The dimensionality of vaccination intentions: One strain or multiple strains?

OBJECTIVE: People likely have different attitudes toward different vaccines (e.g., they may hold a positive attitude toward the measles, mumps, and rubella-vaccine while simultaneously hold a neutral attitude toward the flu shot). To examine the dimensionality of vaccination intentions, we measured vaccination intentions toward 16 different diseases. We hypothesized that people differentiate between child-directed vaccination intentions and self-directed vaccination intentions. Furthermore, we hypothesized that some commonly studied factors (e.g., trust in authorities and fear of needles) might have different associations with the two subtypes of vaccination intentions. METHOD: We used data from a nationally representative sample of the Netherlands collected in 2021. We used exploratory (N = 865) and confirmatory factor analysis (N = 865) to evaluate the dimensionality hypothesis and used linear hypothesis tests (N = 1,779) to test whether the commonly studied factors had different associations with the different subtypes of vaccination intentions. RESULTS: The analysis showed two distinct factors of vaccination intentions: intentions toward childhood diseases and intentions toward nonchildhood diseases. Additionally, spiritual beliefs, trust in authorities, and belief in conspiracy theories had stronger associations with nonchildhood diseases than with childhood diseases. Fear of needles, prosocial personality, and religious orthodox beliefs did not have different associations with both types of vaccination intentions. CONCLUSIONS: These findings suggest that vaccination intentions is a multidimensional construct and that interventions may benefit from being tailored to the factors relevant for each specific type of vaccine. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

From test to rest: evaluating socioeconomic differences along the COVID-19 care pathway in the Netherlands.

INTRODUCTION: The COVID-19 pandemic exacerbated healthcare needs and caused excess mortality, especially among lower socioeconomic groups. This study describes the emergence of socioeconomic differences along the COVID-19 pathway of testing, healthcare use and mortality in the Netherlands. METHODOLOGY: This retrospective observational Dutch population-based study combined individual-level registry data from June 2020 to December 2020 on personal socioeconomic characteristics, COVID-19 administered tests, test results, general practitioner (GP) consultations, hospital admissions, Intensive Care Unit (ICU) admissions and mortality. For each outcome measure, relative differences between income groups were estimated using log-link binomial regression models. Furthermore, regression models explained socioeconomic differences in COVID-19 mortality by differences in ICU/hospital admissions, test administration and test results. RESULTS: Among the Dutch population, the lowest income group had a lower test probability (RR = 0.61) and lower risk of testing positive (RR = 0.77) compared to the highest income group. However, among individuals with at least one administered COVID-19 test, the lowest income group had a higher risk of testing positive (RR = 1.40). The likelihood of hospital admissions and ICU admissions were higher for low income groups (RR = 2.11 and RR = 2.46, respectively). The lowest income group had an almost four times higher risk of dying from COVID-19 (RR = 3.85), which could partly be explained by a higher risk of hospitalization and ICU admission, rather than differences in test administration or result. DISCUSSION: Our findings indicated that socioeconomic differences became more pronounced at each step of the care pathway, culminating to a large gap in mortality. This underlines the need for enhancing social security and well-being policies and incorporation of health equity in pandemic preparedness plans.

Systematic review of individual-level, community-level, and healthcare system-level factors contributing to socioeconomic differences in healthcare utilisation in OECD countries with universal health coverage.

OBJECTIVES: Countries with universal health coverage (UHC) strive for equal access for equal needs without users getting into financial distress. However, differences in healthcare utilisation (HCU) between socioeconomic groups have been reported in countries with UHC. This systematic review provides an overview individual-level, community-level, and system-level factors contributing to socioeconomic status-related differences in HCU (SES differences in HCU). DESIGN: Systematic review following the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines. The review protocol was published in advance. DATA SOURCES: Embase, PubMed, Web of Science, Scopus, Econlit, and PsycInfo were searched on 9 March 2021 and 9 November 2022. ELIGIBILITY CRITERIA: Studies that quantified the contribution of one or more factors to SES difference in HCU in OECD countries with UHC. DATA EXTRACTION AND SYNTHESIS: Studies were screened for eligibility by two independent reviewers. Data were extracted using a predeveloped data-extraction form. Risk of bias (ROB) was assessed using a tailored version of Hoy's ROB-tool. Findings were categorised according to level and a framework describing the pathway of HCU. RESULTS: Of the 7172 articles screened, 314 were included in the review. 64% of the studies adjusted for differences in health needs between socioeconomic groups. The contribution of sex (53%), age (48%), financial situation (25%), and education (22%) to SES differences in HCU were studied most frequently. For most factors, mixed results were found regarding the direction of the contribution to SES differences in HCU. CONCLUSIONS: SES differences in HCU extensively correlated to factors besides health needs, suggesting that equal access for equal needs is not consistently accomplished. The contribution of factors seemed highly context dependent as no unequivocal patterns were found of how they contributed to SES differences in HCU. Most studies examined the contribution of individual-level factors to SES differences in HCU, leaving the influence of healthcare system-level characteristics relatively unexplored.

