The Common Way in Which the Ministry of Health Conveys Information to the Public: A Simulation Among Israeli Parents with Different Attitudes and Behaviors Regarding Vaccination During a Measles Outbreak in Israel.

BACKGROUND: Despite several empirical studies that have emphasized the problematic and ineffective way in which health organizations 'correct' information which does not come from them, they have not yet found ways to properly address vaccine hesitancy. OBJECTIVES: (1) Examining the responses of groups with different attitudes/ behaviors regarding vaccination; (2) Examining the effect of the common methods of correcting information regarding the response of subgroups, while examining issues of reliability, satisfaction, and information seeking, as well as how health organization tools aid the decision-making process regarding vaccines. METHODS: A simulation study that included 150 parents of kindergarten children was carried out. RESULTS: Significant difference was found among the various groups (with respect to vaccination behavior) regarding the extent of their trust in the Ministry of Health (χ2(3) = 46.33; P < 0.0001), the reliability of the Ministry of Health's response (χ2(3) = 31.56; P < 0.0001), satisfaction with the Ministry of Health's response (χ2(3) = 25.25; P < 0.0001), and the level of help they felt the Ministry of Health's tools provided them regarding vaccine-related decision making (χ2(3) = 27.76; P < 0.0001). CONCLUSION: It is important for health organizations to gain the public's trust, especially that of pro-vaccination groups with hesitant attitudes, while addressing the public's fears and concerns.

Czech Adolescents' Face-to-Face Meetings With People from the Internet: The Role of Adolescents' Motives and Expectations.

Research of face-to-face meetings between adolescents and people met online stands on untested assumptions that these meetings are uniform, and adolescents attend them to expand their social circle. It is also unclear what makes such meetings pleasant or unpleasant. This study examined meetings of 611 Czech adolescents (age 11-16, Mage = 14.04, SD = 1.67, 47.1% female). Face-to-face meetings attended with friendly, romantic, or instrumental motives differed from each other, emphasizing the need to investigate them separately. Pleasantness of meetings is closely related to disconfirmation of adolescents' expectations. Unmet expectations related to unpleasant meetings, exceeded expectations to pleasant ones. While present findings uphold existing theories (e.g., social compensation), they also call for new theoretical perspectives for this common adolescents' activity.

Hesitant and anti-vaccination groups: A qualitative study on their perceptions and attitudes regarding vaccinations and their reluctance to participate in academic research- an example during a measles outbreak among a group of Jewish parents in Israel.

Background: Vaccination is widespread in Western countries and, overall, there is a high vaccination rate. However, immunization is still an enduring challenge. In recent years, the number of parents who choose to delay or refuse vaccines has risen. Objectives: (1) to identify the perceptions and attitudes of hesitant and anti-vaccination parents regarding vaccination in general, and vaccinating their children in particular and; (2) to describe the responses of potential participants to the request to participate in academic research regarding their perceptions and attitudes on the subject of vaccines. Methods: The research employs the qualitative hermeneutic phenomenological method using two research tools: (1) in-depth interviews with 7 hesitant and 11 anti-vaccination Jewish parents in Israel; and (2) the researchers' field notes from this study process, which describe the responses of 32 potential participants to the request to participate in this academic research. Results: The main findings indicate that while most of the interviewees admit to the efficacy of vaccines in preventing diseases, they oppose the way in which vaccines are promoted-based on providing partial information and disregarding parents' concerns and questions. Therefore, they demand transparency about the efficacy and safety of vaccines. The findings also point to a paradoxical finding. On the one hand, these groups claim that health organizations do not understand their position, referring to them as "science-deniers", even though they are not. On the other hand, these parents choose to refrain from participating in scientific studies and voicing their opinions, thereby perpetuating the situation of being misunderstood. Conclusion: Hesitant and anti-vaccination groups express mistrust in academic institutions and health organizations. Therefore, an effective dialogue that would include hesitant and anti-vaccination groups, the academy, and health organizations may contribute to a better understanding of the barriers that prevent these groups from getting vaccinated or vaccinating their children and promote public health.

Pro-vaccination Groups Expressing Hesitant Attitudes: A Cross-Sectional Study About the Difference Between Attitudes and Actual Behavior in Israel.

