1
|
Peretti-Watel P, Fressard L, Giry B, Verger P, Ward JK. Social Stigma and COVID-19 Vaccine Refusal in France. J Health Polit Policy Law 2024:11186095. [PMID: 38324348 DOI: 10.1215/03616878-11186095] [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] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
CONTEXT In 2021, French health authorities strongly promoted the vaccination against Covid-19. We assumed that refusing this vaccine became a 'stigma', and we investigated potential 'public stigma' toward unvaccinated people among the French population. METHODS A representative sample of the French adult population (N = 2,015) completed an online questionnaire in September 2021. We focused on participants who were already vaccinated against Covid-19, or intended to get vaccinated (N = 1,742). A cluster analysis was used to obtain contrasted attitudinal profiles, and we investigated associated factors with logistic regressions. FINDINGS Regarding attitudes toward unvaccinated people, several pejorative statements were supported by a majority of respondents, and a significant minority also endorsed social rejection attitudes. We found four contrasted attitudinal profiles: Moral condemnation only (32% of respondents), Full stigma (26%), No stigma (26%) and Stigma rejection (16%). Early vaccination, civic motives for it, faith in science, rejection of political extremes and being 65 or over were the main factors of stigmatizing attitudes toward unvaccinated people. CONCLUSIONS We found some evidence of stigmatization toward unvaccinated people, but further research is needed, especially to investigate perceived stigmatization among them. We discussed our results in reference with the concept of 'Folk Devils', and from a public health perspective.
Collapse
|
2
|
Garrison A, Fressard L, Mitilian E, Gosselin V, Berthiaume P, Casanova L, Gagneur A, Verger P. Motivational interview training improves self-efficacy of GP interns in vaccination consultations: A study using the Pro-VC-Be to measure vaccine confidence determinants. Hum Vaccin Immunother 2023; 19:2163809. [PMID: 36703495 PMCID: PMC10012912 DOI: 10.1080/21645515.2022.2163809] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Immunization-specific motivational interviewing (MI), a patient-centered communication style used to encourage internal motivation for attitudinal and behavioral change, can provide healthcare professionals (HCPs) with the skills and practice required to respond to patients' doubts and concerns related to vaccines. We sought to assess the impact of an MI-training of General Practitioner (GP) interns on the psychosocial determinants of their vaccine confidence and behaviors. French GP interns participated in a virtual three-day MI-workshop in southeastern France. We used the validated Pro-VC-Be questionnaire - before and after the MI-workshop spanning over three months - to measure the evolution of these determinants. Scores before and after workshop trainings were compared in pairs. Participants' scores for commitment to vaccination (+10.5 ± 20.5, P = .001), perceived self-efficacy (+36.0 ± 25.8, P < .0001), openness to patients (+18.7 ± 17.0, P < .0001), and trust in authorities (+9.5 ± 17.2, P = 0.01) significantly increased after the training sessions, but not the score for confidence in vaccines (+1.5 ± 11.9, P = .14). The effect sizes of the four score improvements were moderate to large, with self-efficacy and openness to patients having the largest effect sizes (P = .83 and 0.78, respectively). This study provides evidence that certain determinants of overall vaccine confidence in HCPs, reflected respectively in the openness to patients and self-efficacy scores of the Pro-VC-Be, improve after immunization MI-training workshops. Incorporating immunization-specific MI-training in the curriculum for HCPs could improve several necessary skills to improve HCP-patient relationships and be useful for vaccination and other healthcare services.
Collapse
Affiliation(s)
- Amanda Garrison
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
| | - Lisa Fressard
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
| | - Eva Mitilian
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France.,Faculté des Sciences Médicales et Paramédicales, Département Universitaire de Médecine Générale (DUMG), Aix Marseille Université, Marseille, France
| | - Virginie Gosselin
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | | | - Ludovic Casanova
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France.,Faculté des Sciences Médicales et Paramédicales, Département Universitaire de Médecine Générale (DUMG), Aix Marseille Université, Marseille, France
| | - Arnaud Gagneur
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.,Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Pierre Verger
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
| |
Collapse
|
3
|
Brosset E, Fressard L, Cogordan C, Bocquier A, Annequin M, Bourrelly M, Constance J, Michels D, Mora M, Morel S, Oliveri C, Maradan G, Berenger C, Spire B, Verger P. Gradient of vaccine hesitancy among French men having sex with men: An electronic cross-sectional survey in 2022. Hum Vaccin Immunother 2023; 19:2293489. [PMID: 38093684 PMCID: PMC10730215 DOI: 10.1080/21645515.2023.2293489] [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: 10/23/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
In developed countries, vaccinations against hepatitis B (HBV), hepatitis A (HAV), and human papillomavirus (HPV) are often recommended to men who have sex with men (MSM) because of the risky sexual practices in which some engage. Vaccine coverage against these diseases is not optimal in France, probably due in part to vaccine hesitancy (VH). The overall aim of this survey among MSM was to estimate the prevalence of different grades of VH for these vaccines as well as of general VH (toward any vaccine). The specific objectives were to study the sociodemographic correlates of MSM specific and general VH and its association with vaccine uptake. A cross-sectional electronic survey (February-August 2022) collected information from 3,730 French MSM about their perceptions of HBV, HAV, and HPV and their related vaccines, to construct "specific VH" variables. Information about their past vaccination behaviors for any vaccine was used to construct a "general VH" variable, based on the World Health Organization definition. Almost 90% of MSM showed moderate or high specific VH for HBV, HAV, and/or HPV, and 54% general VH. A higher education level and comfortable financial situation were associated with lower grades of specific and general VH. Younger age was associated with less frequent specific VH and more frequent general VH. Specific VH, versus general, was more strongly associated with frequent self-reported non-vaccination against these three disease. Addressing their concerns about vaccines, improving their knowledge of vaccine-preventable sexually transmitted infections, and motivating them to get vaccinated are public health priorities.
Collapse
Affiliation(s)
- Emeline Brosset
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Lisa Fressard
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Chloé Cogordan
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Aurélie Bocquier
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- Université de Lorraine, APEMAC , Nancy, France
| | - Margot Annequin
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Michel Bourrelly
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Jean Constance
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - David Michels
- AIDES, Pantin, France
- Laboratoire de recherche communautaire, Coalition PLUS, Pantin, France
| | - Marion Mora
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | | | - Camilla Oliveri
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Gwenaëlle Maradan
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Cyril Berenger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Bruno Spire
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| |
Collapse
|
4
|
Barré T, Di Beo V, Roux P, Mourad A, Verger P, Fressard L, Herault T, Buyck JF, Beck F, Carrieri P. Screening for alcohol use in primary care: assessing French general practitioner practices. Alcohol Alcohol 2023; 58:672-682. [PMID: 37818974 DOI: 10.1093/alcalc/agad067] [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: 06/06/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/13/2023] Open
Abstract
Alcohol use is a leading risk factor for premature death and disability. To tackle this issue, more systematic and accurate screening for at-risk consumption is needed in healthcare systems, especially by general practitioners (GPs). We assessed the frequency of at-risk consumption screening by GPs in France. We also identified characteristics associated with more frequent screening and greater use of validated screening tools by these healthcare providers. A cross-sectional survey was conducted among a representative sample of French GPs. Multinomial logistic regressions were used to identify factors associated with more frequent screening and greater use of validated screening tools. Response rate was of 73%. Of the 2412 participants, 42.8% screened all their patients systematically and repeatedly, while 48.0% never used standardized tools to screen potentially at-risk patients. Among other characteristics, being aware of and using the "early identification and brief intervention" screening strategy, and feeling absolutely comfortable talking with patients about reducing or stopping their alcohol use, were both associated with more frequent screening and use of standardized tools. Our results on at-risk alcohol use screening highlight an improvement over data from previous studies. Nevertheless, better training of French GPs in good alcohol screening practices-specifically, increased screening frequency and greater use of standardized tools-may improve identification of at-risk patients.
Collapse
Affiliation(s)
- Tangui Barré
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
| | - Vincent Di Beo
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
| | - Perrine Roux
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
| | - Abbas Mourad
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
| | - Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Faculté des Sciences Médicales et Paramédicales, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Lisa Fressard
- ORS PACA, Southeastern Health Regional Observatory, Faculté des Sciences Médicales et Paramédicales, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Thomas Herault
- Union Régionale des Médecins Libéraux des Pays de La Loire, 13 rue de la Loire, Bâtiment C2, 44230 Saint Sébastien-sur-Loire, Nantes, France
| | - Jean-François Buyck
- Observatoire Régional de La Santé Des Pays de La Loire, 2 Rue de la Loire, 44200 Nantes, France
| | - François Beck
- Santé Publique France, 12, rue du Val d'Osne 94 415 Saint-Maurice cedex, France
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP), Inserm U1018, Université Paris-Saclay, Université Paris-Sud, Université Versailles Saint-Quentin (UVSQ), 16 Av. Paul Vaillant Couturier, 94800 Villejuif, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
| |
Collapse
|
5
|
Verger P, Cogordan C, Fressard L, Gosselin V, Donato X, Biferi M, Verlomme V, Sonnier P, Meur H, Malfait P, Berthiaume P, Ramalli L, Gagneur A. A postpartum intervention for vaccination promotion by midwives using motivational interviews reduces mothers' vaccine hesitancy, south-eastern France, 2021 to 2022: a randomised controlled trial. Euro Surveill 2023; 28:2200819. [PMID: 37733238 PMCID: PMC10515496 DOI: 10.2807/1560-7917.es.2023.28.38.2200819] [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: 10/10/2022] [Accepted: 04/17/2023] [Indexed: 09/22/2023] Open
Abstract
BackgroundDespite childhood vaccine mandates imposed in 2018 in France, parental vaccine hesitancy (VH) remains frequent. Interventions in Quebec, Canada, applying motivational interviewing (MI) techniques have successfully reduced parents' VH for childhood immunisations.AimTo determine whether MI intervention for mothers in maternity wards in the days after birth in France could significantly reduce VH, increase intentions to vaccinate (VI) their child at 2 months and reduce VH social inequalities.MethodsWe conducted a parallel-arm multicentre randomised controlled trial from November 2021 to April 2022 to compare impacts of MI performed by MI-trained midwives (intervention) vs a vaccination leaflet (control). We included 733 mothers from two maternity hospitals in south-eastern France, randomly assigned either arm. The validated Parents Attitudes about Childhood Vaccines questionnaire was used before and after MI or leaflet to assess mothers' VH (13 items, 0-100 score) and VI (1 item, 1-10 score). Difference-in-difference (D-I-D) models were used to estimate net impact of MI vs leaflet for the entire sample and stratified by VH and education level.ResultsMotivational interview intervention reduced mothers' VH score by 33% (p < 0.0001) and increased VI by 8% (p < 0.0001); the effect was largest for the highest initial VH levels. D-I-D analyses estimated net VH decrease at 5.8/100 points (p = 0.007) and net VI increase at 0.6/10 points (p = 0.005). Net VH decrease was highest for high initial VH levels and low education levels.ConclusionsOur results show positive effects of MI intervention, and means of its implementation should be investigated in France.
Collapse
Affiliation(s)
- Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Chloé Cogordan
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Lisa Fressard
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | | | - Xavier Donato
- Maternity ward, Saint-Joseph Hospital, Marseille, France
| | | | | | - Pierre Sonnier
- Comité Régional d'Education pour la Santé Provence-Alpes-Côte-D'Azur, Marseille, France
| | - Hervé Meur
- Agence Régionale de Santé Provence-Alpes-Côte-D'Azur, Marseille, France
| | - Philippe Malfait
- Santé publique France (French National Public Health Agency), Marseille, France
| | | | - Lauriane Ramalli
- Santé publique France (French National Public Health Agency), Marseille, France
| | | |
Collapse
|
6
|
Cogordan C, Fressard L, Ramalli L, Rebaudet S, Malfait P, Dutrey-Kaiser A, Attalah Y, Roy D, Berthiaume P, Gagneur A, Verger P. Motivational interview-based health mediator interventions increase intent to vaccinate among disadvantaged individuals. Hum Vaccin Immunother 2023; 19:2261687. [PMID: 37772602 PMCID: PMC10543359 DOI: 10.1080/21645515.2023.2261687] [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: 05/25/2023] [Accepted: 09/19/2023] [Indexed: 09/30/2023] Open
Abstract
Coverage for recommended COVID-19 and diphtheria-tetanus-poliomyelitis (DTP) booster shots is often inadequate, especially among disadvantaged populations. To help health mediators (HMs) involved in outreach programs deal with the problems of vaccine hesitancy (VH) in these groups, we trained them in motivational interviewing (MI). We evaluated the effectiveness of this training among HMs on their MI knowledge and skills (objective 1) and among the interviewees on their vaccination readiness (VR) and intention to get vaccinated or accept a booster against COVID-19 and/or DTP (objective 2). Two MI specialists trained 16 HMs in a two-day workshop in May 2022. The validated MISI questionnaire evaluated HMs' acquisition of MI knowledge and skills (objective 1). Trained HMs offered an MI-based intervention on vaccination to people in disadvantaged neighborhoods of Marseille (France). Those who consented completed a questionnaire before and after the interview to measure VR with the 7C scale and intentions regarding vaccination/booster against COVID-19 and DTP (objective 2). The training resulted in HMs acquiring good MI skills (knowledge, application, self-confidence in using it). HMs enrolled 324 interviewees, 96% of whom completed both questionnaires. VR increased by 6%, and intentions to get vaccinated or update COVID-19 and DTP vaccination increased by 74% and 52% respectively. Nearly all interviewees were very satisfied with the interview, although 21% still had questions about vaccination. HMs assimilated MI principles well. MI use in outreach programs appears to show promise in improving vaccine confidence and intentions among disadvantaged people.
