, the elderly, and people with pre-existing health conditions. Methods A randomised controlled experiment was conducted from 29 April to 7 June 2021, which coincided with the early phases of the national vaccination programme when vaccine uptake data were largely unavailable. 5784 Malaysians were randomly allocated into 14 experimental arms and exposed to one or two messages that promoted COVID-19 vaccination. Interventional messages were applied alone or in combination and compared against a control message. Outcome measures were assessed as intent to both take the vaccine and recommend it to healthy adults, the elderly, and people with pre-existing health conditions, before and after message exposure. Changes in intent were modelled and we estimated the average marginal effects based on changes in the predicted probability of responding with a positive intent for each of the four outcomes. Results We found that persuasive communication via several of the experimented messages improved recommendation intentions to people with pre-existing health conditions, with improvements ranging from 4 to 8 percentage points. In contrast, none of the messages neither significantly improved vaccination intentions, nor recommendations to healthy adults and the elderly. Instead, we found evidence suggestive of backfiring among certain outcomes with messages using negative attribute frames, risky choice frames, and priming descriptive norms. Conclusion Message frames that briefly communicate verbatim facts and stimulate rational thinking regarding vaccine safety may be ineffective at positively influencing vaccine-hesitant individuals. Messages intended to promote recommendations of novel health interventions to people with pre-existing health conditions should incorporate safety dimensions. Trial registration number NCT05244356.
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Affiliation(s)
- Nicholas Yee Liang Hing
- Centre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Shah Alam, Selangor, Malaysia
| | - Yuan Liang Woon
- Centre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Shah Alam, Selangor, Malaysia
| | - Yew Kong Lee
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hyung Joon Kim
- United Nations Children's Fund Malaysia, Putrajaya, Malaysia
| | - Nurhyikmah M Lothfi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Elizabeth Wong
- United Nations Children's Fund Malaysia, Putrajaya, Malaysia
| | - Komathi Perialathan
- Centre for Health Communication and Informatics Research, Institute for Health Behavioural Research, National Institutes of Health, Shah Alam, Selangor, Malaysia
| | - Nor Haryati Ahmad Sanusi
- Centre for Health Communication and Informatics Research, Institute for Health Behavioural Research, National Institutes of Health, Shah Alam, Selangor, Malaysia
| | - Affendi Isa
- Health Education Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Chin Tho Leong
- Centre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Shah Alam, Selangor, Malaysia
| | - Joan Costa-Font
- Department of Health Policy, The London School of Economics and Political Science, London, UK
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Lajunen T, Wróbel B. Acculturation, trust to health care system, and attitudes to COVID-19 vaccination: A comparative study between Polish immigrants in Norway, Polish in Poland, and Norwegians in Norway. CURRENT RESEARCH IN ECOLOGICAL AND SOCIAL PSYCHOLOGY 2022; 3:100047. [PMID: 35574266 PMCID: PMC9077802 DOI: 10.1016/j.cresp.2022.100047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 04/24/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
Fast deployment of safe and efficient COVID-19 vaccines has changed the course of the pandemic in many countries reducing COVID-19 death rates and allowing countries to abandon strict measures such as social distancing and restrictions to public events. The vaccination strategy, however, is based on the expected high vaccination rate in the population. Several studies have indicated vaccination hesitancy to be higher in ethnic minority communities, which can lead to unnecessary suffering and loss of lives, worsening pre-existing health inequalities and marginalization of ethnic minority groups. The aim of the present study was to investigate the relationships between acculturation to Norwegian culture, trust in health authorities, and attitude to COVID-19 vaccine among Polish immigrants in Norway. An internet-based survey including questions about attitude to COVID-19 vaccination and trust in the health care system was filled by 150 Polish immigrants in Norway, 256 Polish living in Poland, and 264 Norwegians living in Norway. In addition, the Polish immigrants also answered questions about acculturation to Norway. The results showed that the Polish immigrants in Norway had less positive attitudes to COVID-19 vaccination than the Norwegians, while they did not differ from Polish living in Poland. The Polish immigrants also indicated lower trust in the Norwegian health care system than the Norwegians. In regression analysis, the trust in the values of the health care system was the most important predictor of COVID-19 vaccination attitudes in all three samples. A path model showed that trust in the values of the health care system mediated the effects of acculturation to Norway on COVID-19 vaccination attitudes among Polish immigrants. These results underline the importance of taking ethnic minorities and immigrants into account in the health care system to reduce COVID-19 vaccination hesitancy.
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Affiliation(s)
- Timo Lajunen
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Beata Wróbel
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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15
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Determinants of the Hesitancy toward COVID-19 Vaccination in Eastern European Countries and the Relationship with Health and Vaccine Literacy: A Literature Review. Vaccines (Basel) 2022; 10:vaccines10050672. [PMID: 35632428 PMCID: PMC9146656 DOI: 10.3390/vaccines10050672] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/14/2022] [Accepted: 04/22/2022] [Indexed: 02/01/2023] Open
Abstract
Herd immunity is necessary to control the coronavirus disease 2019 (COVID-19) pandemic. However, a low proportion of vaccinated people and low levels of vaccine acceptance have been noted in Eastern Europe. Our paper aimed to review the central attitudes associated with the hesitancy toward COVID-19 vaccination specific to Eastern European countries. The main Eastern European determinants of COVID-19 vaccine acceptance identified from the included studies are: public confidence in the vaccines’ safety and efficacy, vaccine literacy, and public trust in the government and the medical system. Each of these determinants is discussed along with possible improvement measures. Variables specific to Eastern Europe that predict the willingness to vaccinate have also been highlighted. The specific attitudes and their context as identified by our review should be incorporated into local public health programs, with the ultimate goal of reducing viral spreading, mutation emergence, and COVID-19 morbidity and mortality both within the borders of Eastern Europe and beyond.
