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Biasio LR, Zanobini P, Lorini C, Bonaccorsi G. Perspectives in the Development of Tools to Assess Vaccine Literacy. Vaccines (Basel) 2024; 12:422. [PMID: 38675804 PMCID: PMC11054371 DOI: 10.3390/vaccines12040422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/26/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
Vaccine literacy (VL) is the ability to find, understand, and evaluate vaccination-related information to make appropriate decisions about immunization. The tools developed so far for its evaluation have produced consistent results. However, some dimensions may be underestimated due to the complexity of factors influencing VL. Moreover, the heterogeneity of methods used in studies employing these tools hinders a comprehensive understanding of its role even more. To overcome these limitations, a path has been sought to propose new instruments. This has necessitated updating earlier literature reviews on VL and related tools, exploring its relationship with vaccine hesitancy (VH), and examining associated variables like beliefs, attitudes, and behaviors towards immunization. Based on the current literature, and supported by the re-analysis of a dataset from an earlier study, we propose a theoretical framework to serve as the foundation for creating future assessment tools. These instruments should not only evaluate the psychological factors underlying the motivational aspect of VL, but also encompass knowledge and competencies. The positioning of VL in the framework at the intersection between sociodemographic antecedents and attitudes, leading to behaviors and outcomes, explains why and how VL can directly or indirectly influence vaccination decisions by countering VH and operating at personal, as well as at organizational and community levels.
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Affiliation(s)
| | - Patrizio Zanobini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (C.L.); (G.B.)
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (C.L.); (G.B.)
| | - Guglielmo Bonaccorsi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (C.L.); (G.B.)
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Monahan K, Sacco A, Fenn N, Reyes C, Lindsey H, Paiva A, Robbins M. Development of transtheoretical model measures for assessing decisional balance and temptation to vape. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-7. [PMID: 38227915 DOI: 10.1080/07448481.2023.2299412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 11/27/2023] [Indexed: 01/18/2024]
Abstract
Introduction: Vaping is common among young adults in the United States. The Transtheoretical Model (TTM) has demonstrated success in smoking cessation efforts; however, it has not been comprehensively applied to vaping cessation, and core TTM vaping measures have not been developed. Method: A cross-sectional survey including measures of stage of change (SOC), temptation to vape, and decisional balance (DCBL) was disseminated (n = 459). Items were adapted from TTM smoking scales. The sample was split for exploratory and confirmatory factor analyses (EFA/CFA). Analyses of variance assessed relationships between constructs and SOC. Results: EFA/CFA resulted in one Temptation scale (CFI = .95; α = .87) and two DCBL scales (CFI = .91; Pros α = .72; Cons α = .72). Temptation to vape and Pros of vaping decreased significantly across SOC, while Cons increased significantly. Conclusions: TTM vaping measures for two key TTM constructs were developed utilizing a college sample. Results suggest that the developed measures map well onto the TTM framework.
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Affiliation(s)
- Katie Monahan
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Allegra Sacco
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Natalie Fenn
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Cheyenne Reyes
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Hayley Lindsey
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Andrea Paiva
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Mark Robbins
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
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Sacco A, Robbins ML, Paiva AL, Monahan K, Lindsey H, Reyes C, Rusnock A. Measuring Motivation for COVID-19 Vaccination: An Application of the Transtheoretical Model. Am J Health Promot 2023; 37:1109-1120. [PMID: 37612233 DOI: 10.1177/08901171231197899] [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] [Indexed: 08/25/2023]
Abstract
PURPOSE In the United States (US), individuals vary widely in their readiness to get vaccinated for COVID-19. The present study developed measures based on the transtheoretical model (TTM) to better understand readiness, decisional balance (DCBL; pros and cons), self-efficacy (SE), as well as other motivators for change such as myths and barriers for COVID-19 vaccination. DESIGN Cross-sectional measurement development. SETTING Online survey. SAMPLE 528 US adults ages 18-75. MEASURES Demographics, stage of change (SOC), DCBL, SE, myths, and barriers. ANALYSIS The sample was randomly split into halves for exploratory factor analysis using principal components analysis (EFA/PCA), followed by confirmatory factor analyses (CFA) to test measurement models. Correlation matrices were assessed and multivariate analyses examined relationships between constructs and sub-constructs. RESULTS For DCBL, EFA/PCA revealed three correlated factors (one pros, two cons) (n1 = 8, α = .97; n2 = 5, α = .93; n3 = 4, α = .84). For SE, two correlated factors were revealed (n1 = 12, α = .96; n2 = 3, α = .89). Single-factor solutions for Myths (n = 13, α = .94) and Barriers (n = 6, α = .82) were revealed. CFA confirmed models from EFAs/PCAs. Follow-up analyses of variance aligned with past theoretical predictions of the relationships between SOC, pros, cons, and SE, and the predicted relationships with myths and barriers. CONCLUSION This study produced reliable and valid measures of TTM constructs, myths, and barriers to understand motivation to receive COVID-19 vaccination that can be used in future research.