Collapse
Affiliation(s)
- Chloé Cogordan
- Southeastern Health Regional Observatory, ORS PACA, Marseille, France
| | - Lisa Fressard
- Southeastern Health Regional Observatory, ORS PACA, Marseille, France
| | - Lauriane Ramalli
- Santé publique France (French National Public Health Agency), Marseille, France
| | - Stanislas Rebaudet
- Hôpital Européen, Marseille, France
- UMR1252 SESSTIM, Aix-Marseille University, Inserm, IRD, ISSPAM, Marseille, France
| | - Philippe Malfait
- Santé publique France (French National Public Health Agency), Marseille, France
| | | | | | - David Roy
- Centre de recherche du CHUS, Sherbrooke, QC, Canada
| | | | - Arnaud Gagneur
- Centre de recherche du CHUS, Sherbrooke, QC, Canada
- Department of Pediatrics, Sherbrooke University, Sherbrooke, QC, Canada
| | - Pierre Verger
- Southeastern Health Regional Observatory, ORS PACA, Marseille, France
| |
Collapse
|
7
|
Karlsson LC, Garrison A, Holford D, Fasce A, Lewandowsky S, Taubert F, Schmid P, Betsch C, Rodrigues F, Fressard L, Verger P, Soveri A. Healthcare professionals' attitudes to mandatory COVID-19 vaccination: Cross-sectional survey data from four European countries. Hum Vaccin Immunother 2023; 19:2256442. [PMID: 37724556 PMCID: PMC10512846 DOI: 10.1080/21645515.2023.2256442] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/29/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023] Open
Abstract
Mandatory vaccinations are widely debated since they restrict individuals' autonomy in their health decisions. As healthcare professionals (HCPs) are a common target group of vaccine mandates, and also form a link between vaccination policies and the public, understanding their attitudes toward vaccine mandates is important. The present study investigated physicians' attitudes to COVID-19 vaccine mandates in four European countries: Finland, France, Germany, and Portugal. An electronic survey assessing attitudes to COVID-19 vaccine mandates and general vaccination attitudes (e.g. perceived vaccine safety, trust in health authorities, and openness to patients) was sent to physicians in the spring of 2022. A total of 2796 physicians responded. Across all countries, 78% of the physicians were in favor of COVID-19 vaccine mandates for HCPs, 49% favored COVID-19 vaccine mandates for the public, and 67% endorsed COVID-19 health passes. Notable differences were observed between countries, with attitudes to mandates found to be more positive in countries where the mandate, or similar mandates, were in effect. The associations between attitudes to mandates and general vaccination attitudes were mostly small to neglectable and differed between countries. Nevertheless, physicians with more positive mandate attitudes perceived vaccines as more beneficial (in Finland and France) and had greater trust in medical authorities (in France and Germany). The present study contributes to the body of research within social and behavioral sciences that support evidence-based vaccination policymaking.
Collapse
Affiliation(s)
- Linda C. Karlsson
- Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Amanda Garrison
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Potsdam, Potsdam, Germany
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Frederike Taubert
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Implementation Research, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
| | - Philipp Schmid
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Implementation Research, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
- Centre for Language Studies, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Cornelia Betsch
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Implementation Research, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
| | | | - Lisa Fressard
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Pierre Verger
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Anna Soveri
- Department of Clinical Medicine, University of Turku, Turku, Finland
| |
Collapse
|
8
|
Gauna F, Verger P, Fressard L, Jardin M, Ward JK, Peretti-Watel P. Vaccine hesitancy about the HPV vaccine among French young women and their parents: a telephone survey. BMC Public Health 2023; 23:628. [PMID: 37005583 PMCID: PMC10066945 DOI: 10.1186/s12889-023-15334-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/28/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND The human papillomavirus (HPV) vaccine reduces the burden of cervical and other cancers. In numerous countries, a slow uptakeof this vaccine persists, calling for a better understanding of the structural factors leading to vaccine acceptation. We aimed to assess the attitudes toward HPV vaccination among its intended public to explore its specific characteristics. METHODS A random cross-sectional telephone survey of the French general population provided data from a sample of 2426 respondents of the target public: the parents of young women and the young women aged 15-25 themselves. We applied cluster analysis to identify contrasting attitudinal profiles, and logistic regressions with a model averaging method to investigate and rank the factors associated with these profiles. RESULTS A third of the respondents had never heard of HPV. However, most of the respondents who had heard of it agreed that it is a severe (93.8%) and frequent (65.1%) infection. Overall, 72.3% of them considered the HPV vaccine to be effective, but 54% had concerns about its side effects. We identified four contrasting profiles based on their perceptions of this vaccine: informed supporters, objectors, uninformed supporters, and those who were uncertain. In multivariate analysis, these attitudinal clusters were the strongest predictors of HPV vaccine uptake, followed by attitudes toward vaccination in general. CONCLUSIONS Tailored information campaigns and programs should address the specific and contrasted concerns about HPV vaccination of both young women and of their parents.
Collapse
Affiliation(s)
- Fatima Gauna
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.
- IHU-Méditerranée Infection, Marseille, France.
| | - Pierre Verger
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - Lisa Fressard
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - Marie Jardin
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Jeremy K Ward
- CERMES3 (INSERM, CNRS, EHESS, Université de Paris), Villejuif, France
| | - Patrick Peretti-Watel
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| |
Collapse
|
9
|
Garrison A, Karlsson L, Fressard L, Fasce A, Rodrigues F, Schmid P, Taubert F, Holford D, Lewandowsky S, Nynäs P, Anderson EC, Gagneur A, Dubé E, Soveri A, Verger P. International adaptation and validation of the Pro-VC-Be: measuring the psychosocial determinants of vaccine confidence in healthcare professionals in European countries. Expert Rev Vaccines 2023; 22:726-737. [PMID: 37507356 DOI: 10.1080/14760584.2023.2242479] [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: 02/18/2023] [Revised: 06/29/2023] [Accepted: 07/26/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Healthcare professionals (HCPs) play an important role in vaccination; those with low confidence in vaccines are less likely to recommend them to their patients and to be vaccinated themselves. The study's purpose was to adapt and validate long- and short-form versions of the International Professionals' Vaccine Confidence and Behaviors (I-Pro-VC-Be) questionnaire to measure psychosocial determinants of HCPs' vaccine confidence and their associations with vaccination behaviors in European countries. RESEARCH DESIGN AND METHODS After the original French-language Pro-VC-Be was culturally adapted and translated, HCPs involved in vaccination (mainly GPs and pediatricians) across Germany, Finland, France, and Portugal completed a cross-sectional online survey in 2022. A 10-factor multigroup confirmatory factor analysis (MG-CFA) of the long-form (10 factors comprising 34 items) tested for measurement invariance across countries. Modified multiple Poisson regressions tested the criterion validity of both versions. RESULTS 2,748 HCPs participated. The 10-factor structure fit was acceptable to good everywhere. The final MG-CFA model confirmed strong factorial invariance and showed very good fit. The long- and short-form I-Pro-VC-Be had good criterion validity with vaccination behaviors. CONCLUSION This study validates the I-Pro-VC-Be among HCPs in four European countries; including long- and short-form tools for use in research and public health.
Collapse
Affiliation(s)
- Amanda Garrison
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Lisa Fressard
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Philipp Schmid
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Frederike Taubert
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Potsdam, Potsdam, Germany
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Peter Nynäs
- Faculty of Arts, Psychology and Theology, Abo Akademi University, Turku, Finland
| | | | - Arnaud Gagneur
- Department of Pediatrics, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Eve Dubé
- Département d'anthropologie, Faculté des Sciences Sociales, Université Laval, Laval, Canada
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Pierre Verger
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| |
Collapse
|
10
|
Mitilian E, Gosselin V, Casanova L, Fressard L, Berthiaume P, Verger P, Gagneur A. Assessment of training of general practice interns in motivational interviews about vaccination. Hum Vaccin Immunother 2022; 18:2114253. [PMID: 36494997 PMCID: PMC9746523 DOI: 10.1080/21645515.2022.2114253] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The effectiveness of motivational interviewing (MI) for reducing vaccine hesitancy (VH) has been demonstrated in Quebec. We conducted a study to evaluate the acquisition of MI skills after MI training via videoconferencing for interns training as general practitioners (GPs) in southeastern France. A vaccination-specific MI training workshop was offered to interns in 2021, consisting of two separate Zoom videoconference sessions. Participants completed the Motivational Interviewing Skills in Immunization questionnaire before and after the training to measure skills acquisition. We used pairwise exact Wilcoxon-Pratt signed rank tests for the analysis. Among 45 GP interns enrolled in the first MI session, 34 (75.6%) attended both sessions and completed the questionnaire at 3 different time points. After the first session, MI knowledge scores improved significantly (+21.1 ± 21.6; P < .0001), as did application of MI skills (+36.8 ± 36.7; P < .0001), and MI practice confidence (+21.2 ± 11.1; P < .0001). The second MI session maintained the skills developed after the first session without further improvement. Participant satisfaction was high. This is the first study in France assessing the impact of a vaccination-specific MI training for GP interns. It shows a substantial improvement in knowledge, application of MI skills, and self-confidence in the practice of MI. GP interns were highly satisfied with the training despite the videoconference format. These promising results will allow the integration of MI training in GP medical curricula in order to prepare future GPs for communication in the field of vaccination.
Collapse
Affiliation(s)
- Eva Mitilian
- Aix Marseille Univ, DUMG, département universitaire de médecine générale, Marseille, France,ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France,CONTACT Eva Mitilian Aix Marseille Univ, DUMG, département universitaire de médecine générale, 40, rue Saint-Bruno, Marseille13004
| | - Virginie Gosselin
- Centre de Recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Ludovic Casanova
- Aix Marseille Univ, DUMG, département universitaire de médecine générale, Marseille, France,ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France
| | - Lisa Fressard
- ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France
| | | | - Pierre Verger
- ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France
| | - Arnaud Gagneur
- Centre de Recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada,Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| |
Collapse
|
11
|
Garrison A, Fressard L, Karlsson L, Soveri A, Fasce A, Lewandowsky S, Schmid P, Gagneur A, Dubé E, Verger P. Measuring psychosocial determinants of vaccination behavior in healthcare professionals: validation of the Pro-VC-Be short-form questionnaire. Expert Rev Vaccines 2022; 21:1505-1514. [PMID: 35938710 DOI: 10.1080/14760584.2022.2108800] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Vaccine confidence among health care professionals (HCPs) is a key determinant of vaccination behaviors. We validate a short-form version of the 31-item Pro-VC-Be (Health Professionals Vaccine Confidence and Behaviors) questionnaire that measures HCPs' confidence in and commitment to vaccination. RESEARCH DESIGN AND METHODS A cross-sectional survey among 2,696 HCPs established a long-form tool to measure 10 dimensions of psychosocial determinants of vaccination behaviors. Confirmatory factor analysis (CFA) models tested the construct validity of 69,984 combinations of items in a 10-item short form tool. The criterion validity of this tool was tested with four behavioral and attitudinal outcomes using weighted modified Poisson regressions. An immunization resource score was constructed from summing the responses of the dimensions that can influence HCPs' pro-vaccination behaviors: vaccine confidence, proactive efficacy, and trust in authorities. RESULTS The short-form tool showed good construct validity in CFA analyses (RMSEA = 0.035 [0.024; 0.045]; CFI = 0.956; TLI = 0.918; SRMR 0.027) and comparable criterion validity to the long-form tool. The immunization resource score showed excellent criterion validity. CONCLUSIONS The Pro-VC-Be short-form showed good construct validity and criterion validity similar to the long-form and can therefore be used to measure determinants of vaccination behaviors among HCPs.