When opinions differ: the development of a reflection tool for youth professionals to support shared decision-making with parents.

The importance of shared decision-making (SDM) in youth care is increasingly emphasised. Professional reflection on the decision-making process is an important means to improve the use of SDM in practice. In this study, we report on the development of a reflection tool for youth professionals primarily to use when they hold a different opinion then parents about referral to specialised youth care services. In co-creation with local youth professionals and parent representatives from the South of the Netherlands, the tool was developed and tested in practice. This process was guided by a three-stage cyclical research project. First, reflective group discussions provided an initial understanding of professionals' needs, interests and experiences. This input then was analysed and documented into a draft tool with reflective questions. Next, this tool was tested on fictive and real life cases and adjusted with input from youth professionals and parents. This process resulted in an online reflection tool covering 16 overarching reflective questions to support youth professionals' reflection on their shared decision-making in practice. The tool can be used and adapted by others in the field of youth care to improve the process of making shared decisions with parents in complex cases.

Parents of young infants report poor mental health and more insensitive parenting during the first Covid-19 lockdown.

BACKGROUND: The Covid-19 pandemic has put an unprecedented pressure on families with children. How parents were affected by the first Covid-19 lockdown during the early postpartum period, an already challenging period for many, is unknown. AIM: To investigate the associations between Covid-19 related stress, mental health, and insensitive parenting practices in mothers and fathers with young infants during the first Dutch Covid-19 lockdown. METHODS: The Dutch Covid-19 and Perinatal Experiences (COPE-NL) study included 681 parents of infants between 0 and 6 months (572 mothers and 109 fathers). Parents filled out online questionnaires about Covid-19 related stress, mental health (i.e. anxiety and depressive symptoms), and insensitive parenting. Hierarchical regression models were used to analyze the data. RESULTS: Parents of a young infant reported high rates of Covid-19 related stress, with higher reported stress in mothers compared to fathers. Additionally, the percentages of mothers and fathers experiencing clinically meaningful mental health symptoms during the pandemic were relatively high (mothers: 39.7% anxiety, 14.5% depression; fathers: 37.6% anxiety, 6.4% depression). More Covid-19 related stress was associated with more mental health symptoms in parents and increased insensitive parenting practices in mothers. CONCLUSIONS: The results emphasize the strain of the pandemic on young fathers' and mothers' mental health and its potential negative consequences for parenting. As poor parental mental health and insensitive parenting practices carry risk for worse child outcomes across the lifespan, the mental health burden of the Covid-19 pandemic might not only have affected the parents, but also the next generation.

The risk and protective factors of heightened prenatal anxiety and depression during the COVID-19 lockdown.

While pregnant women are already at-risk for developing symptoms of anxiety and depression, this is heightened during the COVID-19 pandemic. We compared anxiety and depression symptoms, as indicators of psychological distress, before and during COVID-19, and investigated the role of partner, social network and healthcare support on COVID-19-related worries and consequently on psychological distress. A national survey, conducted during the first lockdown in The Netherlands, assessed COVID-19 experiences and psychological distress (N = 1421), whereas a comparison sample (N = 1439) was screened for psychological distress in 2017-2018. During COVID-19, the percentage of mothers scoring above the questionnaires' clinical cut-offs doubled for depression (6% and 12%) and anxiety (24% and 52%). Women reported increased partner support during COVID-19, compared to pre-pandemic, but decreased social and healthcare support. Higher support resulted in lower COVID-19-related worries, which in turn contributed to less psychological distress. Results suggest that a global pandemic exerts a heavy toll on pregnant women's mental health. Psychological distress was substantially higher during the pandemic than the pre-pandemic years. We identified a protective role of partner, social, and healthcare support, with important implications for the current and future crisis management. Whether increased psychological distress is transient or persistent, and whether and how it affects the future generation remains to be determined.

