Development and Assessment of a Six-Item Index to Gauge Motivation to Receive COVID-19 Vaccination.

This study examined the factors influencing vaccine uptake using the Fogg Behavioral Model (FBM) and validated a multi-dimensional index for measuring a key construct in the FBM, motivation, using Confirmatory Factor Analysis (CFA) and Cronbach's alpha. The research was conducted in Yopougon Est, Côte d'Ivoire, and Kinshasa, Democratic Republic of Congo. We aimed to develop a motivation index for COVID-19 vaccination uptake informed by the FBM. The motivation index was developed and refined using interviews and cognitive testing, and then used in baseline and endline surveys to measure the motivation to uptake COVID-19 vaccination among 2173 respondents. The index was simplified to six items validated using Confirmatory Factor Analysis (CFA) and demonstrated strong internal reliability with Cronbach's alphas of 0.89 for the baseline and 0.77 for the endline. The study's findings indicate that this motivation index is a valid tool for measuring motivation to receive COVID-19 vaccination, with potential applications in other vaccination campaigns. However, further testing in diverse settings is needed to enhance generalizability, including in rural areas. This research provides valuable insights for designing effective behavior change interventions to increase COVID-19 vaccination rates.

Identifying Drivers of COVID-19 Vaccine Uptake among Residents of Yopougon Est, Abidjan, Côte d'Ivoire.

This study applied the Fogg Behavioral Model (FBM) to identify and prioritize factors influencing COVID-19 vaccination among residents of Yopougon Est, Abidjan, Côte d'Ivoire. A total of 568 respondents were recruited from among individuals entering eleven participant recruitment and data collection sites located near high pedestrian trafficked areas. Among all respondents, 52% reported being vaccinated versus 48% who reported not being vaccinated. Of those who reported being vaccinated, 42% reported received a single dose, 54% a double dose, and 4% three or more doses. A categorical regression analysis suggested that potential predictors of COVID-19 vaccination included acceptance and rejection factors, which are both aligned with motivation in the FBM and socio-demographic characteristics, proximity to services, and religion. Our findings suggest that demand creation activities should target individuals with less formal education, those who are not formally employed, non-Catholic Christians, and individuals who do not identify as Akan. Results also suggest the need to design programmatic messages and activities that focus on generating family and community support for COVID-19 vaccination.

Baseline, Cross-sectional Survey of Knowledge, Attitudes, and Practices Related to Efficient Use of Government Resources in the Health Sector in Malawi.

Background: Misuse of government resources is a challenge within the health sector that can be addressed by increasing public demand for accountability, reporting suspected misuse of resources, and other client-driven changes. This study was led by the USAID/Health Communication for Life Project to inform the design of social accountability communication messages and interventions. The study also established baseline data on Malawians' knowledge, attitudes, and practices related to efficient use of government resources in the health sector. Methods: This baseline, formative research study used a non-experimental, cross sectional survey design. Sampling for the mobile survey was conducted using the random digit dialing technique. Data were collected via mobile phone using interactive voice response technology. Our sample included 1,425 respondents, 67% of whom were male and 33% were female. Respondents were mostly 35 years old or younger, with more than half of female respondents reporting their age as 18-24 years. Results: Our findings indicate that Malawians believe misuse of government resources is pervasive in Malawi. Seventy percent of men and nearly 60% of women reported having noticed, found, or seen drugs believed to be from a government health facility being sold elsewhere. Few respondents who had observed or experienced misuse of government health sector resources reported the incident. When asked the likelihood that they would report a request for a bribe, gift, or favor in exchange for health services in the future, 68% of respondents said they would report it. Conclusions: Social and behavior change communication could serve a key role in motivating those who are aware of misuse of public sector health resources to report the issues they observe and providing them with the information needed to follow through. Further research is needed to understand the best approaches to mitigate underlying factors that drive misuse of resources and underreporting.

Indicators of young women's modern contraceptive use in Burkina Faso and Mali from Demographic and Health Survey data.