Collapse
Affiliation(s)
- Amanda Garrison
- Faculty of Medicine, ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Lisa Fressard
- Faculty of Medicine, ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK.,School of Psychological Science, University of Western Australia, Perth, Australia
| | - Philipp Schmid
- Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Arnaud Gagneur
- Department of Pediatrics, Centre de Recherche du CHUS, Sherbrooke, Quebec, Canada.,Département de Pédiatrie, Université de Sherbrooke-Campus de la Santé, Sherbrooke, Quebec, Canada
| | - Eve Dubé
- Department of Anthropology, Laval University, Quebec City, Quebec, Canada
| | - Pierre Verger
- Faculty of Medicine, ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| |
Collapse
|
12
|
Bocquier A, Jacquemot AF, Dubois C, Tréhard H, Cogordan C, Maradan G, Cortaredona S, Fressard L, Davin-Casalena B, Vinet A, Verger P, Darmon N, Arquier V, Briclot G, Chamla R, Cousson-Gélie F, Danthony S, Delrieu K, Dessirier J, Féart C, Fusinati C, Gazan R, Gibert M, Lamiraud V, Maillot M, Nadal D, Trotta C, Verger EO, Viriot V. Study protocol for a pragmatic cluster randomized controlled trial to improve dietary diversity and physical fitness among older people who live at home (the "ALAPAGE study"). BMC Geriatr 2022; 22:643. [PMID: 35927684 PMCID: PMC9351201 DOI: 10.1186/s12877-022-03260-8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diet and physical activity are key components of healthy aging. Current interventions that promote healthy eating and physical activity among the elderly have limitations and evidence of French interventions' effectiveness is lacking. We aim to assess (i) the effectiveness of a combined diet/physical activity intervention (the "ALAPAGE" program) on older peoples' eating behaviors, physical activity and fitness levels, quality of life, and feelings of loneliness; (ii) the intervention's process and (iii) its cost effectiveness. METHODS We performed a pragmatic cluster randomized controlled trial with two parallel arms (2:1 ratio) among people ≥60 years old who live at home in southeastern France. A cluster consists of 10 people participating in a "workshop" (i.e., a collective intervention conducted at a local organization). We aim to include 45 workshops randomized into two groups: the intervention group (including 30 workshops) in the ALAPAGE program; and the waiting-list control group (including 15 workshops). Participants (expected total sample size: 450) will be recruited through both local organizations' usual practices and an innovative active recruitment strategy that targets hard-to-reach people. We developed the ALAPAGE program based on existing workshops, combining a participatory and a theory-based approach. It includes a 7-week period with weekly collective sessions supported by a dietician and/or an adapted physical activity professional, followed by a 12-week period of post-session activities without professional supervision. Primary outcomes are dietary diversity (calculated using two 24-hour diet recalls and one Food Frequency Questionnaire) and lower-limb muscle strength (assessed by the 30-second chair stand test from the Senior Fitness Test battery). Secondary outcomes include consumption frequencies of main food groups and water/hot drinks, other physical fitness measures, overall level of physical activity, quality of life, and feelings of loneliness. Outcomes are assessed before the intervention, at 6 weeks and 3 months later. The process evaluation assesses the fidelity, dose, and reach of the intervention as its causal mechanisms (quantitative and qualitative data). DISCUSSION This study aims to improve healthy aging while limiting social inequalities. We developed and evaluated the ALAPAGE program in partnership with major healthy aging organizations, providing a unique opportunity to expand its reach. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05140330 , December 1, 2021. PROTOCOL VERSION Version 3.0 (November 5, 2021).
Collapse
Affiliation(s)
- Aurélie Bocquier
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France. .,Université de Lorraine, APEMAC, F-54000, Nancy, France.
| | - Anne-Fleur Jacquemot
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Bordeaux Population Health Research Center, University of Bordeaux, Inserm, UMR 1219, F-33000, Bordeaux, France
| | | | - Hélène Tréhard
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, INSERM, SESSTIM, Aix Marseille Institute of Public Health, ISSPAM, Marseille, France
| | - Chloé Cogordan
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Gwenaëlle Maradan
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Sébastien Cortaredona
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Lisa Fressard
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | | | - Agnès Vinet
- Avignon Université, UPR EA4278, F-84000, Avignon, France
| | - Pierre Verger
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Nicole Darmon
- MoISA, Université de Montpellier, CIHEAM-IAMM, CIRAD, INRAE, Institut Agro, IRD, Montpellier, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Verger P, Fressard L, Soveri A, Dauby N, Fasce A, Karlsson L, Lewandoswky S, Schmid P, Dube E, Gagneur A. An instrument to measure psychosocial determinants of health care professionals' vaccination behavior: Validation of the Pro-VC-Be questionnaire. Expert Rev Vaccines 2022; 21:693-709. [PMID: 35238274 DOI: 10.1080/14760584.2022.2046467] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The lack of validated instruments assessing vaccine hesitancy/confidence among health care professionals (HCPs) for themselves, and their patients led us to develop and validate the Pro-VC-Be instrument to measure vaccine confidence and other psychosocial determinants of HCPs' vaccination behavior among diverse HCPs in different countries. METHODS Cross-sectional survey in October-November 2020 among 1,249 GPs in France, 432 GPs in French-speaking parts of Belgium, and 1,055 nurses in Quebec (Canada), all participating in general population immunization. Exploratory and confirmatory factor analyses evaluated the instrument's construct validity. We used HCPs' self-reported vaccine recommendations to patients, general immunization activity, self-vaccination, and future COVID-19 vaccine acceptance to test criterion validity. RESULTS The final results indicated a 6-factor structure with good fit: vaccine confidence (combining complacency, perceived vaccine risks, perceived benefit-risk balance, perceived collective responsibility), trust in authorities, perceived constraints, proactive efficacy (combining commitment to vaccination and self-efficacy), reluctant trust, and openness to patients. The instrument showed good convergent and criterion validity and adequate discriminant validity. CONCLUSIONS This study found that the Pro-VC-Be is a valid instrument for measuring psychosocial determinants of HCPs' vaccination behaviors in different settings. Its validation is currently underway in Europe among various HCPs in different languages.
Collapse
Affiliation(s)
- Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Lisa Fressard
- ORS PACA, Southeastern Health Regional Observatory, Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Nicolas Dauby
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Centre for Environmental Health and Occupational Health, School of Public health, Université Libre de Bruxelles (ULB), Brussel, Belgium.,Institute for Medical Immunology, Université Libre de Bruxelles (ULB), Brussel, Belgium
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Stephan Lewandoswky
- School of Psychological Science, University of Bristol, Bristol, United Kingdom.,School of Psychological Science, University of Western Australia, Perth, Australia
| | - Philipp Schmid
- Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Eve Dube
- Département d'Anthropologie, Faculté des Sciences Sociales, Université Laval, Quebec, Canada.,Institut National de la Santé Publique du Québec, Quebec, Canada.,Centre de Recherche du CHU de Québec, Université Laval, Quebec, Canada
| | - Arnaud Gagneur
- Department of Pediatrics, Centre de Recherche du CHUS, Sherbrooke, Canada.,Université de Sherbrooke-Campus de la Santé, Sherbrooke,Canada
| |
Collapse
|
14
|
Zeggagh J, Bauer R, Delaugerre C, Carette D, Fressard L, Charreau I, Chidiac C, Pialoux G, Tremblay C, Cua E, Robineau O, Raffi F, Capitant C, Spire B, Meyer L, Molina JM. Incidence and risk factors for recurrent sexually transmitted infections among men who have sex with men on HIV pre-exposure prophylaxis. AIDS 2022; 36:1129-1134. [PMID: 35142708 DOI: 10.1097/qad.0000000000003187] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE High rates of sexually transmitted infections (STIs) have been reported among PrEP users. We wished to assess the incidence and risk factors for recurrent STIs. DESIGN The ANRS IPERGAY trial was a prospective study investigating PrEP among MSM and transgender women in outpatient clinics in France and Canada. In all, 429 participants were enrolled, offered up to four years of PrEP and screened for bacterial STIs (syphilis, chlamydia, and gonorrhea) at baseline and every 6 months. METHODS STIs incidence was calculated yearly. Cox proportional hazards model regression was used to explore associations between participants characteristics at baseline and recurrent STI during follow-up. RESULTS Over a median follow-up of 23 months, bacterial STI incidence was 75, 33, 13, 32 and 30 per 100 person-years (PY) for all STIs, rectal STIs, syphilis, gonorrhoea and chlamydia, respectively. STI incidence significantly increased from the first year to the fourth year of the study (55 vs. 90 per 100 PY, p < 0.001). During the study period, 167 participants (39%) presented with more than one bacterial STIs which accounted for 86% of all STIs. Baseline risk factors associated with recurrent STIs in a multivariate analysis were an STI at baseline (HR: 1.48 (95% CI: 1.06-2.07, p = 0.02), more than 8 sexual partners in prior 2 months (HR: 1.72 (95% CI: 1.21-2.43, p = 0.002), and the use of GHB (HR: 1.66 (95% CI: 1.16-2.38, p = 0.005). CONCLUSIONS STI incidence was high and increased over time. Most STIs were concentrated in a high-risk group that should be targeted for future interventions.
Collapse
|
15
|
Verger P, Peretti-Watel P, Gagneux-Brunon A, Botelho-Nevers E, Sanchez A, Gauna F, Fressard L, Bonneton M, Launay O, Ward JK. Acceptance of childhood and adolescent vaccination against COVID-19 in France: a national cross-sectional study in May 2021. Hum Vaccin Immunother 2021; 17:5082-5088. [PMID: 34905467 PMCID: PMC8904022 DOI: 10.1080/21645515.2021.2004838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The French health authorities extended vaccination against COVID-19 to adolescents in June 2021, during the epidemic resurgence linked to the delta variant and because of insufficient vaccination coverage to ensure collective protection. In May 2021, we conducted a national online cross-sectional survey of 2533 adults in France to study their attitudes toward COVID-19 vaccines and their acceptance of child/adolescent vaccination according to targeted age groups (<6 years; 6-11; 12-17) and its determinants. We applied a multi-model averaged logistic regression for each of these age groups to study the determinants of favorability to vaccination. Among the respondents, 62.7% (1597) accepted COVID-19 vaccination for adolescents, 48.3% (1223) for children aged 6-11 years, and only 31% (783) for children under 6 years. Acceptance increased with fear of contracting COVID-19 and trust in institutions and decreased as the COVID-19 vaccine risk perception score increased. People favorable to vaccination in general and those sensitive to social pressure were also more often favorable to vaccinating children/adolescents than those who were not. Drivers of acceptance were ranked differently for the different age groups. Understanding these differences is essential to anticipating obstacles to vaccination of these age groups and designing appropriate information and motivational strategies to support it.
Collapse
Affiliation(s)
- Pierre Verger
- Southeastern Health Regional Observatory (ORS PACA), Marseille, France,Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France,CONTACT Pierre Verger Observatoire Régional de la Santé Paca, Faculté De Médecine, 27, Bd Jean Moulin, 13385Marseille, Cedex 5, France
| | - Patrick Peretti-Watel
- Southeastern Health Regional Observatory (ORS PACA), Marseille, France,VITROME (Aix Marseille Université, IRD, AP-HM, SSA), Marseille, France
| | - Amandine Gagneux-Brunon
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France,Centre International De Recherche En Infectiologie, Team Gimap, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, Lyon, France,CIC Inserm 1408 Vaccinologie, Chu De Saint-Etienne, France,Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France
| | - Elisabeth Botelho-Nevers
- Centre International De Recherche En Infectiologie, Team Gimap, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, Lyon, France,CIC Inserm 1408 Vaccinologie, Chu De Saint-Etienne, France,Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France
| | - Alvaro Sanchez
- Assistance Publique – Hôpitaux De Paris, Hôpital Cochin, Paris, France
| | - Fatima Gauna
- Southeastern Health Regional Observatory (ORS PACA), Marseille, France
| | - Lisa Fressard
- Southeastern Health Regional Observatory (ORS PACA), Marseille, France
| | - Marion Bonneton
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France,Université De Paris, Inserm CIC 1417, Assistance Publique – Hôpitaux De Paris, Hôpital Cochin, Paris, France
| | - Odile Launay
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France,Université De Paris, Inserm CIC 1417, Assistance Publique – Hôpitaux De Paris, Hôpital Cochin, Paris, France
| | - Jeremy K. Ward
- VITROME (Aix Marseille Université, IRD, AP-HM, SSA), Marseille, France,CERMES3 (Inserm, CNRS, Ehess, Université De Paris), Villejuif, France
| |
Collapse
|
16
|
Affiliation(s)
- Damien Léger
- Université de Paris, EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris, France.,APHP, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Consultation de pathologie professionnelle Sommeil Vigilance et Travail, Paris, France
| | - François Beck
- CESP (Centre de recherche en Épidémiologie et Santé des Populations), Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Villejuif, France
| | - Lisa Fressard
- Southeastern Health Regional Observatory (ORS Paca), Marseille, France
| | - Pierre Verger
- AMU, UMR Vitrome, IHU Méditerrannée, IRD, Marseille, France
| | - Patrick Peretti-Watel
- Southeastern Health Regional Observatory (ORS Paca), Marseille, France.,AMU, UMR Vitrome, IHU Méditerrannée, IRD, Marseille, France
| | | |
Collapse
|
17
|
Beck F, Léger D, Fressard L, Peretti-Watel P, Verger P. Covid-19 health crisis and lockdown associated with high level of sleep complaints and hypnotic uptake at the population level. J Sleep Res 2020; 30:e13119. [PMID: 32596936 PMCID: PMC7361195 DOI: 10.1111/jsr.13119] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/18/2020] [Accepted: 05/18/2020] [Indexed: 11/28/2022]
Abstract
The Covid‐19 pandemic has disrupted the habits of billions of people around the world. Lockdown at home is mandatory, forcing many families, each member with their own sleep–wake habits, to spend 24 hr a day together, continuously. Sleep is crucial for maintaining immune systems and contributes deeply to physical and psychological health. To assess sleep problems and use of sleeping pills, we conducted a cross‐sectional study of a representative sample of the general population in France. The self‐reported sleep complaint items, which covered the previous 8 days, have been used in the 2017 French Health Barometer Survey, a cross‐sectional survey on various public health issues. After 2 weeks of confinement, 74% of the participants (1,005 subjects) reported trouble sleeping compared with a prevalence rate of 49% in the last general population survey. Women reported more sleeping problems than men, with greater frequency or severity: 31% vs. 16%. Unusually, young people (aged 18–34 years) reported sleep problems slightly more frequently than elderly people (79% vs. 72% among those aged 35 or older), with 60% of the younger group reporting that these problems increased with confinement (vs. 51% of their elders). Finally, 16% of participants reported they had taken sleeping pills during the last 12 months, and 41% of them reported using these drugs since the lockdown started. These results suggest that the COVID crisis is associated with severe sleep disorders among the French population, especially young people.