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Affiliation(s)
- Allegra Sacco
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Mark L Robbins
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Andrea L Paiva
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Kathleen Monahan
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Hayley Lindsey
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Cheyenne Reyes
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Andrea Rusnock
- Department of History, College of Arts and Sciences, University of Rhode Island, Kingston, RI, USA
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Olusanya OA, Tomar A, Thomas J, Alonge K, Wigfall LT. Application of the theoretical domains framework to identify factors influencing catch-up HPV vaccinations among male college students in the United States: A review of evidence and recommendations. Vaccine 2023; 41:3564-3576. [PMID: 37164820 DOI: 10.1016/j.vaccine.2023.04.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/13/2023] [Accepted: 04/26/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Genital human papillomavirus (HPV) infection is the most prevalent sexually transmitted infection among young adults ages 15-25 years in the United States (US). Although HPV vaccines are recommended for individuals ages through 26 years, vaccine completion rates remain substantially low. METHODS Accordingly, our study utilized a comprehensive - Theoretical Domains Framework (TDF) of behavior change to systematically identify facilitators and barriers to catch-up HPV vaccinations. Five databases - Medline, Embase, CINAHL, ERIC, and PsycINFO were searched from January 2009 to July 2019 for empirical studies using quantitative and qualitative methods to assess HPV vaccine uptake among males ages 18-26 years within US college and university settings. The TDF analytic process included a content analysis using the mixed deductive-inductive approach to extract, analyze and categorize data into TDF domains/themes and sub-themes. RESULTS Overall, 17 studies were selected for data extraction. We identified eleven key TDF domains that influenced HPV vaccination behavior among college male students: 'knowledge' (82% of included studies), 'environmental context and resources' (53%), 'beliefs about consequences' (53%), 'unrealistic optimism' (50%) and 'pessimism' (6%), 'emotion' (50%), 'social influences' (50%), 'beliefs about capabilities' (41%), 'intention' (24%), 'reinforcement' (18%), 'social professional role and identity'(12%), and 'behavioral regulation' (12%). Barriers influencing HPV vaccine uptake included lack of knowledge and awareness regarding HPV infections, HPV vaccine safety, effectiveness, side effects, and costs; absence of health providers' recommendations; lack of healthcare and health insurance; low levels of perceived susceptibility and severity for HPV infections; HPV vaccine misinformation; as well as social stigma and peer influences regarding HPV vaccinations. Enablers for HPV vaccine uptake included high levels of perceived benefits for HPV vaccines. DISCUSSION Our study theoretically identified factors influencing HPV vaccinations. This could inform the efficient planning, support, and implementation of interventions that facilitate catch-up HPV vaccination practices among high-risk males within college/university settings.
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Affiliation(s)
- Olufunto A Olusanya
- University of Tennessee Health Science Center (UTHSC), UTHSC-Oak Ridge National Laboratory Center for Biomedical Informatics, Department of Pediatrics, Le Bonheur Research Center, 50 N Dunlap, Memphis, TN 38103, United States.
| | - Aditi Tomar
- Department of Health and Kinesiology, Texas A&M University, 107 Gilchrist Building (Reception Area), Mail Stop 4243, College Station, TX 77842-4243, United States.
| | - Jonathan Thomas
- Department of Public Health Studies, Texas A&M School of Public Health, 212 Adriance Lab Rd, College Station, TX 77843, United States.
| | - Kemi Alonge
- Marshfield Clinic Health System, Marshfield, WI 54449, United States.
| | - Lisa T Wigfall
- MD Anderson Cancer Center, Cancer Prevention Research Training Program, The University of Texas MD Anderson Cancer Center, 1150 Pressler Street, Cancer Prevention Research Building (CPB7.3556), Houston, TX 77030, United States.