The relative effects of self-reported noise and odour annoyance on psychological distress: Different effects across sociodemographic groups?

In earlier research, both higher levels of noise and odour annoyance have been associated with decreased mental health. Presumably, these perceptions can trigger feelings of threat and stress reactions and in turn evoke psychological distress. There are two important lacunas in the research on this topic: most studies only consider either noise or odour annoyance and not their relative effect on psychological distress and there is scarce evidence about whether different sociodemographic groups experience more psychological distress due to noise and odour annoyance. Starting from the diversity in the available coping resources and in their daily life patterns, we distinguish gender, age and educational level as relevant sociodemographic variables. Using data from the Health Monitor (n = 25236) in Noord-Brabant, we found using Ordinary Least Squares Regression that individuals that reported higher levels of noise and odour annoyance reported higher levels of psychological distress. Furthermore, the effect of noise annoyance was relatively stronger compared to that of odour annoyance. Regarding the interaction effects, we found that younger adults' psychological distress was more strongly affected by noise annoyance compared to older adults, but not by odour annoyance. The psychological distress of individuals with no or primary education was more strongly affected by both noise and odour annoyance compared those with tertiary education, but not when compared to those who completed lower or higher secondary education. Contrary to our expectations, we did not find different effects between men and women. Though the evidence for the interactions was mixed, classic health inequalities along age and education lines are reinforced when considering the relationship between noise and odour annoyance and psychological distress.

Informal help in a local setting: The Dutch Social Support Act in practice.

The Dutch Social Support Act provides municipal social support for people that experience limitations in daily life and cannot rely on informal help from their social network to compensate these limitations. In this paper, we study whether the probability and intensity (number of services) of receiving municipal social support for daily limitations is affected by informal help by the social network (i.e. family, friends and neighbors). This study took place in Breda, a middle large city in the South of the Netherlands. We combined data from the Municipal Personal Records Database, the registration containing information on demographics and municipal social support receipt of all inhabitants, with data from the Municipality Policy Monitor, a survey containing information on daily limitations and informal help (n = 5256). We find that people experiencing daily limitations are more likely to receive municipal social support and also receive a higher number of support services (intensity). However, the perceived help from family and friends does not decrease either the probability or intensity of receiving municipal social support. Informal help from neighbors decreased the likelihood of receiving of municipal social support, but not the intensity. This implies that the overall relation between daily limitations and municipal social support is not different for people who indicate that they can or cannot rely on their informal network for help.

The influence of organizational factors on the attitudes of residential care staff toward the sexuality of residents with dementia.

BACKGROUND: The attitudes of care staff toward the sexuality of residents with dementia they care for is assumed to influence the residents' expression of their sexuality in the way they want. This paper examines the effect of organizational factors, person-centered care, and the culture of the organization on the attitudes of care staff toward the sexuality of residents with dementia in residential care facilities (RCF) . METHODS: Care staff in different functions at six RCF organizations (N = 187) participated. Using a survey, we gathered information on demographics and care-staff careers, attitudes toward resident sexuality, the culture of the organization, person-centered care, and knowledge of resident sexuality. Ordinary least square (OLS) hierarchical analyses were performed to analyze results. RESULTS: Care staff attitudes were found to be positively affected by person-centered care, and marginally positively affected by a supportive culture in the organization, Moreover, knowledge of resident sexuality positively affected care staff 'attitudes toward resident sexuality, and the presence of policy regarding resident sexuality affected them negatively . CONCLUSIONS: Despite different study limitations, these results give a first insight in a broad perspective on care staff attitudes toward resident sexuality. In addition to improving knowledge of the care staff, enhancing person-centered care and a supportive culture in the organization will improve care-staff attitudes toward resident sexuality.