Collapse
Affiliation(s)
- Francois Beck
- CESP (Centre de recherche en Épidémiologie et Santé des Populations), Université Paris-Saclay, UVSQ, Université de Paris-Sud, Villejuif, France
| | - Damien Léger
- Université de Paris, VIFASOM (EA 7330, Vigilance Fatigue Sommeil et Santé Publique), Paris, France.,APHP, Hôtel Dieu, Centre du Sommeil et de la Vigilance, Consultation de pathologie professionnelle Sommeil Vigilance et Travail, Centre de référence hypersomnies rares, Paris, France
| | - Lisa Fressard
- Southeastern Health Regional Observatory (ORS Paca), Marseille, France
| | | | - Pierre Verger
- Southeastern Health Regional Observatory (ORS Paca), Marseille, France.,UMR Vitrome, AMU, IHU Méditerrannée, IRD, Marseille, France
| | | |
Collapse
|
18
|
Protiere C, Fressard L, Mora M, Meyer L, Préau M, Suzan-Monti M, Lelièvre JD, Lambotte O, Spire B. Characterization of Physicians That Might Be Reluctant to Propose HIV Cure-Related Clinical Trials with Treatment Interruption to Their Patients? The ANRS-APSEC Study. Vaccines (Basel) 2020; 8:vaccines8020334. [PMID: 32585921 PMCID: PMC7350235 DOI: 10.3390/vaccines8020334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/04/2020] [Accepted: 06/17/2020] [Indexed: 12/25/2022] Open
Abstract
HIV cure-related clinical trials (HCRCT) with analytical antiretroviral treatment interruptions (ATIs) have become unavoidable. However, the limited benefits for participants and the risk of HIV transmission during ATI might negatively impact physicians’ motivations to propose HCRCT to patients. Between October 2016 and March 2017, 164 French HIV physicians were asked about their level of agreement with four viewpoints regarding HCRCT. A reluctance score was derived from their answers and factors associated with reluctance identified. Results showed the highest reluctance to propose HCRCT was among physicians with a less research-orientated professional activity, those not informing themselves about cure trials through scientific literature, and those who participated in trials because their department head asked them. Physicians’ perceptions of the impact of HIV on their patients’ lives were also associated with their motivation to propose HCRCT: those who considered that living with HIV means living with a secret were more motivated, while those worrying about the negative impact on person living with HIV’s professional lives were more reluctant. Our study highlighted the need to design a HCRCT that minimizes constraints for participants and for continuous training programs to help physicians keep up-to-date with recent advances in HIV cure research.
Collapse
Affiliation(s)
- Christel Protiere
- Aix Marseille University, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, 13005 Marseille, France; (L.F.); (M.M.); (M.S.-M.); (B.S.)
- Correspondence:
| | - Lisa Fressard
- Aix Marseille University, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, 13005 Marseille, France; (L.F.); (M.M.); (M.S.-M.); (B.S.)
| | - Marion Mora
- Aix Marseille University, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, 13005 Marseille, France; (L.F.); (M.M.); (M.S.-M.); (B.S.)
| | - Laurence Meyer
- INSERM, U1018, Université Paris-Sud 11, AP-HP, Hôpital de Bicêtre, Département D’épidémiologie, 94270 Le Kremlin-Bicêtre, France;
| | - Marie Préau
- GRePS, Lyon 2 Université, 69676 Bron, France;
| | - Marie Suzan-Monti
- Aix Marseille University, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, 13005 Marseille, France; (L.F.); (M.M.); (M.S.-M.); (B.S.)
| | - Jean-Daniel Lelièvre
- INSERM, U955, Equipe 16, Université Paris Est, Faculté de médecine, Vaccine Research Institute, 94000 Créteil, France;
| | - Olivier Lambotte
- Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Service de Médecine Interne et Immunologie Clinique, INSERM, U1184, 94270 Le Kremlin-Bicêtre, France;
- Immunology of Viral Infections and Autoimmune Diseases, Université Paris Sud, UMR 1184, 94270 Le Kremlin-Bicêtre, France
- CEA, DSV/iMETI, IDMIT, 92260 Fontenay-aux-Roses, France
| | - Bruno Spire
- Aix Marseille University, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, 13005 Marseille, France; (L.F.); (M.M.); (M.S.-M.); (B.S.)
| | | |
Collapse
|
19
|
Bocquier A, Fressard L, Cortaredona S, Ward J, Seror V, Peretti-Watel P, Verger P. [Vaccine hesitancy in France: prevalence and association with parents' socioeconomic status]. Med Sci (Paris) 2020; 36:461-464. [PMID: 32452367 DOI: 10.1051/medsci/2020076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Aurélie Bocquier
- Aix-Marseille Université, IRD, AP-HM, Service de Santé des Armées (SSA), Vecteurs -Infections Tropicales et Méditeranéennes (VITROME), Marseille, France. - Institut hospitalo-universitaire Méditerranée infection, 19-21 boulevard Jean Moulin, 13385 Marseille Cedex 05, France - Observatoire régional de la santé Provence-Alpes-Côte d'Azur (ORS PACA), Marseille, France
| | - Lisa Fressard
- Aix-Marseille Université, IRD, AP-HM, Service de Santé des Armées (SSA), Vecteurs -Infections Tropicales et Méditeranéennes (VITROME), Marseille, France. - Institut hospitalo-universitaire Méditerranée infection, 19-21 boulevard Jean Moulin, 13385 Marseille Cedex 05, France - Observatoire régional de la santé Provence-Alpes-Côte d'Azur (ORS PACA), Marseille, France
| | - Sébastien Cortaredona
- Aix-Marseille Université, IRD, AP-HM, Service de Santé des Armées (SSA), Vecteurs -Infections Tropicales et Méditeranéennes (VITROME), Marseille, France. - Institut hospitalo-universitaire Méditerranée infection, 19-21 boulevard Jean Moulin, 13385 Marseille Cedex 05, France
| | - Jeremy Ward
- Aix-Marseille Université, IRD, AP-HM, Service de Santé des Armées (SSA), Vecteurs -Infections Tropicales et Méditeranéennes (VITROME), Marseille, France. - CNRS, Université Paris-Sorbonne, Groupe d'Étude des Méthodes de l'Analyse Sociologique de la Sorbonne (GEMASS), Paris, France
| | - Valérie Seror
- Aix-Marseille Université, IRD, AP-HM, Service de Santé des Armées (SSA), Vecteurs -Infections Tropicales et Méditeranéennes (VITROME), Marseille, France. - Institut hospitalo-universitaire Méditerranée infection, 19-21 boulevard Jean Moulin, 13385 Marseille Cedex 05, France
| | - Patrick Peretti-Watel
- Aix-Marseille Université, IRD, AP-HM, Service de Santé des Armées (SSA), Vecteurs -Infections Tropicales et Méditeranéennes (VITROME), Marseille, France. - Institut hospitalo-universitaire Méditerranée infection, 19-21 boulevard Jean Moulin, 13385 Marseille Cedex 05, France - Observatoire régional de la santé Provence-Alpes-Côte d'Azur (ORS PACA), Marseille, France
| | - Pierre Verger
- Aix-Marseille Université, IRD, AP-HM, Service de Santé des Armées (SSA), Vecteurs -Infections Tropicales et Méditeranéennes (VITROME), Marseille, France. - Institut hospitalo-universitaire Méditerranée infection, 19-21 boulevard Jean Moulin, 13385 Marseille Cedex 05, France - Observatoire régional de la santé Provence-Alpes-Côte d'Azur (ORS PACA), Marseille, France - Inserm, French Clinical Research Infrastructure Network (F-CRIN), Innovative clinical research network in vaccinology (I-REIVAC), Paris, France
| |
Collapse
|
20
|
Bocquier A, Cortaredona S, Fressard L, Galtier F, Verger P. Seasonal influenza vaccination among people with diabetes: influence of patients' characteristics and healthcare use on behavioral changes. Hum Vaccin Immunother 2020; 16:2565-2572. [PMID: 32209014 PMCID: PMC7644174 DOI: 10.1080/21645515.2020.1729628] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Annual seasonal influenza vaccination (SIV) is recommended for people with diabetes, but vaccine coverage remains low. We estimated the probabilities of stopping or starting SIV, their correlates, and the expected time spent in the vaccinated state over 10 seasons for different patient profiles. We set up a retrospective cohort study of patients with diabetes in 2006 (n = 16,026), identified in a representative sample of beneficiaries of the French National Health Insurance Fund. We followed them up over 10 seasons (2005/06–2015/16). We used a Markov model to estimate transition probabilities and a proportional hazards model to study covariates. Between two consecutive seasons, the probabilities of starting (0.17) or stopping (0.09) SIV were lower than those of remaining vaccinated (0.91) or unvaccinated (0.83). Men, older patients, those with type 1 diabetes, treated diabetes or more comorbidities, frequent contacts with doctors, and with any hospital stay for diabetes or influenza during the last year were more likely to start and/or less likely to stop SIV. The mean expected number of seasons with SIV uptake over 10 seasons (range: 2.6–7.9) was lowest for women <65 years with untreated diabetes and highest for men ≥65 years with type 1 diabetes. Contacts with doctors and some clinical events may play a key role in SIV adoption. Healthcare workers have a crucial role in reducing missed opportunities for SIV. The existence of empirical patient profiles with different patterns of SIV uptake should encourage their use of tailored educational approaches about SIV to address patients’ vaccine hesitancy.
Collapse
Affiliation(s)
- A Bocquier
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME , Marseille, France.,IHU-Méditerranée Infection , Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur , Marseille, France
| | - S Cortaredona
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME , Marseille, France.,IHU-Méditerranée Infection , Marseille, France
| | - L Fressard
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME , Marseille, France.,IHU-Méditerranée Infection , Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur , Marseille, France
| | - F Galtier
- INSERM, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-Reivac), GH Cochin Broca Hôtel Dieu , Paris, France.,CIC 1411, CHU Montpellier, Hôpital Saint Eloi , Montpellier, France
| | - P Verger
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME , Marseille, France.,IHU-Méditerranée Infection , Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur , Marseille, France.,INSERM, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-Reivac), GH Cochin Broca Hôtel Dieu , Paris, France
| |
Collapse
|
21
|
Protiere C, Arnold M, Fiorentino M, Fressard L, Lelièvre JD, Mimi M, Raffi F, Mora M, Meyer L, Sagaon‐Teyssier L, Zucman D, Préau M, Lambotte O, Spire B, Suzan‐Monti M. Differences in HIV cure clinical trial preferences of French people living with HIV and physicians in the ANRS-APSEC study: a discrete choice experiment. J Int AIDS Soc 2020; 23:e25443. [PMID: 32077248 PMCID: PMC7048214 DOI: 10.1002/jia2.25443] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 12/04/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Despite the advent of HIV cure-related clinical trials (HCRCT) for people living with HIV (PLWH), the risks and uncertainty involved raise ethical issues. Although research has provided insights into the levers and barriers to PLWH and physicians' participation in these trials, no information exists about stakeholders' preferences for HCRCT attributes, about the different ways PLWH and physicians value future HCRCT, or about how personal characteristics affect these preferences. The results from the present study will inform researchers' decisions about the most suitable HCRCT strategies to implement, and help them ensure ethical recruitment and well-designed informed consent. METHODS Between October 2016 and March 2017, a discrete choice experiment was conducted among 195 virally controlled PLWH and 160 physicians from 24 French HIV centres. Profiles within each group, based on individual characteristics, were obtained using hierarchical clustering. Trade-offs between five HCRCT attributes (trial duration, consultation frequency, moderate (digestive disorders, flu-type syndrome, fatigue) and severe (allergy, infections, risk of cancer) side effects (SE), outcomes) and utilities associated with four HCRCT candidates (latency reactivation, immunotherapy, gene therapy and a combination of latency reactivation and immunotherapy), were estimated using a mixed logit model. RESULTS Apart from severe SE - the most decisive attribute in both groups - PLWH and physicians made different trade-offs between HCRCT attributes, the latter being more concerned about outcomes, the former about the burden of participation (consultation frequency and moderate SE). These different trades-offs resulted in differences in preferences regarding the four candidate HCRCT. PLWH significantly preferred immunotherapy, whereas physicians preferred immunotherapy and combined therapy. Despite the heterogeneity of characteristics within the PLWH and physician profiles, results show some homogeneity in trade-offs and utilities regarding HCRCT. CONCLUSIONS Severe SE, not outcomes, was the most decisive attribute determining future HCRCT participation. Particular attention should be paid to providing clear information, in particular on severe SE, to potential participants. Immunotherapy would appear to be the best HCRCT candidate for both PLWH and physicians. However, if the risk of cancer could be avoided, gene therapy would become the preferred strategy for the latter and the second choice for the former.