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Jin SW, Lee Y, Brandt HM. Human Papillomavirus (HPV) Vaccination Knowledge, Beliefs, and Hesitancy Associated with Stages of Parental Readiness for Adolescent HPV Vaccination: Implications for HPV Vaccination Promotion. Trop Med Infect Dis 2023; 8:tropicalmed8050251. [PMID: 37235299 DOI: 10.3390/tropicalmed8050251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
The vaccination against human papillomavirus (HPV) has shown effectiveness in preventing six different types of cancer. Despite a safe, effective HPV vaccine, vaccination coverage for adolescents remains suboptimal, especially in the Memphis, Tennessee metropolitan area. Parents/Guardians have a substantial influence on adolescent vaccination, but little is known about parental cognitive factors contributing to intent on adolescent HPV vaccination in this region. Thus, this study examined factors associated with stages of parental readiness for adolescent HPV vaccination by applying the transtheoretical model. A cross-sectional, online survey was conducted to collect quantitative data on sociodemographic characteristics; health-related information; HPV vaccination knowledge, beliefs, and hesitancy; and stages of readiness for adolescent HPV vaccination among parents. Convenience sampling was performed to recruit a total of 497 parents of adolescents aged 11-17 years in Shelby and Tipton Counties in Tennessee and DeSoto County in Mississippi. Binary logistic regression analyses showed that greater knowledge of HPV vaccination, greater perceived susceptibility to HPV, and lower levels of HPV vaccination hesitancy, respectively, distinguished higher from lower stages of parental readiness for adolescent HPV vaccination after controlling for other variables. The findings provide implications for developing readiness for stage-specific interventions targeted to effectively influence the parental decision-making process regarding HPV vaccination for adolescents.
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Affiliation(s)
- Seok Won Jin
- School of Social Work, The University of Memphis, 119 McCord Hall, Memphis, TN 38152, USA
- Department of Medical Humanities and Social Science, College of Medicine, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Yeonggeul Lee
- Social Science Research, University of Seoul, 163 Seoulsiripdaero, Dongdaemun-gu, Seoul 02504, Republic of Korea
| | - Heather M Brandt
- HPV Cancer Prevention Program, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
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Balcezak HC, Olusanya OA, Tomar A, Foster M, Wigfall LT. A 10-year systematic review of theory-driven approaches to increasing catch-up HPV vaccination rates among young adult males in colleges/university settings. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:2535-2547. [PMID: 33529122 DOI: 10.1080/07448481.2021.1873350] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 12/14/2020] [Accepted: 01/03/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To describe rates and identify factors associated with human papillomavirus (HPV) vaccination among young adult males in college/university settings. METHODS Study was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five electronic databases were searched for empirical studies published between 2009 and 2019 and focused on predictors for HPV vaccine uptake. Studies' methodological quality scores ranged between 12 and 23 points. RESULTS Five hundred and ninety eight titles/abstracts and 154 full-text articles were screened. Eighteen studies were included for final analysis. Results depicted participants' attitude, perceived susceptibility, severity, benefits, and barriers in receiving HPV vaccine. Many participants did not perceive themselves to be susceptible to HPV infection, and barriers to receiving HPV vaccine outweighed benefits. HPV knowledge and vaccination rates were relatively low among respondents. CONCLUSION Prevention campaigns that increase knowledge, promote positive attitudes, change perception of susceptibility, and address barriers may result in higher HPV vaccination rates among males in college/university settings.
