Spatial Analysis of Determinants of COVID-19 Vaccine Hesitancy in Portugal.

Vaccine hesitancy tends to exhibit geographical patterns and is often associated with social deprivation and migrant status. We aimed to estimate COVID-19 vaccination hesitancy in a high-vaccination-acceptance country, Portugal, and determine its association with sociodemographic risk factors. We used the Registry of National Health System Users to determine the eligible population and the Vaccination Registry to determine individuals without COVID-19 vaccine doses. Individuals older than five with no COVID-19 vaccine dose administered by 31 March 2022 were considered hesitant. We calculated hesitancy rates by municipality, gender, and age group for all municipalities in mainland Portugal. We used the spatial statistical scan method to identify spatial clusters and the Besag, Yorke, and Mollié (BYM) model to estimate the effect of age, gender, social deprivation, and migrant proportion across all mainland municipalities. The eligible population was 9,852,283, with 1,212,565 (12%) COVID-19 vaccine-hesitant individuals. We found high-hesitancy spatial clusters in the Lisbon metropolitan area and the country's southwest. Our model showed that municipalities with higher proportions of migrants are associated with an increased relative risk (RR) of vaccine hesitancy (RR = 8.0; CI 95% 4.6; 14.0). Social deprivation and gender were not associated with vaccine hesitancy rates. We found COVID-19 vaccine hesitancy has a heterogeneous distribution across Portugal and has a strong association with the proportion of migrants per municipality.

The effects of weather and mobility on respiratory viruses dynamics before and during the COVID-19 pandemic in the USA and Canada.

The flu season is caused by a combination of different pathogens, including influenza viruses (IVS), that cause the flu, and non-influenza respiratory viruses (NIRVs), that cause common colds or influenza-like illness. These viruses exhibit similar dynamics and meteorological conditions have historically been regarded as a principal modulator of their epidemiology, with outbreaks in the winter and almost no circulation during the summer, in temperate regions. However, after the emergence of SARS-CoV2, in late 2019, the dynamics of these respiratory viruses were strongly perturbed worldwide: some infections displayed near-eradication, while others experienced temporal shifts or occurred "off-season". This disruption raised questions regarding the dominant role of weather while also providing an unique opportunity to investigate the roles of different determinants on the epidemiological dynamics of IVs and NIRVs. Here, we employ statistical analysis and modelling to test the effects of weather and mobility in viral dynamics, before and during the COVID-19 pandemic. Leveraging epidemiological surveillance data on several respiratory viruses, from Canada and the USA, from 2016 to 2023, we found that whereas in the pre-COVID-19 pandemic period, weather had a strong effect, in the pandemic period the effect of weather was strongly reduced and mobility played a more relevant role. These results, together with previous studies, indicate that behavioral changes resulting from the non-pharmacological interventions implemented to control SARS-CoV2, interfered with the dynamics of other respiratory viruses, and that the past dynamical equilibrium was disturbed, and perhaps permanently altered, by the COVID-19 pandemic.

Validation of the Spanish Healthy Lifestyle Questionnaire / Validación española del Cuestionario de Estilos de Vida Saludables

Background/Objective: It is essential to carry out a diagnosis of people’s healthy lifestyles, in order to apply strategies to improve them. The aim of the study was to validate the Healthy Lifestyles Questionnaire (CEVS-II), collecting all factors that make up the concept of a healthy lifestyle, such as a balanced diet, respect for mealtimes, tobacco consumption, rest habits, alcohol consumption, other drug use and physical activity. Method: The questionnaire was completed by 1,132 people between 18 and 89 (M = 42.43; SD = 18.69) years from different parts of Spain. Results: The seven-factor model proposed by the Confirmatory Factor Analysis, according to the goodness indices, presented an acceptable fit (SRMR = .059; CFI = .973; RMSEA = .049; 90% CI [.046, .052]; χ2/df = 3.76), also presented good reliability indices and was endowed with concurrent validity. Conclusions: The results of the present study proved the validity and reliability of the Healthy Lifestyles Questionnaire in a Spanish population, which is an adequate instrument for the diagnosis of a healthy lifestyles in the Spanish population. (AU)

Antecedentes/Objetivo: Resulta primordial realizar un diagnóstico de los estilos de vida saludables de las personas, con el fin de aplicar estrategias para la mejora de estos. El objetivo del estudio fue validar el Cuestionario de Estilos de Vida Saludables (CEVS-II), recogiendo todos los factores que componen el concepto de estilo de vida saludable como son la alimentación equilibrada, el respeto al horario de las comidas, el consumo de tabaco, los hábitos de descanso, el consumo de alcohol, el consumo de otras drogas y la práctica de actividad física. Método: El cuestionario fue cumplimentado por 1.132 personas de 18-89 (M = 42,43; DT = 18,69) años de diferentes partes de España. Resultados: El modelo de siete factores propuesto por el Análisis Factorial Confirmatorio presentó un ajuste aceptable (SRMR = 0,059; CFI = 0,973; RMSEA = 0,049; 90% CI [0,046 - 0,052]; χ2/df = 3,76), buenos índices de fiabilidad y de validez concurrente. Conclusiones: Los resultados del presente estudio probaron la validez y fiabilidad del Cuestionario de Estilos de Vida Saludables en una muestra española, dando lugar a un instrumento adecuado para la medición de estilos de vida saludables en la población española. (AU)

Validation of the Spanish Healthy Lifestyle Questionnaire.

Background/Objective: It is essential to carry out a diagnosis of people's healthy lifestyles, in order to apply strategies to improve them. The aim of the study was to validate the Healthy Lifestyles Questionnaire (CEVS-II), collecting all factors that make up the concept of a healthy lifestyle, such as a balanced diet, respect for mealtimes, tobacco consumption, rest habits, alcohol consumption, other drug use and physical activity. Method: The questionnaire was completed by 1,132 people between 18 and 89 (M = 42.43; SD = 18.69) years from different parts of Spain. Results: The seven-factor model proposed by the Confirmatory Factor Analysis, according to the goodness indices, presented an acceptable fit (SRMR = .059; CFI = .973; RMSEA = .049; 90% CI [.046, .052]; χ 2/df = 3.76), also presented good reliability indices and was endowed with concurrent validity. Conclusions: The results of the present study proved the validity and reliability of the Healthy Lifestyles Questionnaire in a Spanish population, which is an adequate instrument for the diagnosis of a healthy lifestyles in the Spanish population.

Antecedentes/Objetivo: Resulta primordial realizar un diagnóstico de los estilos de vida saludables de las personas, con el fin de aplicar estrategias para la mejora de estos. El objetivo del estudio fue validar el Cuestionario de Estilos de Vida Saludables (CEVS-II), recogiendo todos los factores que componen el concepto de estilo de vida saludable como son la alimentación equilibrada, el respeto al horario de las comidas, el consumo de tabaco, los hábitos de descanso, el consumo de alcohol, el consumo de otras drogas y la práctica de actividad física. Método: El cuestionario fue cumplimentado por 1.132 personas de 18-89 (M = 42,43; DT = 18,69) años de diferentes partes de España. Resultados: El modelo de siete factores propuesto por el Análisis Factorial Confirmatorio presentó un ajuste aceptable (SRMR = 0,059; CFI = 0,973; RMSEA = 0,049; 90% CI [0,046 - 0,052]; χ 2/df = 3,76), buenos índices de fiabilidad y de validez concurrente. Conclusiones: Los resultados del presente estudio probaron la validez y fiabilidad del Cuestionario de Estilos de Vida Saludables en una muestra española, dando lugar a un instrumento adecuado para la medición de estilos de vida saludables en la población española.