Collapse
Affiliation(s)
- Christel Protiere
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information MédicaleAix Marseille UnivMarseilleFrance
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | | | - Marion Fiorentino
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information MédicaleAix Marseille UnivMarseilleFrance
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - Lisa Fressard
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - Jean D Lelièvre
- INSERMCréteilFrance
- Faculté de médecineUniversité Paris EstCréteilFrance
- Vaccine Research InstituteCréteilFrance
| | - Mohamed Mimi
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information MédicaleAix Marseille UnivMarseilleFrance
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - François Raffi
- Department of Infectious DiseasesHotel‐Dieu Hospital ‐ INSERM CIC 1413Nantes University HospitalNantesFrance
| | - Marion Mora
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information MédicaleAix Marseille UnivMarseilleFrance
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - Laurence Meyer
- Département d'épidémiologie, INSERM, U1018Université Paris‐Sud 11AP‐HPHôpital de BicêtreLe Kremlin‐BicêtreFrance
| | - Luis Sagaon‐Teyssier
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information MédicaleAix Marseille UnivMarseilleFrance
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - David Zucman
- Hôpital Foch, service de médecine interneSuresnesFrance
| | | | - Olivier Lambotte
- Assistance Publique ‐ Hôpitaux de ParisHôpital BicêtreService de Médecine Interne et Immunologie cliniqueLe Kremlin‐BicêtreFrance
- Immunology of Viral Infections and Autoimmune DiseasesINSERM, U1184Le Kremlin‐BicêtreFrance
- UMR 1184Université Paris SudLe Kremlin‐BicêtreFrance
- CEADSV/iMETIIDMITFontenay‐aux‐RosesFrance
| | - Bruno Spire
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information MédicaleAix Marseille UnivMarseilleFrance
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - Marie Suzan‐Monti
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information MédicaleAix Marseille UnivMarseilleFrance
- ORS PACAObservatoire régional de la santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | | |
Collapse
|
22
|
Wilson R, Zaytseva A, Bocquier A, Nokri A, Fressard L, Chamboredon P, Carbonaro C, Bernardi S, Dubé E, Verger P. Vaccine hesitancy and self-vaccination behaviors among nurses in southeastern France. Vaccine 2020; 38:1144-1151. [DOI: 10.1016/j.vaccine.2019.11.018] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 11/17/2022]
|
23
|
Verger P, Fressard L, Cortaredona S, Lévy-Bruhl D, Loulergue P, Galtier F, Bocquier A. Trends in seasonal influenza vaccine coverage of target groups in France, 2006/07 to 2015/16: Impact of recommendations and 2009 influenza A(H1N1) pandemic. ACTA ACUST UNITED AC 2019; 23. [PMID: 30514414 PMCID: PMC6280418 DOI: 10.2807/1560-7917.es.2018.23.48.1700801] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background and aimsSeasonal influenza vaccination (SIV) uptake (SIVU) rates in France are below target. We (i) describe trends in French SIVU over 10 consecutive seasons among different target groups and (ii) examine the effects of the 2009 influenza A(H1N1) pandemic and the publication of new SIV recommendations in 2011 and 2013.MethodsOur study was based on records of vaccines delivered in community pharmacies for a permanent, representative sample of 805,000 beneficiaries of the French National Health Insurance Fund. For the first objective, we analysed SIVU rate trends among ≥ 65 year olds as well as among < 65 year olds with each of the following conditions: diabetes, respiratory, cardiovascular, neuromuscular, or chronic liver disease. For the second goal, we computed segmented log-binomial regression analyses.ResultsAfter the 2009 pandemic, except for the target group with liver diseases, where the difference was not statistically significant, SIVU fell significantly in all groups during the 2010/11 season, remaining relatively stable until 2015/16 in groups not targeted by new recommendations. Crude SIVU rates in 2015/16 were 48% (43,950/91,794) for ≥ 65 year olds and between 16% (407/2,565) and 29% (873/3,056) for < 65 year olds depending on their condition. SIVU increased modestly after new recommendations were published, but only in patients newly eligible for a free vaccine voucher.ConclusionsOur results suggest: (i) a prolonged confidence crisis in SIV, initially impelled by the 2009 pandemic vaccination campaign; (ii) that new recommendations are ineffective without additional measures. Interventional research in this field is a priority.
Collapse
Affiliation(s)
- Pierre Verger
- INSERM, F-CRIN, Innovative Clinical research Network in vaccinology (I-Reivac), GH Cochin Broca Hôtel Dieu, Paris, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix-Marseille Université, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | - Lisa Fressard
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Sébastien Cortaredona
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix-Marseille Université, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | - Daniel Lévy-Bruhl
- Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France
| | - Pierre Loulergue
- Assistance Publique Hôpitaux de Paris, CIC Cochin-Pasteur, Paris, France.,Inserm CIC 1417, Paris, France.,Université Paris Descartes, Sorbonne Paris cité, Paris, France.,INSERM, F-CRIN, Innovative Clinical research Network in vaccinology (I-Reivac), GH Cochin Broca Hôtel Dieu, Paris, France
| | - Florence Galtier
- CIC 1411, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France.,INSERM, F-CRIN, Innovative Clinical research Network in vaccinology (I-Reivac), GH Cochin Broca Hôtel Dieu, Paris, France
| | - Aurélie Bocquier
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix-Marseille Université, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| |
Collapse
|
24
|
Rey D, Fressard L, Cortaredona S, Bocquier A, Gautier A, Peretti-Watel P, Verger P, On Behalf Of The Baromètre Santé Group. Vaccine hesitancy in the French population in 2016, and its association with vaccine uptake and perceived vaccine risk-benefit balance. ACTA ACUST UNITED AC 2019; 23. [PMID: 29717693 PMCID: PMC5930729 DOI: 10.2807/1560-7917.es.2018.23.17.17-00816] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Vaccine hesitancy (VH) is prominent in France. Objectives: This study aimed to estimate the prevalence and socio-demographic correlates of VH in sub-groups of the French population and to investigate the association of VH with both vaccine uptake and perceived risk–benefit balance (RBB) for four vaccines. Methods: During the 2016 Health Barometer – a national cross-sectional telephone survey in a representative sample of the French population – parents of 1–15 year-old children, parents of 11–15 year-old girls and elderly people aged 65–75 years were asked about VH (using three questions adapted from the World Health Organization definition), vaccine uptake and perceived RBB for measles and hepatitis B (children’s parents), human papillomavirus (girls’ parents) and seasonal influenza (elderly people) vaccines. Results: A total of 3,938 parents including 959 girls' parents – and 2,418 elderly people were interviewed. VH prevalence estimates were 46% (95% confidence interval (CI): 44–48) among parents, 48% (95%CI: 45–51) among girls’ parents and 35% (95% CI: 33–36) among elderly people, with higher estimates associated with high education level, children’s age (10–15 years), and, for the elderly, poor perception of health status. VH was associated with uncertainty about and/or an unfavourable perception of vaccines’ RBB for the four vaccines and with lower self-reported vaccine uptake, except for human papillomavirus vaccine in girls. Results were confirmed by multivariable analysis. Conclusion: Further research is needed to study the association between VH and vaccine uptake for other vaccines, and to design and validate measurement tools to monitor VH over time.
Collapse
Affiliation(s)
- Dominique Rey
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Lisa Fressard
- Aix-Marseille University, IRD, UMR-S912, Marseille, France.,INSERM, UMR S912, « Economics and Social Sciences Applied to Health & Analysis of Medical Information » (SESSTIM), Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Sébastien Cortaredona
- IRD, AP-HM, VITROME, IHU-Méditerranée Infection, Aix-Marseille University, Marseille, France
| | - Aurélie Bocquier
- IRD, AP-HM, VITROME, IHU-Méditerranée Infection, Aix-Marseille University, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Arnaud Gautier
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Patrick Peretti-Watel
- IRD, AP-HM, VITROME, IHU-Méditerranée Infection, Aix-Marseille University, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Pierre Verger
- IRD, AP-HM, VITROME, IHU-Méditerranée Infection, Aix-Marseille University, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | | |
Collapse
|
25
|
Fiorentino M, Protière C, Sagaon-Teyssier L, Mimi M, Fressard L, Arnold MP, Lambotte O, Barbot J, Fainzang S, Meyer L, Goujard C, Préau M, Spire B, Suzan-Monti M. What is the effect of self-identified HIV activism in willingness to participate in HIV cure-related clinical trials? Results from the ANRS-APSEC study. J Virus Erad 2019; 5:152-162. [PMID: 31700661 PMCID: PMC6816119] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Enrolling people living with HIV with undetectable viral load into HIV cure-related clinical trials (HCRCT) is challenging. Few data are currently available about the individual factors that influence willingness to participate in HCRCT (WPHCRCT). We hypothesised that WPHCRCT would be more frequent among people living with HIV considering themselves HIV activists. The objective of this study was to investigate the individual characteristics associated with both WPHCRCT and self-identification as an HIV activist. METHODS The study enrolled 195 long-term ART-treated and virologically suppressed people living with HIV, followed-up in 19 French HIV services, 2016-2017. A Bayesian model averaging approach was used to assess correlates of both outcomes i.e. WPHCRCT and self-identified HIV activism. RESULTS WPHCRCT was reported by 43% of participants and was positively associated with self-identification as an HIV activist (adjusted odds ratio [aOR] 2.90 95% confidence interval [CI] 2.17-3.63], P<0.05) and self-confidence as an HIV positive person (aOR 1.17, 95% CI 0.99-1.35, P<0.1). Self-identified HIV activists (56% of participants) were more likely to have a higher 'relationship with others' score using the post-traumatic growth inventory (aOR 1.10, 95% CI 0.99-1.20, P<0.1), to obtain information about HIV from a greater number of sources (aOR 1.35 [95% CI 1.00-1.68], P<0.1), and to feel greatly affected by mandatory daily treatment (aOR 2.15, 95% CI 1.27-3.03, P<0.1). All associations had relative importance weight>0.75, indicating strong evidence. CONCLUSIONS WPHCRCT is strongly related to HIV activism, and also to positive psychosocial characteristics as a person living with HIV, especially regarding relationships with others. The desire to contribute to the fight against HIV for the sake of the HIV community and society should be taken into account to improve participation in upcoming HCRCT.
Collapse
Affiliation(s)
- Marion Fiorentino
- Aix Marseille University, INSERM, IRD, SESSTIM, Economic and Social Health Sciences and Medical Information Processing,
Marseille,
France,Observatoire régional de la santé Provence-Alpes-Côte d’Azur,
Marseille,
France,Corresponding author: Marion Fiorentino,
SESSTIM Faculté de médecine,
27 bd Jean Moulin,
13005Marseille,
France
| | - Christel Protière
- Aix Marseille University, INSERM, IRD, SESSTIM, Economic and Social Health Sciences and Medical Information Processing,
Marseille,
France,Observatoire régional de la santé Provence-Alpes-Côte d’Azur,
Marseille,
France
| | - Luis Sagaon-Teyssier
- Aix Marseille University, INSERM, IRD, SESSTIM, Economic and Social Health Sciences and Medical Information Processing,
Marseille,
France,Observatoire régional de la santé Provence-Alpes-Côte d’Azur,
Marseille,
France
| | - Mohamed Mimi
- Aix Marseille University, INSERM, IRD, SESSTIM, Economic and Social Health Sciences and Medical Information Processing,
Marseille,
France,Observatoire régional de la santé Provence-Alpes-Côte d’Azur,
Marseille,
France
| | - Lisa Fressard
- Aix Marseille University, INSERM, IRD, SESSTIM, Economic and Social Health Sciences and Medical Information Processing,
Marseille,
France,Observatoire régional de la santé Provence-Alpes-Côte d’Azur,
Marseille,
France
| | | | - Olivier Lambotte
- INSERM, U1184, Université Paris-Sud , Hôpital de Bicêtre, Service de Médecine Interne,
Le Kremlin-Bicêtre,
France
| | - Janine Barbot
- INSERM, Centre d’étude des mouvements sociaux,
Paris,
France
| | - Sylvie Fainzang
- Centre for Research in Medicine, Science, Health, Mental Health, and Society,
Villejuif,
France
| | - Laurence Meyer
- INSERM, U1018, Université Paris-Sud, Hôpital de Bicêtre, Department of Epidemiology,
Le Kremlin-Bicêtre,
France
| | - Cécile Goujard
- INSERM, U1018, Université Paris-Sud, Hôpital de Bicêtre, Department of Epidemiology,
Le Kremlin-Bicêtre,
France
| | | | - Bruno Spire
- Aix Marseille University, INSERM, IRD, SESSTIM, Economic and Social Health Sciences and Medical Information Processing,
Marseille,
France,Observatoire régional de la santé Provence-Alpes-Côte d’Azur,
Marseille,
France
| | - Marie Suzan-Monti
- Aix Marseille University, INSERM, IRD, SESSTIM, Economic and Social Health Sciences and Medical Information Processing,
Marseille,
France,Observatoire régional de la santé Provence-Alpes-Côte d’Azur,
Marseille,
France
| |
Collapse
|
26
|
Bocquier A, Cortaredona S, Fressard L, Loulergue P, Raude J, Sultan A, Galtier F, Verger P. Trajectories of seasonal influenza vaccine uptake among French people with diabetes: a nationwide retrospective cohort study, 2006-2015. BMC Public Health 2019; 19:918. [PMID: 31288768 PMCID: PMC6617633 DOI: 10.1186/s12889-019-7209-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 06/20/2019] [Indexed: 01/20/2023] Open
Abstract
Background Annual seasonal influenza vaccination (SIV) is recommended for people with diabetes, but their SIV rates remain far below public health targets. We aimed to identify temporal trajectories of SIV uptake over a 10-year period among French people with diabetes and describe their clinical characteristics. Methods We identified patients with diabetes in 2006 among a permanent, representative sample of beneficiaries of the French National Health Insurance Fund. We followed them up over 10 seasons (2005/06–2015/16), using SIV reimbursement claims and group-based trajectory modelling to identify SIV trajectories and to study sociodemographic, clinical, and healthcare utilization characteristics associated with the trajectories. Results We identified six trajectories. Of the 15,766 patients included in the model, 4344 (28%) belonged to the “continuously vaccinated” trajectory and 4728 (30%) to the “never vaccinated” one. Two other trajectories showed a “progressive decrease” (2832, 18%) or sharp “postpandemic decrease” (1627, 10%) in uptake. The last two trajectories (totalling 2235 patients, 14%) showed an early or delayed “increase” in uptake. Compared to “continuously vaccinated” patients, those in the “progressively decreasing” trajectory were older and those in all other trajectories were younger with fewer comorbidities at inclusion. Worsening diabetes and comorbidities during follow-up were associated with the “increasing” trajectories. Conclusions Most patients with diabetes had been continuously vaccinated or never vaccinated and thus had stable SIV behaviours. Others adopted or abandoned SIV. These behaviour shifts might be due to increasing age, health events, or contextual factors (e.g., controversies about vaccine safety or efficacy). Healthcare professionals and stakeholders should develop tailored strategies that take each group’s specificities into account. Electronic supplementary material The online version of this article (10.1186/s12889-019-7209-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Aurélie Bocquier
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, 19-21 Boulevard Jean Moulin, 13385, Marseille Cedex 05, France. .,IHU-Méditerranée Infection, Marseille, France. .,ORS PACA Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.
