It just doesn't feel right - the relevance of emotions and intuition for parental vaccine conspiracy beliefs and vaccination uptake

Objective: Vaccine hesitancy has been identified as one of the major contributors to child under-vaccination. Research indicates that some hesitant parents' mistrust extends to specific conspiracy ideation, but research on vaccine conspiracy beliefs is still scarce. Our objective was to explore factors contributing to parental vaccine conspiracy beliefs and actual vaccine uptake in children.Design: A cross-sectional correlational design with a non-probabilistic sample of 823 volunteer participants surveyed online.Main outcome measures: We focussed on the contributions of the analytically rational and experientially intuitive thinking styles, as well as measures of emotional functioning, namely optimism and emotions towards vaccination, to vaccine conspiracy beliefs and vaccine uptake as outcomes.Results: The obtained results showed that greater vaccine conspiracy beliefs were associated with stronger unpleasant emotions towards vaccination and greater experientially intuitive thinking, as well as lower levels of education. Furthermore, unpleasant emotions towards vaccination and intuitive thinking were associated with vaccine refusal.Conclusion: These findings confirm the primary importance of emotions, along with the propensity towards intuitive thinking, in the context of vaccine conspiracy beliefs and refusal, supporting the notion that parents' avoidance is guided by their affect. These results have direct implications for addressing vaccine hesitancy within public campaigns and policies.

Decision making processes underlying avoidance of mandatory child vaccination in Croatia - a qualitative study

Despite extensive research evidencing child vaccination is safe and effective, we are witnessing a trend of increasing vaccine hesitancy which is listed among the top ten global health threats. Although some countries incorporate mandatory vaccination programs, no particularly efficient strategies for addressing vaccine avoidance have so far been identified. Within this study we investigated perceptions and reasoning of vaccine hesitant parents from Croatia where child vaccination is mandatory. The aims were to reveal different strategies by which they avoid mandatory vaccination schedules and hypothetical situations in which they would reconsider vaccinating, as well as to identify features of related decision-making. We conducted 25 semi-structured interviews with vaccine hesitant parents and analyzed the data using the framework of thematic analyses. The identified themes were related to the parents’ decision-making process, reflection as well as justification of their decision, avoidance behavior of mandatory vaccination schedules and related consequences, dealing with outcomes of the decision and reconsidering vaccinating. The results support and extend previous findings regarding vaccine reasoning, linking hesitancy with the experientially intuitive thinking style and social intuitionist model of moral reasoning. The findings provide important insights into vaccination avoidance and potential for reconsideration, as well as dealing with related risks. Furthermore, we offer a general framework as well as practical guidelines that may help the development of strategies aimed at increasing vaccination rates.

Contribution of rationality to vaccine attitudes: Testing two hypotheses

Although previous studies have demonstrated an association between vaccine attitudes and cognitive biases, often resulting in vaccination hesitancy, the exact contribution of rationality has not been fully clarified. We tested two hypotheses regarding the impact of rationality on vaccine attitudes stemming from bounded and expressive rationality. We focused on parental vaccine attitudes operationalized by the affective, behavioral, and cognitive attitude components and investigated how these are influenced by disillusionment toward authorities and ability to engage in rational thinking operationalized using cognitive reflection and heuristics and biases tasks. The study was of a cross‐sectional correlational design with a non‐probabilistic sample of 823 volunteer participants surveyed online in April and May 2018 in Croatia. The results identified disillusionment toward authorities as a predictor of all components. Furthermore, performance on heuristics and biases tasks also predicted the affective and cognitive, but not the behavioral component, whereas cognitive reflection had no impact on vaccine attitudes. Next, a moderation effect of disillusionment toward authorities on the association between the omission bias task and all attitude components was identified. Parents with low disillusionment demonstrated positive vaccine attitudes regardless of their rationality, whereas for parents with high disillusionment a significant positive correlation between performance on the omission bias task as assessed with a vaccination vignette and attitudes was identified. This suggests that the ability to resist vaccine specific omission bias, that is, higher rationality, can decrease the negative effects of disillusionment, which supports the bounded rationality hypothesis.

Turning 18 in mental health services: a multicountry qualitative study of service user experiences and views

BACKGROUND

Worldwide, the division between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) has frequently resulted in fragmented care with an unprepared, non-gradual transition. To improve continuity of care and other service transition experiences, service user input is essential. However, such previous qualitative studies are from a decade ago or focused on one mental disorder or country. The aim of the present study was to learn from service users' transition experiences and suggested improvements.

METHODS

Semi-structured interviews were held with young people aged 18-24 and/or parents/caregivers in the United Kingdom, Ireland, the Netherlands and Croatia. Inclusion was based on the experience of specialist mental health care before and after turning 18. Thematic analysis of transcribed and translated interview transcripts was performed using ATLAS.ti 9.

RESULTS

Main themes of service user experiences included abrupt changes in responsibilities, various barriers and a lack of preparation, communication and ongoing care. Young people expressed a great need for continuity of care. Their suggestions to improve transitional care included early and adequate preparation, joint working, improved communication from and between services, overlapping services, staying at CAMHS for longer and designated youth mental health teams.

CONCLUSIONS

Young people who experienced care before and after turning 18 suggested either altering the age limits of services or ensuring early preparation and communication regarding the transition and finding AHMS. This communication should include general changes when turning 18. Further considerations include increasing collaboration and overlap between CAMHS and AMHS.