A pre-vaccine analysis using the Health Belief Model to explain parents' willingness to vaccinate (WTV) their children in the United States: implications for vaccination programs.

BACKGROUND: This study uses the Health Belief Model (HBM) to explain parents' willingness to vaccinate (WTV) their children with COVID-19 vaccine in the United States (US). The analysis included determining if vaccination choice among parents statistically varied based on geography among the sample collected. METHODS: A cross-sectional survey was administered on November 2020. Multiple regression analysis was completed, determining which HBM constructs to be most relevant to parents' WTV their children with COVID-19 vaccine. To determine 'hot' and 'cold' geographic spots for WTV, a hot spot analysis based on Getis-Ord Gi* statistics was executed. RESULTS: Primary data collection included a convenience sample of US parents. Approximately 66% of parents surveyed were 'likely/extremely likely' to vaccinate their children if the COVID-19 vaccine was provided free by the government. The results highlight HBM connections to WTV. CONCLUSIONS: The relationship between parents' WTV their children with a COVID-19 vaccine and constructs within the theoretical framework of the HBM represents a necessary point in the development of efficacious COVID-19 vaccination programs among parents in the US. Interpreting differences in location and health beliefs toward vaccines merit in-depth investigation for local-, state-, and federal-level vaccination programs to be effective.

Primary Factors Influencing the Decision to Vaccinate against COVID-19 in the United States: A Pre-Vaccine Analysis.

Because vaccine hesitancy is a dynamic trait, it is critical to identify and compare the contributing factors at the different stages of a pandemic. The prediction of vaccine decision making and the interpretation of the analytical relationships among variables that encompass public perceptions and attitudes towards the COVID-19 pandemic have been extensively limited to the studies conducted after the administration of the first FDA-approved vaccine in December of 2020. In order to fill the gap in the literature, we used six predictive models and identified the most important factors, via Gini importance measures, that contribute to the prediction of COVID-19 vaccine acceptors and refusers using a nationwide survey that was administered in November 2020, before the widespread use of COVID-19 vaccines. Concerns about (re)contracting COVID-19 and opinions regarding mandatory face covering were identified as the most important predictors of vaccine decision making. By investigating the vaccine acceptors and refusers before the introduction of COVID-19 vaccines, we can help public health officials design and deliver individually tailored and dynamic vaccination programs that can increase the overall vaccine uptake.

Parents' willingness to pay for a COVID-19 vaccine for themselves and their children in the United States.

Differences in obtaining a vaccine vary based on a multitude of factors including perceptions of vaccine safety, efficacy and willingness to pay (WTP). This study focuses on parent perceptions toward a vaccine for COVID-19 including their WTP decisions for their children and themselves. A mixed methods design using a cross-sectional survey was used to assess the perceptions of US parents, with children under 18, in response to the COVID-19 pandemic. The survey was administered online in November 2020 and 584 final responses were collected. The questionnaire consisted of approximately 37 closed and open-ended questions regarding personal background information; awareness, knowledge, and experience of the virus; perception toward vaccines and COVID-19; and the contingent valuation of a hypothetical COVID-19 vaccine. WTP was found to be higher for children and a direct relationship between the number of children and WTP was observed. Parents were willing to pay US$228-$291 for a vaccine for themselves and US$243-US$321 for their children. A positive impact on WTP was found with self-reported parent health status but not children. The findings of this study have important implications for policy programs which require detailed cost-benefit analyses. WTP for a COVID-19 vaccine is crucial to determine the partial benefits of vaccinating to reduce the risk of repetitive widespread outbreaks.

Elementary student and teacher perceptions of a mindfulness and yoga-based program in school: A qualitative evaluation.

RESEARCH QUESTION: What are the qualitative insights and perspectives about the implementation of a mindfulness and yoga-based program from elementary youth and teachers? CONTEXT: A mindfulness and yoga-based curriculum was implemented in 15 schools. The curriculum was taught to students during a physical education or dance class by instructors who were within each school and received training on the curriculum. SAMPLE SELECTION: Volunteer focus group elementary students who participated for one year and teachers who did not implement the program were qualitatively interviewed, by three trained University researchers. DATA COLLECTION: Nine focus groups were completed within three different elementary schools. Six focus groups were completed with 3rd and 5th grade students. Three focus groups were conducted with teachers within each school which received the program, excluding instructors. ANALYSIS: Focus group data were coded and a thematic analysis was completed among the 40 students and 23 teachers. INTERPRETATION AND MAIN RESULTS: Teachers had varying degrees of involvement with the program and communication emerged as a critical theme for buy-in as communication represents the underpinnings of creating and retaining stakeholders. Most students talked about perceived improvements in focus, emotional regulation, flexibility, breathing, and school work. A common theme to describe benefits of the program emerged with the idea of "increased focus". Conceptually, it may be that increasing mindfulness increases "focus" thus increasing positive outcomes. More research is needed to understand if "focus" may serve as a mediating variable on emotional regulation, cognitive improvements, and other health outcomes.