Background: Vaccines have contributed to the decline in mortality, morbidity, and even the eradication of various infectious diseases. Over time, the availability of information to the public and the request for public involvement in the health decision-making process have risen, and the confidence in vaccines has dropped. An increasing number of parents and individuals are choosing to delay or refuse vaccines. Objectives: (1) Identifying hesitant attitudes among pro-vaccination parents; (2) testing the difference between the rate of hesitant attitudes and the rate of hesitancy in practice among pro-vaccination parents; and (3) examining the association of sociodemographic characteristics (gender, age, marital status education and religious affiliation) with the difference between hesitant attitudes and hesitancy in practice among pro-vaccination parents. Methods: Descriptive cross-sectional survey using an online survey that measured vaccine hesitancy among pro-vaccination parents (n = 558) whose children were in kindergarten (3-5 years), according to a variety of sociodemographic characteristics. Results: A significant difference was found between the rate of hesitant attitudes and the rate of hesitation in actual vaccination among pro-vaccination and hesitant parents, where despite that 26% of the parents had hesitant attitudes, only 19% hesitated in practice [P = 0.0003]. There was also a significant difference between the rate of hesitant attitudes and the rate of hesitancy in practice among women [P = 0.0056] and men [P = 0.0158], parents between 30 and 39 years of age [P = 0.0008], traditional parents [P = 0.0093], Non-academic parents [P = 0.0007] and parents with BA degree [P = 0.0474]. Conclusion: Pro-vaccination individuals may have hesitant attitudes regarding vaccines. Therefore, it is very important for health authorities to address the public's fears and concerns, including those who are classified as pro-vaccination.

Risk perceptions regarding inclusion of seasonal influenza vaccinations in the school immunization program in Israel: Arab vs. Jewish mothers.

BACKGROUND: The issue of whether to include seasonal influenza vaccinations in school-located vaccination programs (SLIV) has been examined in many countries, mainly in the context of economic effectiveness and morbidity prevention. Yet not enough studies have examined the impact of parental risk perceptions, health literacy and SLIV on parental vaccination uptake. OBJECTIVES: The most recent statistics in Israel point to a higher rate of seasonal influenza vaccination among Arab children (aged 7-9 years) than among Jewish children in the same age group. The present study attempts to explain this high vaccination uptake among mothers from Arab society by comparing their risk perceptions regarding seasonal influenza vaccination and disease to those of Jewish mothers. The study further examines the impact of SLIV on parental risk perceptions and influenza vaccination uptake. METHODS: This cross-sectional study included mothers of children in the second and third grades faced with the decision of whether their children should receive the seasonal influenza vaccination at school. The study population included a stratified sample of Jewish mothers (n = 159) and Arab mothers from all the Arab population sub-groups: Muslim, Christian, Druse and Bedouin (n = 534). RESULTS: A comparison of the Arab and Jewish populations revealed a significant difference in vaccination rates; 61.7% among Arab mothers compared to 33.5% among Jewish mothers (χ2(1) = 39.15, P<0.0001). Moreover, significant differences emerged between the Arab and Jewish populations in health literacy and ability to seek information regarding the seasonal influenza vaccination (t (691) = -5.81, p < 0.0001). While no differences emerged in mothers' perceptions regarding influenza as a disease (t (691) = 1.20, p = 0.2318), Arab mothers perceived the vaccination to be safer than Jewish mothers (t (691) = 2.74, p = 0.0063) and saw its inclusion in the school-located vaccination program as providing more legitimacy (Z = -6.6719, P < .0001). CONCLUSION: This study showed that the factors influencing vaccination uptake among both the Arab and the Jewish populations include perceived influenza risk, perceived vaccination risk, inclusion in the school-located vaccination program and health literacy. Moreover, influenza vaccination uptake is higher among those who have positive attitudes toward vaccinations, low risk perceptions regarding the vaccine, and low health literacy that impedes their ability to seek information. The research also points to the need for education and tools to boost health literacy among minority groups so that mothers can make independent and informed decisions about whether or not to vaccinate their children.

Factors associated with seasonal influenza and HPV vaccination uptake among different ethnic groups in Arab and Jewish society in Israel.

