1
|
Cameron DB, Grage L, Van Wyck R, Edwards A, Chavez Mapaye J, Cheng A, Garcia G. Identifying trusted local sources and predicting behavior change pathways according to COVID-19 vaccination status: Results of a 2022 statewide survey of Alaskan adults. Vaccine 2024; 42:2592-2607. [PMID: 38490821 PMCID: PMC11005074 DOI: 10.1016/j.vaccine.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/08/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Low rates of COVID-19 vaccination remain a substantial public health challenge. Despite early successes, vaccinations of Alaskans trail the US average, drawing attention to the need for better-designed and targeted vaccine confidence interventions. Our objective was to assess levels of community trust and theory-driven predictors of vaccination status to inform the design of future programs. METHODS We conducted a cross-sectional, telephone-based survey of 940 Alaskan adults between May and June 2022. Data were collected on vaccination status (including initial vaccination and receipt of booster shots), trust in local community members, demographic characteristics, and thematic questions designed using the Capability, Opportunity, Motivation - Behavior (COM-B) model to examine possible predictors (barriers/facilitators) of vaccination status. FINDINGS Among those who are not fully vaccinated and boosted, we observe significantly lower trust placed in many immediate community members, especially health workers (e.g., doctors, nurses, specialty care physicians, health administrators). Firefighters and emergency medical technicians enjoy the most community trust, followed by medical professionals. Among those who received only a primary vaccine series, we find that perceptions of whether close friends are vaccinated, a sense of professional responsibility, and age were the strongest predictors vaccination status. Among the unvaccinated, we find significant predictive power from the same variables, as well as perceptions of whether family members are vaccinated, perceived risks from non-vaccination and whether vaccination is a healthy choice. CONCLUSIONS These findings will help inform the design and targeting of future vaccine promotion interventions to adult populations in Alaska. Interventions that leverage reflective motivation and social opportunity domains of the COM-B framework may be most effective. Local community members including firefighters and emergency medical technicians, as well as medical professionals may be perceived as the most trustworthy and influential messengers among those who are not fully vaccinated and boosted.
Collapse
Affiliation(s)
- Drew B Cameron
- Department of Health Policy and Management, Yale School of Public Health, Yale University, 60 College Street, New Haven, CT 06502, United States.
| | - Laura Grage
- Information Insights, PO Box 83070, Fairbanks, AK 99708, United States.
| | - Rebecca Van Wyck
- DPHS Institute for Circumpolar Health Sciences, University of Alaska, Anchorage, 3211 Providence Dr., Anchorage, AK 99508, United States; Institute for Social and Economic Research, University of Alaska, Anchorage, 3211 Providence Dr., Anchorage, AK 99508, United States.
| | - Alexandra Edwards
- Institute for Social and Economic Research, University of Alaska, Anchorage, 3211 Providence Dr., Anchorage, AK 99508, United States; Center for Behavioral Health Research & Services, University of Alaska, Anchorage, 3211 Providence Dr., Anchorage, AK 99508, United States.
| | - Joy Chavez Mapaye
- Department of Journalism and Public Communications, Fine Arts Building, 3211 Providence Drive, Anchorage, AK 99508, United States.
| | - Ann Cheng
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, 60 College Street, New Haven, CT 06502, United States; L&M Policy Research, 1743 Connecticut Ave NW, Suite 200, Washington, DC 20009, United States.
| | - Gabriel Garcia
- Division of Population Health Sciences, University of Alaska, 3211 Providence Dr., PSB 206J, Anchorage, AK 99508, United States.
| |
Collapse
|
2
|
Grage L, Cuellar MJ. Did text-based news-media coverage about the COVID-19 pandemic increase vaccine uptake? A population-based study in Alaska. Int J Circumpolar Health 2023; 82:2213913. [PMID: 37216574 DOI: 10.1080/22423982.2023.2213913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/18/2023] [Accepted: 05/10/2023] [Indexed: 05/24/2023] Open
Abstract
COVID-19 vaccinations protect against severe infection, hospitalisation, and death. News media can be an important source of information for the public during a health crisis. This study explores the extent to which local or statewide text-based news coverage of the pandemic was related to the uptake of initial doses of COVID-19 vaccines among adults in Alaska. Multilevel modelling was employed to explore the association between news media intensity and vaccine uptake rates across boroughs and census areas, while controlling for relevant covariates. Results suggest that the intensity of news media did not significantly influence vaccine uptake during the majority of this time period and had a negative affect during the Delta-surge in the fall of 2021. However, the political lean and median age of boroughs or census areas were significantly associated with vaccine uptake. Race, poverty, or education were not significant determinants of vaccine uptake suggesting there are unique differences in Alaska compared to the U.S., particularly amongst Alaska Native people. The political environment in Alaska surrounding the pandemic was polarized. Future research in communications and channels that can cut through this polarized and politicized environment, and reach younger adults is needed.
Collapse
Affiliation(s)
- Laura Grage
- College of Health, Division of Population Health Sciences, University of Alaska Anchorage, Anchorage, Alaska, USA
| | - Matthew J Cuellar
- College of Health, School of Social Work, University of Alaska Anchorage, Anchorage, Alaska, USA
| |
Collapse
|
3
|
Grage L, Wise F, Meyer J. Exploring factors associated with parent-reported early childhood caries with Alaska's childhood understanding behaviors survey data. J Public Health Dent 2023; 83:284-291. [PMID: 37309218 DOI: 10.1111/jphd.12577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/03/2023] [Accepted: 05/17/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Early Childhood Caries (ECC) can negatively impact the lives of young children, despite being preventable. The purpose of this study was to utilize available data in Alaska to describe changes in parent reports of ECC, and identify factors related to ECC. METHODS The Childhood Understanding Behaviors Survey (CUBS) is a population-based survey of parents of 3-year-old children and was utilized to describe changes in: parent-reported ECC among children with a dental visit, access to and or utilization of dental care, and consumption of three or more cups of sweetened beverages between 2009-2011 and 2016-2019. Logistic regression modeling was used to explore factors associated with parent-reported ECC among children with a dental visit. RESULTS Over time, a significantly smaller proportions of parents whose 3-year-old child had seen a dental professional reported ECC. Additionally, a smaller proportion of parents reported three or more cups of sweetened beverage consumption by their child, while larger proportions had seen a dental professional by age 3. Factors associated with parent-reported ECC included consumption of three or more cups of sweetened beverages, and enrollment in Medicaid or Tribal health care insurance, while protective factors included a parent earning a college degree, and military insurance. CONCLUSIONS Although at the statewide level, improvements were observed in parent-reported measures over time, regional disparities were apparent. Social and economic factors as well as excessive consumption of sweetened beverages appear to play important roles in ECC. CUBS data can help identify trends in ECC within Alaska.
Collapse
Affiliation(s)
- Laura Grage
- Division of Population Health Sciences, University of Alaska Anchorage, Anchorage, AK, USA
| | - Frances Wise
- State of Alaska, Department of Health, Anchorage, AK, USA
| | - Jennifer Meyer
- Division of Population Health Sciences, University of Alaska Anchorage, Anchorage, AK, USA
| |
Collapse
|