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Vaccinating to Protect Others: The Role of Self-Persuasion and Empathy among Young Adults. Vaccines (Basel) 2022; 10:vaccines10040553. [PMID: 35455302 PMCID: PMC9029351 DOI: 10.3390/vaccines10040553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 11/26/2022] Open
Abstract
Direct persuasion is usually less effective than self-persuasion. As research shows that most young adults are unafraid of COVID-19, this study aimed to investigate the effectiveness of self-persuasion targeted at protecting the health of others to encourage young adults to be vaccinated against COVID-19 and examined the link between empathy and vaccination intention. We conducted two studies: Study 1 (n = 352) compared the effectiveness of self-persuasion targeted at others’ health versus personal health and direct persuasion in encouraging COVID-19 vaccination intention; Study 2 (n = 375) investigated the applicability of self-persuasion through a poster framed as an open-ended question. The theory of planned behavior-based tools were used in both studies, and structural equation modeling was conducted. Study 1 found that self-persuasion targeted at others’ health (compared to other forms of persuasion) indirectly affects vaccination intention through utility and social norm beliefs. Higher empathy, utility, social norms, and control beliefs are associated with a greater vaccination intention. Study 2 found that the poster with self-persuasion targeted at others’ health enhanced vaccination intention compared with a direct persuasion poster. Our findings demonstrate that self-persuasion targeted at others’ health can potentially increase COVID-19 vaccination uptake among young adults.
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Benham JL, Atabati O, Oxoby RJ, Mourali M, Shaffer B, Sheikh H, Boucher JC, Constantinescu C, Parsons Leigh J, Ivers NM, Ratzan SC, Fullerton MM, Tang T, Manns BJ, Marshall DA, Hu J, Lang R. COVID-19 Vaccine-Related Attitudes and Beliefs in Canada: National Cross-sectional Survey and Cluster Analysis. JMIR Public Health Surveill 2021; 7:e30424. [PMID: 34779784 PMCID: PMC8709417 DOI: 10.2196/30424] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 10/07/2021] [Accepted: 11/11/2021] [Indexed: 01/03/2023] Open
Abstract
Background There are concerns that vaccine hesitancy may impede COVID-19 vaccine rollout and prevent the achievement of herd immunity. Vaccine hesitancy is a delay in acceptance or refusal of vaccines despite their availability. Objective We aimed to identify which people are more and less likely to take a COVID-19 vaccine and factors associated with vaccine hesitancy to inform public health messaging. Methods A Canadian cross-sectional survey was conducted in Canada in October and November 2020, prior to the regulatory approval of the COVID-19 vaccines. Vaccine hesitancy was measured by respondents answering the question “what would you do if a COVID-19 vaccine were available to you?” Negative binomial regression was used to identify the factors associated with vaccine hesitancy. Cluster analysis was performed to identify distinct clusters based on intention to take a COVID-19 vaccine, beliefs about COVID-19 and COVID-19 vaccines, and adherence to nonpharmaceutical interventions. Results Of 4498 participants, 2876 (63.9%) reported COVID-19 vaccine hesitancy. Vaccine hesitancy was significantly associated with (1) younger age (18-39 years), (2) lower education, and (3) non-Liberal political leaning. Participants that reported vaccine hesitancy were less likely to believe that a COVID-19 vaccine would end the pandemic or that the benefits of a COVID-19 vaccine outweighed the risks. Individuals with vaccine hesitancy had higher prevalence of being concerned about vaccine side effects, lower prevalence of being influenced by peers or health care professionals, and lower prevalence of trust in government institutions. Conclusions These findings can be used to inform targeted public health messaging to combat vaccine hesitancy as COVID-19 vaccine administration continues. Messaging related to preventing COVID among friends and family, highlighting the benefits, emphasizing safety and efficacy of COVID-19 vaccination, and ensuring that health care workers are knowledgeable and supported in their vaccination counselling may be effective for vaccine-hesitant populations.
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Affiliation(s)
- Jamie L Benham
- Department of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Omid Atabati
- Department of Economics, University of Calgary, Calgary, AB, Canada
| | - Robert J Oxoby
- Department of Economics, University of Calgary, Calgary, AB, Canada
| | - Mehdi Mourali
- Haskayne School of Business, University of Calgary, Calgary, AB, Canada
| | - Blake Shaffer
- Department of Economics, University of Calgary, Calgary, AB, Canada
| | - Hasan Sheikh
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Jean-Christophe Boucher
- School of Public Policy and Department of Political Sciences, University of Calgary, Calgary, AB, Canada
| | - Cora Constantinescu
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | | | - Noah M Ivers
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - Scott C Ratzan
- School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Madison M Fullerton
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Theresa Tang
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Braden J Manns
- Department of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Deborah A Marshall
- Department of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Jia Hu
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Raynell Lang
- Department of Medicine, University of Calgary, Calgary, AB, Canada
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