BACKGROUND: Parents in the Arab population of Israel are known to be "pro-vaccination" and vaccinate their children at higher rates than the Jewish population, specifically against human papilloma virus (HPV) and seasonal influenza. OBJECTIVES: This study seeks to identify and compare variables associated with mothers' uptake of two vaccinations, influenza and HPV, among different subgroups in Arab and Jewish society in Israel. METHODS: A cross-sectional study of the entire spectrum of the Israeli population was conducted using a stratified sample of Jewish mothers (n = 159) and Arab mothers (n = 534) from different subgroups: Muslim, Christian, Druse and Northern Bedouins. From March 30, 2019 through October 20, 2019, questionnaires were distributed manually to eighth grade pupils (13-14 years old) who had younger siblings in second (7-8 years old) or third (8-9 years old) grades. RESULTS: Arab mothers exhibited a higher rate of uptake for both vaccinations (p < .0001, HPV - 90%; influenza - 62%) than Jewish mothers (p = 0.0014, HPV - 46%; influenza - 34%). Furthermore, results showed that HPV vaccination uptake is significantly higher than seasonal influenza vaccination uptake in both populations. Examination of the different ethnic subgroups revealed differences in vaccination uptake. For both vaccinations, the Northern Bedouins exhibited the highest uptake rate of all the Arab subgroups (74%), followed by the Druse (74%) and Muslim groups (60%). The Christian Arab group exhibited the lowest uptake rate (46%). Moreover, the uptake rate among secular Jewish mothers was lower than in any of the Arab groups (38%), though higher than among religious/traditional Jewish mothers, who exhibited the lowest uptake rate (26%). A comparison of the variables associated with mothers' vaccination uptake revealed differences between the ethnic subgroups. Moreover, the findings of the multiple logistic regression revealed the following to be the most significant factors in Arab mothers' intake of both vaccinations: school-located vaccination and mothers' perceived risk and perceived trust in the system and in the family physician. These variables are manifested differently in the different ethnic groups. CONCLUSIONS: This research shows that all Arabs cannot be lumped together as one monolithic group in that they exhibit major differences according to religion, education and access to information. Ranking of variables associated with uptake of the two vaccines can provide decision-makers an empirical basis for tailoring appropriate and specific interventions to each subgroup to achieve the highest vaccine uptake rate possible. Media campaigns targeting the Arab population should be segmented to appeal to the various sub-groups according to their viewpoints, needs and health literacy.

The influence of new information that contradicts common knowledge about earthquake preparedness in Israel: A mixed methods experiment study.

BACKGROUND: A major earthquake in Israel is inevitable. Individual risk perceptions and preparedness can mitigate harm and save lives. The gap between the public's concerns and those of experts is reflected in their differential perceptions regarding the components that influence the occurrence of an earthquake in Israel. Whereas the public believes that geographic location is the critical variable, the experts note additional variables that need to be considered. Common knowledge regarding the risks of earthquake occurrence in Israel is based on a distinction between high and low-risk areas, such that the closer a residential area is to the Great Rift Valley, the higher the risk that an earthquake will occur. OBJECTIVES: To examine the variables affecting public preparedness in Israel (effective communication agent (communicator), high and low earthquake risk areas) and the degree to which experts' knowledge contradicts respondents' common knowledge. METHODS: The study used a mixed-methods approach combining qualitative and quantitative research. The first stage included in-depth interviews with earthquake experts (n = 19). The second stage consisted of an experiment conducted among a representative sample of the public (n = 834). RESULTS: Most people believe that geographical location constitutes the main risk factor for earthquakes in Israel. Yet experts claim that additional variables affect earthquake intensity and damage: building strength, earthquake magnitude, distance from earthquake epicenter, soil type, and interaction between these four. The study found that knowledge of expert information affects public willingness to prepare. The direction of this influence depends on participants' risk perceptions regarding residential area and on degree of consistency with common knowledge. In low-risk areas, added knowledge increased willingness to prepare whereas in high-risk areas this knowledge decreased willingness. CONCLUSION: To turn expert information into common knowledge and to increase earthquake preparedness, the authorities must educate the public to generate a new public preparedness norm.

Confidence in social institutions, perceived vulnerability and the adoption of recommended protective behaviors in Brazil during the COVID-19 pandemic.

The current worldwide COVID19 pandemic has required the rapid and drastic adoption of social distancing and protective measures as the leading method for reducing the spread of the disease and death. The purpose of this study is to investigate the factors associated with the adoption of such measures in a large sample of the Brazilian population. We relied on recreancy theory, which argues that confidence in the ability of social institutions and perceived vulnerability to the disease are central factors predicting the adoption of these behaviors. Our results, drawn from 7554 respondents, indicate that self-confidence in the ability to carry out these behaviors, confidence in the ability of social institutions such as the government, hospitals, health workers and the media to cope with the pandemic crisis, and risk perceptions are associated with the adoption of preventive behaviors. Our results expand the recreancy theory and show that beyond the main effects, the effect of perceived vulnerability depends on the values of self-confidence and confidence in social institutions. The theoretical implications of the findings are discussed.