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Affiliation(s)
- Hannah C Balcezak
- Division of Biomedical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
- Department of Health and Kinesiology, Transdisciplinary Center for Health Equity Research, Texas A&M University, College Station, Texas, USA
| | - Olufunto A Olusanya
- Department of Health and Kinesiology, Transdisciplinary Center for Health Equity Research, Texas A&M University, College Station, Texas, USA
- Department of Pediatrics, Oak Ridge National Laboratory Center for Biomedical Informatics, University of Tennessee Health Science Center (UTHSC), Memphis, Tennessee, USA
| | - Aditi Tomar
- Department of Health and Kinesiology, Transdisciplinary Center for Health Equity Research, Texas A&M University, College Station, Texas, USA
- Department of Health and Kinesiology, College of Education and Human Development, Texas A&M University, College Station, Texas, USA
| | - Margaret Foster
- Department of Client Services, Medical Science Library, Texas A&M University, College Station, Texas, USA
| | - Lisa T Wigfall
- Department of Health and Kinesiology, Transdisciplinary Center for Health Equity Research, Texas A&M University, College Station, Texas, USA
- Department of Health and Kinesiology, College of Education and Human Development, Texas A&M University, College Station, Texas, USA
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Darville-Sanders G, Burns J, Chavanduka T, Anderson-Lewis C. The Male Domain-Digital Game-Based Learning for Human Papillomavirus Vaccination Among Young Males. Games Health J 2022; 11:312-320. [PMID: 35856843 DOI: 10.1089/g4h.2021.0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Human papillomavirus (HPV) is the most common sexually transmitted disease, with the highest infection rates among those sexually active under 25. Although vaccination can reduce HPV cancers among men, public health interventions have primarily targeted females. Increased gaming rates among men provide innovative opportunities to motivate behavior change. This study sought to explore which game development and design strategies are most effective in a game for sexual health, specifically focused on HPV. We also sought to capture information relevant to preferred gaming platforms and game mechanics (health messages, avatars, and visual imagery). Materials and Methods: Twenty-two (n = 22) qualitative interviews were conducted with experts. Using grounded theory, interview data was coded, and emergent themes were identified. Results: Game mechanics most mentioned included simulation/role-playing, social interaction, narrative, and rewards. Experts felt it was important to keep the game in the context of the target audience and integrate the game into an existing game/game scenario or application. Experts also felt the game should link to external resources and enlist partnerships or collaborations with external health agencies. Moreover, while there are benefits to each gaming platform, games on mobile phones and tablets are most appropriate. Conclusion: Digital games are a nonconfrontational approach to discussing HPV and can increase knowledge/awareness and positively influence behavior change toward vaccine uptake. Digital games present a safe environment for role-playing through simulated activities without real-world consequences.
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Affiliation(s)
| | - Jade Burns
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Tanaka Chavanduka
- Department of Health Psychology and Clinical Science, The City University of New York, New York, New York, USA
| | - Charkarra Anderson-Lewis
- College of Nursing and Health Professions, The University of Southern Mississippi, Hattiesburg, Mississippi, USA
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Riccò M, Peruzzi S. Tetanus Vaccination Status and Vaccine Hesitancy in Amateur Basketball Players (Italy, 2020). Vaccines (Basel) 2022; 10:vaccines10010131. [PMID: 35062792 PMCID: PMC8778061 DOI: 10.3390/vaccines10010131] [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: 10/06/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 12/12/2022] Open
Abstract
Basketball is among the third most popular team sport in Italy. Albeit not usually perceived as being at high risk for tetanus, the Italian legal framework (Law No. 292 of 1963; Presidential Decree 1301/1965) requires tetanus vaccination (TeV) even for amateur practice. Even though some previous reports have suggested a relatively low adherence towards vaccination practice among basketball player, corresponding knowledge, attitudes and practices towards TeV remain largely unknown. Our study specifically investigated such topics in a total of 270 amateur basketball players participating into an internet-based survey by completing a structured questionnaire. Of them, 73.0% had a proper vaccination status, but a third of respondents (33.3%) exhibited some degree of vaccine hesitancy. The average understanding of TeV and tetanus (79.8% with a potential range 0–100) as well as the risk perception for natural infection (63.9% ± 26.6) were quite good. Even though unmotivated fears towards TeV were more scarcely reported (14.0% ± 15.4), they still represented the main reasons for having missed vaccination shots (63.0%). Knowledge status and risk perception for natural infection and TeV were well correlated (R = 0.22 and R = −0.64, respectively). Appropriate TeV status was more likely in respondents not exhibiting vaccine hesitancy (Odds Ratio (OR) 0.114, 95% Confidence Interval (95%CI) 0.059–0.225). In turn, vaccine hesitancy was more frequently reported among individuals of male gender (OR 3.148, 95%CI 1.072–9.244), while better formal education (OR 0.065, 95%CI 0.013–0.319) and working in healthcare settings (OR 0.042, 95%CI 0.007–0.265) were characterized as negative effectors. Vaccinations in athletes represent an often overlooked issue, with a considerable lack of available evidence. The results stress the opportunity for appropriate TeV screening programs among amateur athletes and the potential relevance of interventions aimed at raising the perceived significance of TeV in order to cope with a significant share of vaccine-hesitant athletes.