| | - Sébastien Cortaredona
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, 19-21 Boulevard Jean Moulin, 13385, Marseille Cedex 05, France.,IHU-Méditerranée Infection, Marseille, France
| | - Lisa Fressard
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, 19-21 Boulevard Jean Moulin, 13385, Marseille Cedex 05, France.,IHU-Méditerranée Infection, Marseille, France.,ORS PACA Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Pierre Loulergue
- INSERM, F-CRIN Innovative Clinical research Network in vaccinology (I-Reivac), GH Cochin Broca Hôtel Dieu, 75014, Paris, France.,Université Paris Descartes, Sorbonne Paris cité, Paris, France.,Inserm CIC 1417, Paris, France.,Assistance Publique Hôpitaux de Paris, CIC Cochin-Pasteur, Paris, France
| | - Jocelyn Raude
- EHESP Rennes, Université Sorbonne Paris Cité, Paris, France.,Unité des Virus Emergents (UVE: Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France
| | - Ariane Sultan
- Endocrinology-Diabetology-Nutrition Department, University Hospital, Montpellier, France.,PhyMedExp, University of Montpellier CNRS INSERM, Montpellier, France
| | - Florence Galtier
- INSERM, F-CRIN Innovative Clinical research Network in vaccinology (I-Reivac), GH Cochin Broca Hôtel Dieu, 75014, Paris, France.,CIC 1411 CHU Montpellier Hôpital Saint Eloi, Montpellier, France
| | - Pierre Verger
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, 19-21 Boulevard Jean Moulin, 13385, Marseille Cedex 05, France.,IHU-Méditerranée Infection, Marseille, France.,ORS PACA Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,INSERM, F-CRIN Innovative Clinical research Network in vaccinology (I-Reivac), GH Cochin Broca Hôtel Dieu, 75014, Paris, France
| |
Collapse
|
27
|
Fiorentino M, Protière C, Sagaon-Teyssier L, Mimi M, Fressard L, Arnold M, Lambotte O, Barbot J, Fainzang S, Meyer L, Goujard C, Préau M, Spire B, Suzan-Monti M. What is the effect of self-identified HIV activism in willingness to participate in HIV cure-related clinical trials? Results from the ANRS-APSEC study. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30045-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
28
|
Sagaon-Teyssier L, Mabire X, Laguette V, Fressard L, Suzan-Monti M, Rojas Castro D, Hall N, Capitant C, Meyer L, Chidiac C, Tremblay C, Préau M, Spire B, Molina JM. A Group-Based Trajectory Model for Changes in Pre-Exposure Prophylaxis and Condom Use Among Men Who Have Sex with Men Participating in the ANRS IPERGAY Trial. AIDS Patient Care STDS 2018. [DOI: 10.1089/apc.2018.0081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Luis Sagaon-Teyssier
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Xavier Mabire
- Groupe de Recherche en Psychologie Sociale (EA 4163), Université Lumière Lyon 2, Université de Lyon, Lyon, France
| | - Vanessa Laguette
- Groupe de Recherche en Psychologie Sociale (EA 4163), Université Lumière Lyon 2, Université de Lyon, Lyon, France
- University of Picardie Jules Verne, Amiens, France
| | - Lisa Fressard
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Marie Suzan-Monti
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Daniela Rojas Castro
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France
- AIDES, MIRE, Paris, France
- Coalition Plus, Pantin, France
| | - Nolwenn Hall
- Department of Infectious diseases, CHU de Nantes, Nantes, France
| | | | - Laurence Meyer
- INSERM SC10 US19, Villejuif, France
- Université Paris Sud, Paris Saclay, France
| | - Christian Chidiac
- Department of Infectious Diseases, Hôpital de la Croix Rousse, INSERM U1052, Lyon, France
| | - Cécile Tremblay
- Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, Canada
| | - Marie Préau
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France
- Groupe de Recherche en Psychologie Sociale (EA 4163), Université Lumière Lyon 2, Université de Lyon, Lyon, France
| | - Bruno Spire
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Jean-Michel Molina
- Department of Infectious Diseases, Hospital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | | |
Collapse
|
29
|
Bocquier A, Fressard L, Cortaredona S, Galtier F, Verger P. Trajectories of seasonal influenza vaccination uptake in French people with diabetes from 2006 to 2015. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
30
|
Bocquier A, Fressard L, Verger P, Legleye S, Peretti-Watel P. Alcohol and cancer: risk perception and risk denial beliefs among the French general population. Eur J Public Health 2018; 27:705-710. [PMID: 28459975 DOI: 10.1093/eurpub/ckx024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background Worldwide, millions of deaths each year are attributed to alcohol. We sought to examine French people's beliefs about the risks of alcohol, their correlates, and their associations with alcohol use. Methods Data came from the 2010 Baromètre Cancer survey, a random cross-sectional telephone survey of the French general population (n = 3359 individuals aged 15-75 years). Using principal component analysis of seven beliefs about alcohol risks, we built two scores (one assessing risk denial based on self-confidence and the other risk relativization). Two multiple linear regressions explored these scores' socio-demographic and perceived information level correlates. Multiple logistic regressions tested the associations of these scores with daily drinking and with heavy episodic drinking (HED). Results About 60% of the respondents acknowledged that alcohol increases the risk of cancer, and 89% felt well-informed about the risks of alcohol. Beliefs that may promote risk denial were frequent (e.g. 72% agreed that soda and hamburgers are as bad as alcohol for your health). Both risk denial and risk relativization scores were higher among men, older respondents and those of low socioeconomic status. The probability of daily drinking increased with the risk relativization score and that of HED with both scores. Conclusions Beliefs that can help people to deny the cancer risks due to alcohol use are common in France and may exist in many other countries where alcoholic beverages have been an integral part of the culture. These results can be used to redesign public information campaigns about the risks of alcohol.
Collapse
Affiliation(s)
- Aurélie Bocquier
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Economics and Social Sciences Applied to Health & Analysis of Medical Information, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Lisa Fressard
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Economics and Social Sciences Applied to Health & Analysis of Medical Information, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Pierre Verger
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Economics and Social Sciences Applied to Health & Analysis of Medical Information, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Stéphane Legleye
- Institut National d'Études Démographiques (INED), Paris, France.,Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Patrick Peretti-Watel
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Economics and Social Sciences Applied to Health & Analysis of Medical Information, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| |
Collapse
|
31
|
Suzan-Monti M, Cotte L, Fressard L, Cua E, Capitant C, Meyer L, Pialoux G, Molina JM, Spire B. Factors associated with partner notification of STIs in men who have sex with men on PrEP in France: a cross-sectional substudy of the ANRS-IPERGAY trial. Sex Transm Infect 2018; 94:490-493. [PMID: 29378903 DOI: 10.1136/sextrans-2017-053304] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 06/09/2017] [Revised: 09/28/2017] [Accepted: 10/28/2017] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Partner notification (PN) is a useful public health approach to enhance targeted testing of people at high risk of HIV and other STIs, and subsequent linkage to care for those diagnosed. In France, no specific PN guidelines exist and information about current practices is scarce. We used the ANRS-IPERGAY PrEP trial to investigate PN in HIV-negative men who have sex with men (MSM) reporting a bacterial STI. METHODS This substudy included 275 participants who completed a specific online PN questionnaire during the open-label extension study of the ANRS-Intervention Préventive de l'Exposition aux Risques avec et pour les Gays (IPERGAY) trial. Variables used as proxies of at-risk practices were defined using data collected at the previous follow-up visit about participants' most recent sexual encounter and preventive behaviours. χ2 or Fisher's exact test helped select variables eligible for multiple logistic models. RESULTS Of the 275 participants, 250 reported at least one previous STI. Among the latter, 172 (68.8%) had informed their partner(s) of their most recent STI. Of these, 138 (80.2%) and 83 (48.3%) had notified their casual and main partners, respectively. Participants were less likely to notify their main partner when their most recent sexual encounter involved unsafe anal sex with a casual partner (adjusted OR (aOR) (95% CI) 0.18 (0.06 to 0.54), P=0.02). Older participants were less likely to inform casual partners (aOR (95% CI) 0.44 (0.21 to 0.94), P=0.03), while those practising chemsex during their most recent sexual encounter were more likely to inform their casual partners (aOR (95% CI) 2.56 (1.07 to 6.09), P=0.03). CONCLUSION Unsafe sexual encounters with people other than main partners and street drugs use were two sociobehavioural factors identified, respectively, as a barrier to main PN and a motivator for casual PN, in a sample of high-risk MSM. These results provide an insight into current PN practices regarding STI in France and might inform future decisions about how to define feasible and acceptable PN programmes.
Collapse
Affiliation(s)
- Marie Suzan-Monti
- Aix-Marseille University, INSERM, IRD, SESSTIM, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Laurent Cotte
- Department of Infectious Diseases, Hôpital de la Croix Rousse, INSERM U1052, Lyon, France
| | - Lisa Fressard
- Aix-Marseille University, INSERM, IRD, SESSTIM, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Eric Cua
- Department of Infectious Diseases, Hôpital de l'Archet, Centre Hospitalier de Nice, Nice, France
| | | | | | - Gilles Pialoux
- Department of Infectious Diseases, Hospital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Jean-Michel Molina
- Department of Infectious Diseases, Hospital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Bruno Spire
- Aix-Marseille University, INSERM, IRD, SESSTIM, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | | |
Collapse
|
32
|
Le Marechal M, Fressard L, Agrinier N, Verger P, Pulcini C. General practitioners' perceptions of vaccination controversies: a French nationwide cross-sectional study. Clin Microbiol Infect 2017; 24:858-864. [PMID: 29104170 DOI: 10.1016/j.cmi.2017.10.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 07/22/2017] [Revised: 10/12/2017] [Accepted: 10/28/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVES We aimed to study general practitioners' (GPs') perceptions of vaccines that have been a subject of controversy in France. METHODS A cross-sectional survey in 2014 asked a representative national sample of GPs, randomly selected from the exhaustive database of health professionals in France, about their perceptions of the likelihood of serious adverse events potentially associated with six different vaccines: for two of them the association was based on some scientific evidence, whereas for the other four this is not the case. We performed a cluster analysis to construct a typology of GPs' perceptions about the likelihood of these potential six associations. Factors associated with certain clusters of interest were identified using logistic regression models. RESULTS Overall, 1582 GPs participated in the questionnaire survey (1582/1712 GPs who agreed to participate, 92%). Cluster analysis identified four groups of GPs according to their susceptibility to vaccine controversies: 1) limited susceptibility to controversies (52%); 2) overall unsure, but rejected the association between hepatitis B vaccine and multiple sclerosis (32%); 3) highly susceptible to controversies (11%); and 4) unsure (5%). We found that GPs who occasionally practised alternative medicine (OR 2.71, 95% CI 1.65-4.45), and those who considered information provided by mass media as reliable (OR 2.04, 95% CI 1.65-3.99) were more susceptible to controversies. CONCLUSIONS GPs had different profiles of susceptibility to vaccination controversies, and most of their perceptions of these controversies were not based on scientific evidence.