The Adoption of Preventive Behaviors during the COVID-19 Pandemic in China and Israel.

The COVID-19 pandemic represents a massive global health crisis. The rapid transmission rate of the virus, as well as the lack of effective medications and vaccines, has posed serious challenges to controlling the spread of the disease. Dealing with this public health crisis has required major changes in people's behavior, including the adoption of social distancing measures such as avoiding meeting with family members and friends, crowded places, and public transportation. The purpose of this study is to investigate the factors associated with the adoption of these behaviors in China and Israel. We relied on the 3Cs model that has been used to predict the adoption of a specific preventive behavior (vaccinations) with the goal of testing its applicability to other preventive behaviors such as in response to the COVID-19 pandemic. The model indicates that confidence in social institutions, complacency (fear of and assessments about the risk of becoming ill) and constraints (levels of self-efficacy and confidence in being able to engage in the behaviors) are predictors of adopting preventive behaviors. Data were collected in China and Israel through an online survey of the population (n = 1406). We used latent variables and structural equation modeling to test the hypotheses derived from the 3Cs model. The findings indicate that there are some differences in the types of preventive behaviors adopted in the two countries. In Israel, higher levels of confidence predicted the adoption of avoidant behaviors and more constraints predicted engaging in fewer avoidant behaviors. In China, more constraints also contributed to the adoption of fewer avoidant behaviors, but people's level of confidence fully mediated this result. The multi-group analysis indicated that the conceptualized model fits the Chinese and Israeli data reasonably well. The findings suggest that the 3Cs model can be generalized from getting vaccinated to adopting avoidant behaviors and that the model can be used across cultures and countries.

People Are Taller in Countries With Better Environmental Conditions.

Background: Height is considered an indicator of health and well-being of an individual and population. Height variation results from a complex interaction of genetic, environmental, socioeconomic, and cultural influences. In order to understand the contribution of environmental stress associated with the child's growth, we correlated indicators of a stressful environment with adult height. Methods: We utilized seven equally weighted indicators of a stressful environment: homicide rates, GDP per capita, income inequality (GINI index), corruption perception index (CPI), unemployment rate, urban air pollution, and life expectancy (LE). Data on male and female height by country from 1992 to 1996 were obtained from the NCD Risk Factor Collaboration dataset. We assessed separately data from the 31 member countries of the Organization for Economic Co-operation and Development (OECD). In order to establish whether the indicators reflected a single conceptual dimension, we conducted an exploratory analysis and principal component analysis (PCA) with orthogonal transformation of the original variables. The relationships between male and female heights and the z-transformed principal components: Quality of life (QoL) and the Social factor (SF) that were derived after the PCA was assessed. Results: Male and female heights strongly correlated (p < 0.0001) with each of the seven indicators. In the PCA, the indicators clustered into "Quality of Life" factors (QoL), which comprised the CPI, GDP, air pollution, LE, and "Social factors" (SF), which comprised homicide rate and GINI index. For males and females, the average height by country strongly correlated with QoL (p < 0.0001) and SF (p < 0.0001). Within OECD countries, male and female height strongly and negatively correlated with the SF, but not with QoL. Conclusion: Growth attenuation is a tradeoff adaptive response: a calorie used for growth cannot be used for fighting stress. Here we show that: (1) Adult height, when used as a measure of child's growth, is an indicator of a stressful environment in context with the genetic background and spatial factors; (2) Stressful QoL factors and the SF exert a greater effect on men's height than women's height; and (3) The ranking of the indicators of short stature are income inequality > air pollution > GDP > CPI > homicide rate > LE > unemployment.

Perceived trust in the health system among mothers and nurses and its relationship to the issue of vaccinations among the Arab population of Israel: A qualitative research study.

The literature indicates that trust plays an important role in people's decision-making with respect to vaccinations. This research seeks to examine the impact of trust on the high response rate to vaccinations among the minority Arab population living in Israel. The research employs the qualitative phenomenological research method, using personal interviews to identify and analyze perceived trust among mothers of young children and teenagers (n = 70) and among nurses (n = 20) in the Arab population in the context of vaccinations and the high response rate to vaccinations among this population. The research findings point to differing levels of trust in the medical system. The participants placed the highest trust in the nurses working in the Tipat Halav Family Health Centers run by the Ministry of Health. These nurses are the main communicators of information about childhood vaccinations in Israel. Moreover, the interviewees saw vaccinations as an example of the state offering equal and optimal services to the Arab minority population. In addition, the interviewees consider the explanatory materials to be limited, superficial and not culturally appropriate. These positive attitudes toward vaccinations alongside reports that no importance is attributed to the explanatory materials due to their low quality may cause the population to accept vaccination recommendations as they are and to delegate responsibility and authority to the state.