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Affiliation(s)
- Matteo Riccò
- Dipartimento di Sanità Pubblica, Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), AUSL—IRCCS di Reggio Emilia, Via Amendola n.2, I-42022 Reggio Emilia, Italy
- Correspondence: ; Tel.: +39-339-2994343
| | - Simona Peruzzi
- Laboratorio Analisi Chimico Cliniche e Microbiologiche, Ospedale Civile di Guastalla, AUSL—IRCCS di Reggio Emilia, I-42016 Guastalla, Italy;
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Laserson AK, Oliffe JL, Krist J, Kelly MT. HPV Vaccine and College-Age Men: A Scoping Review. Am J Mens Health 2020; 14:1557988320973826. [PMID: 33225805 PMCID: PMC7686636 DOI: 10.1177/1557988320973826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/20/2020] [Accepted: 10/23/2020] [Indexed: 12/15/2022] Open
Abstract
The human papillomavirus (HPV) potentially affects every sexually active man in the United States and Canada. In 2017, the vaccine became publicly funded in Canada for males ages 9-26, and was integrated into school vaccination programs. In 2019, HPV vaccination was recommended as routine for all U.S.-based males and females ages 9 through 26, and a shared decision for adults >26 years; however, since the approval of the vaccine in 2006 for females only, the age and dosing recommendations for males have followed a complicated and changing trajectory. Current adherence rates are low among college and university age males (18-26 years); therefore, understanding and addressing the barriers and facilitators for men's HPV vaccination is critically important. The purpose of the current scoping review is to provide a synthesis of recent literature pertaining to HPV in college and university age men, as a means to guiding health-care providers (HCPs). Drawing from 15 published articles, three thematic findings were inductively derived. Theme one, lack of awareness, was underpinned by men's knowledge deficits about their eligibility for, and the availability of HPV vaccines. Theme two, underestimating and embodying risk, included men's engagement in sexual activities while misinformed or denying the risk for contracting HPV. The third theme, strategies for increasing men's awareness, summarizes messaging strategies used to lobby young men to vaccinate. The review findings indicate gender-sensitive interventions targeting college-age men, including early, frequent, and consistent messaging on HPV are key.
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Affiliation(s)
- Alyssa K. Laserson
- School of Nursing, University of
British Columbia, Vancouver, BC, Canada
| | - John L. Oliffe
- School of Nursing, University of
British Columbia, Vancouver, BC, Canada
- Department of Nursing, University
of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer Krist
- School of Nursing, University of
British Columbia, Vancouver, BC, Canada
| | - Mary T. Kelly
- School of Nursing, University of
British Columbia, Vancouver, BC, Canada
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Shirazi M, Moradi K, Haeri Mehrizi AA, Keshmiri F, Montazeri A. Readiness to change for interprofessional collaboration in healthcare: Development and validation of a theory-based instrument. J Interprof Care 2018; 32:539-548. [PMID: 29589773 DOI: 10.1080/13561820.2018.1448371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This paper presents a study that aimed to develop and validate a theory-based instrument for the assessment of readiness to change for interprofessional collaboration in healthcare (IPC-TTM). The instrument was developed in the Persian language and tested in the Iranian context. Healthcare professionals from medical and nursing professions participated in the assessment of validity and reliability of the instrument. We conducted this psychometric study in two phases: First, the questionnaire was developed based on the transtheoretical model (TTM) through literature review and expert panel. Then, in the validation phase, we held three modified Delphi rounds to assess the content and face validity of the questionnaire. We used confirmatory factor analysis (CFA) to evaluate the fit of the questionnaire as applied to modified TTM. Reliability of the final instrument was tested by assessing the test-retest reliability of instrument items with Kappa coefficient. We also calculated the intraclass correlation coefficient (ICC) and Cronbach's alpha to assess the test-retest reliability and internal consistency of the instrument sub-scales. The initial item pool consisted of 30 items and three sub-scales (Attitude, Intention, and Action). The content validity of the questionnaire was confirmed with 17 items. Based on the CFA results two additional items were deleted to increase the fit of the model. The final instrument was confirmed with 15 items and three sub-scales. Reliability assessment on the 15-item instrument showed an acceptable test-retest reliability of the instrument items. ICC values for the Attitude, Intention, and Action sub-scales of the instrument were calculated as 0.82, 0.73, and 0.71, respectively. Moreover, Cronbach's alpha for the Attitude, Intention, and Action sub-scales were 0.85, 0.73, and 0.77, respectively. This study offers a new theory-based instrument to measure readiness to change for interprofessional collaboration in healthcare in the Iranian context. The questionnaire can be used for 'needs assessment' in developing tailored educational interventions and self-assessments in interprofessional education studies.