Collapse
Affiliation(s)
- M Le Marechal
- Université de Lorraine, EA 4360 APEMAC, Nancy, France
| | - L Fressard
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - N Agrinier
- Université de Lorraine, EA 4360 APEMAC, Nancy, France; INSERM, CIC-1433 Epidémiologie clinique, CHRU de Nancy, Nancy, France
| | - P Verger
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France; INSERM, F-CRIN, I-Reivac (Innovative clinical research network in vaccinology), France
| | - C Pulcini
- Université de Lorraine, EA 4360 APEMAC, Nancy, France; Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; CHRU de Nancy, Service de Maladies Infectieuses et Tropicales, Nancy, France.
| |
Collapse
|
33
|
Le Maréchal M, Fressard L, Raude J, Verger P, Pulcini C. General practitioners and vaccination of children presenting with a benign infection. Med Mal Infect 2017; 48:44-52. [PMID: 29113691 DOI: 10.1016/j.medmal.2017.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 12/16/2016] [Accepted: 09/28/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To assess the self-reported vaccination behavior of general practitioners (GPs) when asked whether they would recommend the vaccination of a child presenting with a febrile uncomplicated common cold. METHODS We performed a cross-sectional survey in 2014 on a national sample of GPs. GPs were randomly assigned to one of eight clinical vignettes, all describing a child presenting with an uncomplicated febrile common cold, but differing by age (4 or 11 months), temperature (38°C or 39°C), and the mother's emotional state (calm or worried). GPs were asked whether they would recommend immediate vaccination of the child with a hexavalent vaccine (diphtheria, tetanus, pertussis, poliomyelitis, Haemophilus influenzae type b, and hepatitis B), or postpone it. We investigated the relation between the GPs' recommendation to vaccinate, the clinical vignette's variables, and the GPs' perceptions, attitudes, and practices toward vaccination in a multivariate model. RESULTS Among the 1582 participating GPs, 6% recommended immediate vaccination. This behavior was more frequent with a temperature of 38°C rather than 39°C (10% vs. 3%, P<0.001). GPs who felt comfortable giving explanations about vaccine safety were more likely to recommend immediate vaccination of the febrile child (P=0.045), but none of the other GPs' characteristics were associated with their vaccination behavior. CONCLUSIONS Almost all GPs postponed the hexavalent vaccination of the febrile child presenting with an uncomplicated viral disease; fever being the major factor affecting their decision. More research is needed on vaccination responses in sick children, as well as clearer guidelines.
Collapse
Affiliation(s)
- M Le Maréchal
- Université de Lorraine, EA 4360 APEMAC, 54000 Nancy, France.
| | - L Fressard
- Aix-Marseille université, UMR_S912, IRD, 13000 Marseille, France; Observatoire régional de la santé Provence-Alpes-Côte d'Azur (ORS PACA), 13000 Marseille, France; Inserm, UMR_S912, « Sciences Économiques & Sociales de la Santé et Traitement de l'Information Médicale » (SESSTIM), 13000 Marseille, France
| | - J Raude
- EHESP-Rennes, Sorbonne-Paris-Cité, 35043 Rennes, France; Aix-Marseille université, EPV-UMR_D 190 « Émergence des Pathologies Virales », 13000 Marseille, France
| | - P Verger
- Aix-Marseille université, UMR_S912, IRD, 13000 Marseille, France; Observatoire régional de la santé Provence-Alpes-Côte d'Azur (ORS PACA), 13000 Marseille, France; Inserm, UMR_S912, « Sciences Économiques & Sociales de la Santé et Traitement de l'Information Médicale » (SESSTIM), 13000 Marseille, France; Inserm, F-CRIN, I-Reivac (Innovative clinical research network in vaccinology), 75654 Paris, France
| | - C Pulcini
- Université de Lorraine, EA 4360 APEMAC, 54000 Nancy, France; Inserm, F-CRIN, I-Reivac (Innovative clinical research network in vaccinology), 75654 Paris, France; Service de maladies infectieuses et tropicales, CHRU de Nancy, 54000 Nancy, France
| |
Collapse
|
34
|
Bocquier A, Fressard L, Galtier F, Verger P. Influenza vaccine coverage trends among targeted groups from 2006 to 2015, in France. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
35
|
Bocquier A, Fressard L, Paraponaris A, Davin B, Verger P. Seasonal influenza vaccine uptake among people with disabilities: A nationwide population study of disparities by type of disability and socioeconomic status in France. Prev Med 2017; 101:1-7. [PMID: 28533104 DOI: 10.1016/j.ypmed.2017.05.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 05/14/2017] [Accepted: 05/16/2017] [Indexed: 11/17/2022]
Abstract
People with disabilities use various preventive health services less frequently than others, notably because of a lower socioeconomic status (SES). We examined variations of seasonal influenza vaccine uptake according to type/severity of disability and SES. We analyzed (in 2016) data from the 2008 French national cross-sectional survey on health and disability (n=12,396 adults living in the community and belonging to target groups for seasonal influenza vaccination). We defined seasonal influenza vaccine uptake during the 2007-2008 season by the self-reporting of a flu shot between September 2007 and March 2008. We built scores of mobility, cognitive, and sensory limitations, and an SES score based on education, occupation, and income. We performed bivariate analyses and then multiple log-binomial regressions. The prevalence of vaccine uptake was 23% in the 18-64 group and 63% in the ≥65 group. In bivariate analyses, it was higher among people in both age groups who had mobility and/or cognitive limitations and in the ≥65 group among those with sensory limitations. In the multiple regression analyses, only the presence of major mobility limitations in the18-64 group remained significant. The probability of vaccine uptake was higher in the highest SES category than in the lowest. Among at-risk groups, people with disabilities were more frequently vaccinated than others, mainly because of their higher levels of morbidity and healthcare use. Socioeconomic inequalities in access to vaccination persist in France. Future research is needed to monitor the trend in vaccine uptake in institutions.
Collapse
Affiliation(s)
- Aurélie Bocquier
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Economics and Social Sciences Applied to Health & Analysis of Medical Information, Marseille, France; ORS PACA, Southeastern Health Regional Observatory, Marseille, France.
| | - Lisa Fressard
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Economics and Social Sciences Applied to Health & Analysis of Medical Information, Marseille, France; ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Alain Paraponaris
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France; Aix Marseille Univ, CNRS, EHESS, Centrale Marseille, GREQAM, Marseille, France
| | - Bérengère Davin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Economics and Social Sciences Applied to Health & Analysis of Medical Information, Marseille, France; ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Pierre Verger
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Economics and Social Sciences Applied to Health & Analysis of Medical Information, Marseille, France; ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| |
Collapse
|
36
|
Verger P, Collange F, Fressard L, Bocquier A, Gautier A, Pulcini C, Raude J, Peretti-Watel P. Prevalence and correlates of vaccine hesitancy among general practitioners: a cross-sectional telephone survey in France, April to July 2014. ACTA ACUST UNITED AC 2017; 21:30406. [PMID: 27918262 PMCID: PMC5291145 DOI: 10.2807/1560-7917.es.2016.21.47.30406] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 07/11/2016] [Indexed: 01/21/2023]
Abstract
This article sought to estimate the prevalence of vaccine hesitancy (VH) among French general practitioners (GPs) and to study its demographic, professional and personal correlates. We conducted a cross-sectional telephone survey about GPs' vaccination-related attitudes and practices in 2014 in a national panel of 1,712 GPs in private practice, randomly selected from an exhaustive database of health professionals in France. A cluster analysis of various dimensions of VH (self-reported vaccine recommendations, perceptions of vaccine risks and usefulness) identified three clusters: 86% of GPs (95% confidence interval (CI): 84-88) were not or only slightly vaccine-hesitant, 11% (95% CI: 9-12) moderately hesitant and 3% (95% CI: 3-4) highly hesitant or opposed to vaccination. GPs in the latter two clusters were less frequently vaccinated and reported occasional practice of alternative medicine more often than those in the first cluster; they also described less experience with vaccine-preventable diseases and more experience with patients who they considered had serious adverse effects from vaccination. This study confirms the presence of VH among French GPs but also suggests that its prevalence is moderate. Given GPs' central role in vaccination, these results nevertheless call for a mobilisation of stakeholders to address VH among GPs.
Collapse
Affiliation(s)
- Pierre Verger
- INSERM, UMR912 'Economics and Social Sciences Applied to Health and Analysis of Medical Information' (SESSTIM), Marseille, France.,ORS PACA, South-eastern Health Regional Observatory, Marseille, France.,Aix Marseille Université, UMR_S 912, IRD, Marseille, France.,INSERM, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), GH Cochin Broca Hôtel Dieu, Paris, France
| | - Fanny Collange
- INSERM, UMR912 'Economics and Social Sciences Applied to Health and Analysis of Medical Information' (SESSTIM), Marseille, France.,ORS PACA, South-eastern Health Regional Observatory, Marseille, France.,Aix Marseille University, URMITE, IRD 198, UMR CNRS 7278, INSERM 1095, Faculté de Médecine, Marseille, France
| | - Lisa Fressard
- INSERM, UMR912 'Economics and Social Sciences Applied to Health and Analysis of Medical Information' (SESSTIM), Marseille, France.,ORS PACA, South-eastern Health Regional Observatory, Marseille, France.,Aix Marseille Université, UMR_S 912, IRD, Marseille, France
| | - Aurélie Bocquier
- INSERM, UMR912 'Economics and Social Sciences Applied to Health and Analysis of Medical Information' (SESSTIM), Marseille, France.,ORS PACA, South-eastern Health Regional Observatory, Marseille, France.,Aix Marseille Université, UMR_S 912, IRD, Marseille, France
| | - Arnaud Gautier
- Santé publique France (the French national public health agency), Saint-Maurice, France
| | - Céline Pulcini
- CHU de Nancy, Service de Maladies Infectieuses et Tropicales, Hôpitaux de Brabois, Vandœuvre-lès-Nancy, France.,Lorraine University, Paris Descartes University, EA 4360 Apemac, Vandœuvre-lès-Nancy, France
| | - Jocelyn Raude
- EHESP, Sorbonne Paris Cité, Rennes, France.,Aix-Marseille University, IRD French Institute of Research for Development, EHESP, UMR_D 190 'Emergence des Pathologies Virales', Marseille, France
| | - Patrick Peretti-Watel
- INSERM, UMR912 'Economics and Social Sciences Applied to Health and Analysis of Medical Information' (SESSTIM), Marseille, France.,ORS PACA, South-eastern Health Regional Observatory, Marseille, France.,Aix Marseille Université, UMR_S 912, IRD, Marseille, France
| |
Collapse
|
37
|
Carrieri MP, Marcellin F, Fressard L, Préau M, Sagaon-Teyssier L, Suzan-Monti M, Guagliardo V, Mora M, Roux P, Dray-Spira R, Spire B. Suicide risk in a representative sample of people receiving HIV care: Time to target most-at-risk populations (ANRS VESPA2 French national survey). PLoS One 2017; 12:e0171645. [PMID: 28192455 PMCID: PMC5305195 DOI: 10.1371/journal.pone.0171645] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 01/24/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Suicide risk is high among people living with HIV (PLHIV). This study aimed to identify major correlates of suicide risk in a representative sample of PLHIV in France, in order to help target individuals who would benefit from suicide risk screening and psychiatric care. METHODS The ANRS VESPA2 cross-sectional survey (April 2011-January 2012) collected socio-demographic, medical and behavioral data from 3,022 PLHIV recruited in 73 French HIV hospital departments. The study sample comprised the 2,973 participants with available self-reported data on suicide risk (defined as having either thought about and planned to commit suicide during the previous 12 months or attempted suicide during the same period of time) and medical data on comorbidities. Weighted Poisson models adjusted for HCV co-infection and significant clinical variables were used to estimate the relationship between suicide risk and HIV transmission groups, experience with HIV disease and other psychosocial factors. RESULTS Suicide risk was reported by 6.3% of PLHIV in the study sample. After adjustment for HIV immunological status and HCV co-infection, women (IRR [95%CI]:1.93 [1.17; 3.19]) and men who have sex with men (MSM) (1.97 [1.22; 3.19]) had a higher suicide risk than the rest of the sample. Moreover, the number of discrimination-related social contexts reported (1.39 [1.19; 1.61]), homelessness (4.87 [1.82; 13.02]), and reporting a feeling of loneliness (4.62 [3.06; 6.97]) were major predictors of suicide risk. CONCLUSIONS Reducing the burden of precarious social conditions and discrimination is an important lever for preventing suicide risk among PLHIV in France. Comprehensive care models involving peer/community social interventions targeted at women and MSM need to be implemented to lower the risk of suicide in these specific subgroups of PLHIV.
Collapse
Affiliation(s)
- Maria Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
- * E-mail: (FM); (LF)
| | - Lisa Fressard
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
- * E-mail: (FM); (LF)
| | - Marie Préau
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- GREPS, Psychology Institute, Lyon 2 University, 5 avenue Pierre Mendes-France, Bron, France
| | - Luis Sagaon-Teyssier
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Marie Suzan-Monti
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Valérie Guagliardo
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Marion Mora
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Perrine Roux
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Rosemary Dray-Spira
- INSERM, UMR_S1136, Pierre Louis Institute of Epidemiology and Public Health, Team Research in social epidemiology, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S1136, Pierre Louis Institute of Epidemiology and Public Health, Team Research in social epidemiology, Paris, France
| | - Bruno Spire
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - ANRS-VESPA2 Study Group
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| |
Collapse
|
38
|
Sagaon-Teyssier L, Fressard L, Mora M, Maradan G, Guagliardo V, Suzan-Monti M, Dray-Spira R, Spire B. Larger is not necessarily better! Impact of HIV care unit characteristics on virological success: results from the French national representative ANRS-VESPA2 study. Health Policy 2016; 120:936-47. [PMID: 27450774 DOI: 10.1016/j.healthpol.2016.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 08/02/2015] [Revised: 06/28/2016] [Accepted: 07/03/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To determine the impact of hospital caseload size on HIV virological success when taking into account individual patient characteristics. METHODS Data from the ANRS-VESPA2 survey representative of people living with HIV in France was used. Analyses were carried out on the 2612 (86.4% out of 3022) individuals receiving antiretroviral (ARV) treatment for at least one year. Outcomes correspond to two definitions of virological success (VS1 and VS2 respectively) and were analyzed under a multi-level modeling framework with a special focus on the effect of the caseload size on VS. RESULTS Structures with caseloads <1700 patients were more likely to have increased the proportion of patients achieving virological success (59% and 81% for VS1 and VS2, respectively) than structures whose caseloads numbered ≥1700 patients. Our results highlight that patients in the 11 largest care units in the sample were exposed to a context where their VS was potentially compromised by care unit characteristics, independently of both their individual characteristics and their own HIV treatment adherence behavior. CONCLUSIONS Our results suggest that - at least in the case of HIV care - in France large care units are not necessarily better. This result serves as an evidence-based warning to public authorities to ensure that health outcomes are guaranteed in an era when the French hospital sector is being substantially restructured.