Perceptions of college and university presidents regarding tobacco-free campus policies.

OBJECTIVE: To identify college presidents' support for tobacco-free campus policies (TFCP), perceived barriers and benefits to implementing such policies, and activities that might initiate policy adoption. PARTICIPANTS: Participants were 405 presidents (51% of 796 delivered surveys) from a national sample of eligible 4-year institutions in summer 2012. METHODS: A 4-page, 24-item cross-sectional questionnaire was mailed to potential participants in 4 waves to maximize the response rate. RESULTS: The vast majority of presidents support TFCP (84%) and believed they should play a key role in establishing TFCP (80%). A majority agreed advocacy by campus groups was necessary to establishing TFCP. Presidents with an existing policy were twice as likely to believe advocacy was necessary for policy establishment. Presidents most commonly selected creating policy drafts and designating a committee as important to initiating TFCP. CONCLUSION: Advocates would benefit from focusing on presidential involvement and solutions to personnel barriers in establishing TFCP.

Physician assistants training on firearm injury prevention.

OBJECTIVE: The purpose of this study was to assess physician assistant training programs incorporation of firearm injury prevention training in their curricula. Also, content of such programs as well as perceived benefits and barriers of providing such training were explored. METHODS: A three-wave postal mailing of a 24-item questionnaire was sent to the population (n=145) of physician assistant program directors. RESULTS: The majority (77%) of directors responded. The majority (81.3%) reported they had not seriously thought about providing such training (pre-contemplation). The three most important barriers to providing firearm injury prevention training were: lack of time, lack of faculty expertise on the topic, and lack of standardized teaching materials. Those programs that offered training averaged one-half hour. Yet, 77.7% thought that firearm injuries were a very large or large problem to the health and wellbeing of the U.S. population. CONCLUSION: There is a paucity of professional training for physician assistants regarding firearm injury prevention. It appears unlikely that physician assistants are playing a role in helping to reduce one of the leading causes of death in the U.S., firearm trauma. The American Academy of Physician Assistants needs to take the lead in improving training in this area for physician assistants. PRACTICE IMPLICATIONS: Physician Assistant training program directors should consider offering firearm injury prevention training to help reduce patient suicides and homicides.

Hookah use among college students from a Midwest University.

National data indicate nearly a quarter of college students smoked from a hookah at some point in their lifetime regardless of gender. To address this issue, researchers assessed the perceptions, knowledge, beliefs of hookah users at a large Midwestern University and also determined what other drug related high-risk behaviors were associated with this behavior. An anonymous, online survey was sent to 2,000 randomly selected undergraduate students from a large Midwestern University. Researchers used a cross sectional research design to determine the prevalence and motivating factors associated with hookah use. Respondents included 438 individuals (60% female) with an average age of 23.1 (SD = 12.32), yielding a response rate of 22%. Approximately 15.4% of the sample had previously smoked hookah, while 6% used hookah within the past 30 days. Common motivating factors associated with smoking hookah included socializing/partying (29%), peer influence (27%), and for relaxation (25%). Correlations were calculated comparing hookah use to other high risk behaviors with the two highest correlations consisted of 30-day tobacco use (r = 0.67) and marijuana (r = 0.39). The results from this study suggest hookah use is limited to a small percentage of students. Students appear to smoke hookah for social reasons and underestimate the addictive properties associated with the product. Researchers and practitioners need to develop and evaluate specific interventions to educate college students about the health hazards associated with hookah use.

Strategies for implementing a tobacco-free campus policy.

This report examines the rationale for creating a tobacco-free campus to utilize in passing antitobacco policies, and recommendations for overcoming barriers. As with any type of advocacy effort, a variety of impediments exist, including lack of administrative and staff support, absence of student involvement, and sparse resources. A variety of potential remedies and advocacy opportunities are explored and delineated.