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Affiliation(s)
- Mandana Shirazi
- a Educational Development Center, Department of Medical Education , Tehran University of Medical Sciences , Tehran , Iran.,b Clinical Science Education Department , Karolinska Institutet , Sodersukest , Sweden
| | - Kamran Moradi
- c Evidence-Based Practice Research Center, Endocrine and Metabolism Research Institute , Shariati Hospital, Tehran University of Medical Sciences , Tehran , Iran
| | - Ali Asghar Haeri Mehrizi
- d Health Metrics Research Center , Iranian Institute for Health Sciences Research, Academic Center for Education, Culture and Research , Tehran , Iran
| | - Fatemeh Keshmiri
- e Educational Development Center, Medical Education Department , Health Faculty, Shahid Sadoughi University of Medical Sciences , Yazd , Iran
| | - Ali Montazeri
- d Health Metrics Research Center , Iranian Institute for Health Sciences Research, Academic Center for Education, Culture and Research , Tehran , Iran
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11
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Pitts MJ, Stanley SJ, Kim S. College Males' Enduring and Novel Health Beliefs about the HPV Vaccine. HEALTH COMMUNICATION 2017; 32:995-1003. [PMID: 27463072 DOI: 10.1080/10410236.2016.1196421] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
College males represent an important and overlooked catch-up population in the pursuit of human papillomavirus (HPV) prevention. An in-depth understanding of college males' health beliefs about HPV and HPV prevention can guide the development of HPV health promotion messages targeted toward college males. We convened 9 focus groups among 84 college-aged males to discuss their perceptions of benefits and barriers toward HPV prevention 4 years after vaccine approval. Through participants' discourse, we identified health beliefs that continue to endure as barriers to HPV prevention (e.g., lack of knowledge/awareness, apathy, dismissiveness, stigma, practical barriers, and skepticism). Prevention and protection endure as perceived benefits to HPV prevention. We also identified novel college male health beliefs that have emerged since vaccine approval and hold great potential for the development of more effective health messaging. One novel barrier that emerged was the perception that it was "too late" for college males to benefit from the vaccine. Several novel benefits also emerged including a perception of wider social benefit beyond the self and partner, reduced worry and anticipated regret, and the belief that "there is no reason not to [vaccinate]." This study was guided by the health belief model (HBM) and implications are discussed.
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Affiliation(s)
| | | | - Sara Kim
- a Department of Communication , University of Arizona
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12
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Santiago-Rivas M, Velicer WF, Redding C. Mediation analysis of decisional balance, sun avoidance and sunscreen use in the precontemplation and preparation stages for sun protection. Psychol Health 2015; 30:1433-49. [PMID: 26040293 DOI: 10.1080/08870446.2015.1056791] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Mediation analyses of sun protection were conducted testing structural equation models using longitudinal data with three waves. An effect was said to be mediated if the standardised path between processes of change, decisional balance and sun protection outcomes was significant. DESIGN Longitudinal models of sun protection using data from individuals in the precontemplation (N = 964) and preparation (N = 463) stages who participated of an expert system intervention. MAIN OUTCOME MEASURES Nine processes of change for sun protection, decisional balance constructs of sun protection (pros and cons), sun avoidance behaviour and sunscreen use. RESULTS With the exception of two processes in the preparation stage, processes of change predicted the pros (r = .126-.614), and the pros predicted the outcomes (r = .181-.272). Three models with the cons as mediator in the preparation stage, and none in the precontemplation stage, showed a mediated relationship between processes and outcomes. CONCLUSION In general, mediation analyses found both the process of change-to-pros and pros-to-behaviour paths significant for both precontemplation and preparation stages, and for both sun avoidance and sunscreen use outcomes. Findings provide support for the importance of assessing the role of underlying risk cognitions in improving sun protection adherence.
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Affiliation(s)
- Marimer Santiago-Rivas
- a Department of Oncological Sciences , Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Wayne F Velicer
- b Cancer Prevention Research Center , University of Rhode Island , Kingston , RI , USA
| | - Colleen Redding
- b Cancer Prevention Research Center , University of Rhode Island , Kingston , RI , USA
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