Collapse
Affiliation(s)
- Luis Sagaon-Teyssier
- INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), Marseille, France; Aix Marseille University, UMR_S912, IRD, Marseille, France; ORS PACA, Southeastern Health Regional Observatory, Marseille, France.
| | - Lisa Fressard
- INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), Marseille, France; Aix Marseille University, UMR_S912, IRD, Marseille, France; ORS PACA, Southeastern Health Regional Observatory, Marseille, France.
| | - Marion Mora
- INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), Marseille, France; Aix Marseille University, UMR_S912, IRD, Marseille, France; ORS PACA, Southeastern Health Regional Observatory, Marseille, France.
| | - Gwenaëlle Maradan
- INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), Marseille, France; Aix Marseille University, UMR_S912, IRD, Marseille, France; ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Valérie Guagliardo
- INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), Marseille, France; Aix Marseille University, UMR_S912, IRD, Marseille, France; ORS PACA, Southeastern Health Regional Observatory, Marseille, France.
| | - Marie Suzan-Monti
- INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), Marseille, France; Aix Marseille University, UMR_S912, IRD, Marseille, France; ORS PACA, Southeastern Health Regional Observatory, Marseille, France.
| | - Rosemary Dray-Spira
- INSERM, UMR_S1136, Pierre Louis Institute of Epidemiology and Public Health, Team Research in social epidemiology, F-75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S1136, Pierre Louis Institute of Epidemiology and Public Health, Team Research in Social Epidemiology, F-75013, Paris, France.
| | - Bruno Spire
- INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), Marseille, France; Aix Marseille University, UMR_S912, IRD, Marseille, France; ORS PACA, Southeastern Health Regional Observatory, Marseille, France.
| | | |
Collapse
|
39
|
Agrinier N, Le Maréchal M, Fressard L, Verger P, Pulcini C. COL 5-05 - Discordances chez les médecins généralistes entre la vaccination de leurs patients et celle de leur(s) enfant(s) : une étude transversale. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30280-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
40
|
Raude J, Fressard L, Gautier A, Pulcini C, Peretti-Watel P, Verger P. Opening the 'Vaccine Hesitancy' black box: how trust in institutions affects French GPs' vaccination practices. Expert Rev Vaccines 2016; 15:937-48. [PMID: 27140417 DOI: 10.1080/14760584.2016.1184092] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND In recent years, vaccine hesitancy among health professionals has emerged as an important issue on public health agendas. However, we do not yet know very much about whether, and if so how, trust in institutions affects their practices. METHODS A path analysis model explaining the influence of trust on GPs' vaccine hesitancy was applied to a cross-sectional survey of 1,582 French GPs performed in 2014. We hypothesized that distrust in public health institutions influences GPs' concerns about the safety of various vaccines, their perceptions about the importance of vaccination, their self-efficacy in the doctor-patient relationship, and ultimately their vaccination recommendations to patients. RESULTS GPs' trust in institutions was found to be significantly associated with lower vaccine hesitancy, an association mediated to a large extent by the vaccine's perceived safety (β = 0.09, P < 0.01) and the importance of vaccination (β = 0.46, P < 0.001). CONCLUSION These results suggest that restoration of high vaccination coverage may require the re-establishment of a significant degree of trust in the public health system among health professionals.
Collapse
Affiliation(s)
- Jocelyn Raude
- a IRD French Institute of Research for Development, EHESP French School of Public Health, UMR_D 190 'Emergence des Pathologies Virales' , Aix Marseille University , Marseille , France.,b UMR PIMIT, INSERM 1187, CNRS 9192, IRD 249. Plateforme Technologique CYROI , Université de La Réunion , Réunion , France
| | - Lisa Fressard
- c UMR912 'Economics and Social Sciences Applied to Health & Analysis of Medical Information' (SESSTIM) , INSERM , Marseille , France.,d UMR_S912, IRD, 13006, Aix Marseille University , Marseille , France.,e ORS PACA, Southeastern Health Regional Observatory , Marseille , France
| | - Arnaud Gautier
- f French Public Health Agency, Direction de la prévention - promotion de la santé , Saint-Maurice , France
| | - Céline Pulcini
- g Université de Lorraine, Université Paris Descartes, EA 4360 APEMAC , Nancy , France.,h CHU de Nancy, Service de Maladies Infectieuses , Nancy cedex , France
| | - Patrick Peretti-Watel
- c UMR912 'Economics and Social Sciences Applied to Health & Analysis of Medical Information' (SESSTIM) , INSERM , Marseille , France.,d UMR_S912, IRD, 13006, Aix Marseille University , Marseille , France.,e ORS PACA, Southeastern Health Regional Observatory , Marseille , France
| | - Pierre Verger
- c UMR912 'Economics and Social Sciences Applied to Health & Analysis of Medical Information' (SESSTIM) , INSERM , Marseille , France.,d UMR_S912, IRD, 13006, Aix Marseille University , Marseille , France.,e ORS PACA, Southeastern Health Regional Observatory , Marseille , France
| |
Collapse
|
41
|
Collange F, Fressard L, Pulcini C, Sebbah R, Peretti-Watel P, Verger P. General practitioners' attitudes and behaviors toward HPV vaccination: A French national survey. Vaccine 2016; 34:762-8. [PMID: 26752063 DOI: 10.1016/j.vaccine.2015.12.054] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [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: 09/30/2015] [Revised: 12/18/2015] [Accepted: 12/23/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE General practitioners (GPs) play a crucial role in human papillomavirus (HPV) vaccine acceptance in France. We sought to study: (1) GPs' perceptions of its risks and efficacy and their recommendation behavior; (2) the relative importance of factors associated with the frequency of their recommendations. METHODS Cross-sectional observational study in 2014 nested in a national panel of 1712 randomly selected GPs in private practice in France (response rate: 92.4%). We used model averaging to analyze the associations of self-reported frequency of GPs' HPV vaccine recommendations with their perception of its risk-benefit balance and their opinions about the utility of vaccines in general. RESULTS Overall, 72% of participants reported frequently recommending HPV vaccination; 60% considered that not enough is known about its risks. The model averaging showed that the factors most associated with infrequent recommendation of this vaccine by GPs were: unfavorable perceptions of its risk-benefit balance (OR=0.13; 95%CI=0.09-0.21; partial R(2)=0.10), a decision not to vaccinate one's own daughter(s) with this vaccine (OR=0.13; 95%CI=0.07-0.24; partial R(2)=0.05), and doubts about vaccine utility in general (OR=0.78; 95%CI=0.71-0.86; partial R(2)=0.03). CONCLUSION Although nearly three-quarters of French GPs frequently recommended the HPV vaccine, our findings indicate that a substantial percentage of them are hesitant about it. Doubts about its risks and efficacy strongly influence their recommendation behavior. More research is warranted to help design and evaluate tailored tools and multicomponent intervention strategies to address physician's hesitancy about this vaccine.
Collapse
Affiliation(s)
- Fanny Collange
- Aix Marseille University, URMITE, IRD 198, UMR CNRS 7278, INSERM 1095, Faculté de Médecine, 13005 Marseille, France; INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006 Marseille, France; ORS PACA, Southeastern Health Regional Observatory, 13006 Marseille, France
| | - Lisa Fressard
- INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006 Marseille, France; ORS PACA, Southeastern Health Regional Observatory, 13006 Marseille, France; Aix-Marseille University, IRD, UMR-S912, 13006 Marseille, France
| | - Céline Pulcini
- CHU de Nancy, Service de Maladies Infectieuses et Tropicales, Hôpitaux de Brabois, 54511 Vandœuvre-lès-Nancy cedex, France; Lorraine University, Paris Descartes University, EA 4360 Apemac, 54505 Vandœuvre-lès-Nancy cedex, France
| | - Rémy Sebbah
- Regional Unions of Healthcare Professionals (Southeastern Region) - Self-employed Physicians (URPS-ML PACA), 13006 Marseille, France
| | - Patrick Peretti-Watel
- INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006 Marseille, France; ORS PACA, Southeastern Health Regional Observatory, 13006 Marseille, France; Aix-Marseille University, IRD, UMR-S912, 13006 Marseille, France
| | - Pierre Verger
- INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006 Marseille, France; ORS PACA, Southeastern Health Regional Observatory, 13006 Marseille, France; Aix-Marseille University, IRD, UMR-S912, 13006 Marseille, France; INSERM, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), GH Cochin Broca Hôtel Dieu, 75014 Paris, France.
| |
Collapse
|
42
|
Le Maréchal M, Collange F, Fressard L, Peretti-Watel P, Sebbah R, Mikol F, Agamaliyev E, Gautier A, Pulcini C, Verger P. Design of a national and regional survey among French general practitioners and method of the first wave of survey dedicated to vaccination. Med Mal Infect 2015; 45:403-10. [PMID: 26494319 DOI: 10.1016/j.medmal.2015.09.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [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: 02/23/2015] [Revised: 07/20/2015] [Accepted: 09/10/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES France is currently facing a vaccine-hesitancy crisis. We conducted a questionnaire-based telephone interview with a large sample of general practitioners (GPs) as they play a crucial role in the vaccination process. Our main objectives were to study the GPs' vaccination behaviors when it comes to their own vaccination and that of their relatives, and the vaccine recommendations made to their patients. We also aimed to understand their opinion related to the severity of vaccine-preventable diseases and to assess their trust in various sources of information. Finally, we enquired about their opinion in terms of vaccination-related tools that could help them in their daily practice. The article aimed to present the design of this panel and survey. PATIENTS AND METHODS Four samples of GPs (one national and three regional) were selected among all the French GPs (metropolitan France) using random sampling. Five cross-sectional surveys should be conducted with that panel. The mean targeted sample size is 2350 GPs for each survey. The survey dedicated to vaccination was conducted by telephone or on the Internet. RESULTS GPs were included in the survey between December 2013 and February 2014. The national sample included 1582 GPs (response rate: 46%) and the three regional samples included 1297 GPs (response rate: 44%). The survey dedicated to vaccination was conducted between April and July 2014; the national sample response rate was 92% (1582/1712). CONCLUSION The results of the first wave of surveys, conducted on a large sample of French GPs, provide important information to guide the French vaccination policy.
Collapse
Affiliation(s)
- M Le Maréchal
- EA4360APEMAC, université de Lorraine, université Paris-Descartes, 54000 Nancy, France
| | - F Collange
- UMR912 (SESSTIM), Inserm, 13000 Marseille, France; UMR_S912, IRD, Aix-Marseille université, 13000 Marseille, France; Observatoire régional de la santé Provence-Alpes-Côte d'Azur (ORS PACA), 13000 Marseille, France
| | - L Fressard
- UMR912 (SESSTIM), Inserm, 13000 Marseille, France; UMR_S912, IRD, Aix-Marseille université, 13000 Marseille, France; Observatoire régional de la santé Provence-Alpes-Côte d'Azur (ORS PACA), 13000 Marseille, France
| | - P Peretti-Watel
- UMR912 (SESSTIM), Inserm, 13000 Marseille, France; UMR_S912, IRD, Aix-Marseille université, 13000 Marseille, France; Observatoire régional de la santé Provence-Alpes-Côte d'Azur (ORS PACA), 13000 Marseille, France
| | - R Sebbah
- Union régionale des professionnels de santé - médecins libéraux (URPS-ML) PACA, 37/39, boulevard Vincent-Delpuech, 13006 Marseille, France
| | - F Mikol
- Bureau des professions de santé, DREES, ministère des Affaires sociales, de la Santé et des Droits des femmes, 14, avenue Duquesne, 75350 Paris 07 SP, France
| | - E Agamaliyev
- Bureau des professions de santé, DREES, ministère des Affaires sociales, de la Santé et des Droits des femmes, 14, avenue Duquesne, 75350 Paris 07 SP, France
| | - A Gautier
- Institut national de prévention et d'éducation pour la santé, direction des affaires scientifiques, 42, boulevard de la Libération, 93203 Saint-Denis cedex, France
| | - C Pulcini
- EA4360APEMAC, université de Lorraine, université Paris-Descartes, 54000 Nancy, France; Service de maladies infectieuses et tropicales, bâtiment des spécialités médicales, hôpitaux de Brabois, CHU de Nancy, allée du Morvan, 54511 Vandœuvre-lès-Nancy cedex, France.
| | - P Verger
- UMR912 (SESSTIM), Inserm, 13000 Marseille, France; UMR_S912, IRD, Aix-Marseille université, 13000 Marseille, France; Observatoire régional de la santé Provence-Alpes-Côte d'Azur (ORS PACA), 13000 Marseille, France; Inserm, F-CRIN, I-Reivac, immeuble AROPA, 35, rue Bernard-de-Ventadour, 31300 Toulouse, France
| |
Collapse
|