BACKGROUND: High total fertility rates in Burkina Faso and Mali are leading to population growth beyond the agricultural and fiscal means of its citizens. Providing access to affordable family planning methods is a key step in driving the demographic transition where fertility and mortality rates decline. Furthermore, both nations face significant challenges as climate change is projected to disproportionately impact the western Sahel region undermining environmental, social and economic stability within the region. This analysis was included in formative research to inform family planning programming. The aim of this study was to examine possible indicators of long acting and permanent contraceptive method (LAPM) and short-term method (STM) use for young women in Burkina Faso and Mali. METHODS: Secondary data analysis was conducted using the three most recent Demographic and Health Survey (DHS) datasets for Burkina Faso (1998, 2003, 2010) and Mali (2001, 2006, 2012). Women ages 15-24, at risk for unwanted pregnancy were included in these analyses. Summary descriptive statistics across all time points are reported and multinomial logistic regression was used with the most recent data to determine potential indicators of different types of modern contraceptive methods. RESULTS: In Burkina Faso in 2010, 24% of women ages 15-24 were using modern contraceptives. Only 2.9% reported using LAPMs in 2010, an increase from 0.3% in 1998. In Mali, modern contraceptive use increased more recently, rising from 9.4% in 2001 to 10.2% in 2006 to 15.3% in 2012. LAPM use also increased from 0.3% in 2001 to 4.1% in 2012. Significant indicators of LAPM contraceptive use in both countries included educational attainment, ideal family size, home ownership and husband's desire for more children. CONCLUSIONS: Young women in Burkina Faso and Mali are increasingly using modern contraceptives for family planning; however, the LAPM contraceptive prevalence rate remains low. Our analysis indicates that social norms around ideal family size for both men and women continue to drive young women's choices around family planning and impede use of LAPMs. To increase modern contraceptive use and curb fertility rates, local governments and development organizations should focus on women's empowerment and include male partners.

Stress, burnout, compassion fatigue, and mental health in hospice workers in Minnesota.

BACKGROUND: Working in hospice care is a highly challenging yet rewarding profession. However, the challenges of working with dying patients and their families can overwhelm even the most highly dedicated professional, leading to burnout, compassion fatigue, anxiety, and depression. OBJECTIVE: The aim of this study was to better understand how stress affects the mental health of hospice workers in terms of burnout and compassion fatigue and how they cope with these issues. METHODS: Data for this study are from Compassion Fatigue and You, a cross-sectional survey of hospice staff from across Minnesota. We surveyed 547 hospice workers throughout Minnesota to better understand the overall mental health of staff, including levels of stress, burnout, and compassion fatigue, and how they cope with these issues. The study was conducted in 2008 and 2009 through a private, not-for-profit research institute affiliated with a large Midwestern health plan. RESULTS: Hospice staff reported high levels of stress, with a small but significant proportion reporting moderate-to-severe symptoms of depression, anxiety, compassion fatigue, and burnout. Staff reported managing their stress through physical activity and social support, and they suggested that more opportunities to connect with coworkers and to exercise could help decrease staff burnout. CONCLUSIONS: Poor mental health places staff at risk for burnout and likely contributes to staff leaving hospice care; this is a critical issue as the profession attempts to attract new staff to meet the expanding demands for hospice care.

Testing the importance of family solidarity, community structure, information access, and social capital in predicting nutrition health knowledge and food choices in the Philippines.

This study investigates the influence of family solidarity, community structure, information access, social capital, and socioeconomic status on the extent of nutrition and health knowledge (NHK) among primary household meal planners. In turn, we pose the question: does this knowledge influence dietary decision making? Data are taken from a survey determining socioeconomic impacts of vitamin A fortified peanut butter on Philippine households. Questions on the relationships of nutrition to health were selected to construct a knowledge index on which household respondents could be ranked. We then tested hypotheses regarding what types of individual, family-level, and community structural characteristics would predict performance on this index. The results indicate that the strongest predictors of NHK come from sociological theory related to family solidarity and community centrality, in addition to information accessibility and household income. Our findings also indicate that NHK influences dietary choices with regard to the purchase of a vitamin fortified staple food product, which is essential when addressing nutritional deficiency problems in developing countries.