Vaccination hesitancy: fear, trust, and exposure expectancy of an Ebola outbreak.

The purpose of this paper is to examine the relationship between vaccination hesitancy and fear, trust, and expectation of a potential imminent and proximate outbreak of Ebola. Our hypothesis is that people engage in self-protective behavior against an infectious disease when they are: fearful about things in general; trustful of government's ability to control the disease outbreak; and anticipating a direct threat to their health. The self-protective behavior we examine is the intention to accept a prospective anti-Ebola vaccination. We examine these relationships with basic demographic variables taken into account: gender, age, ethnicity, race and education. The data source is a national random sample of 1,018 United States adults interviewed early during the 2014 Ebola outbreak. We constructed a new three-item Exposure Expectancy Scale (alpha = 0. 635) to measure the degree of respondents' expectancy of a potential nearby Ebola outbreak. Our data analysis employs multiple logistic regressions. The findings support our hypothesis: willingness to take the Ebola vaccination is positively associated with a generalized sense of fear, trust in the government's ability to control an outbreak of the disease, and expectation of a potential Ebola outbreak that is imminent and proximate. The addition of the exposure expectancy variable in this analysis adds significantly to our understanding of contributors to vaccine hesitancy.

Case of Paradoxical Cultural Sensitivity: Mixed Method Study of Web-Based Health Informational Materials About the Human Papillomavirus Vaccine in Israel.

BACKGROUND: Designing web-based informational materials regarding the human papillomavirus (HPV) vaccine has become a challenge for designers and decision makers in the health authorities because of the scientific and public controversy regarding the vaccine's safety and effectiveness and the sexual and moral concerns related to its use. OBJECTIVE: The study aimed to investigate how cultural sensitivity (CS) is articulated in the explanatory informational materials on the HPV vaccine that are posted on the websites of the Israeli health authorities. In addition, the study examined the effect of transparency on the expression of CS in the informational materials. METHODS: The study employed a quantitative and qualitative content analysis of the texts of explanatory informational materials published on the Arabic and Hebrew websites of the Israel Ministry of Health and the Clalit health maintenance organization (HMO). RESULTS: The findings revealed the differences in the dimensions of CS (based on the CS model by Resnicow) between the informational materials targeting the majority Jewish population and those targeting the minority Arab population. Indeed, the research findings point to a paradox. On the one hand, the materials appealing to the conservative Arab population exhibited CS, in that the sexual context of the vaccine was missing. On the other hand, analysis of Resnicow's deep dimensions showed that disregarding the sexual context does not allow the relevant target audience to reflect on the barriers and concerns. In addition, the way the information was provided exhibited a lack of transparency regarding the CS dimensions (surface and deep). CONCLUSIONS: The public health authorities have 2 main objectives in the context of vaccinations. One is to raise the vaccination rates and the other is to provide full and culturally sensitive information to give the public the tools to make intelligent decisions. The findings of this study indicated that despite the high uptake rate for HPV vaccination in the Arab population, the health authorities did not exercise full transparency and CS in transmitting the association between engaging in sexual relations and the necessity of the vaccination. Thus, the major challenge for the health authorities is to find ways to implement the objective of communicating information about the vaccination in a way that is transparent and culturally sensitive, even if this raises questions and fears among the public deriving from their culture.

Correcting misinformation by health organizations during measles outbreaks: A controlled experiment.

BACKGROUND: During epidemic crises, some of the information the public receives on social media is misinformation. Health organizations are required to respond and correct the information to gain the public's trust and influence it to follow the recommended instructions. OBJECTIVES: (1) To examine ways for health organizations to correct misinformation concerning the measles vaccination on social networks for two groups: pro-vaccination and hesitant; (2) To examine the types of reactions of two subgroups (pro-vaccination, hesitant) to misinformation correction; and (3) To examine the effect of misinformation correction on these two subgroups regarding reliability, satisfaction, self-efficacy and intentions. METHODS: A controlled experiment with participants divided randomly into two conditions. In both experiment conditions a dilemma was presented as to sending a child to kindergarten, followed by an identical Facebook post voicing the children mothers' concerns. In the third stage the correction by the health organization is presented differently in two conditions: Condition 1 -common information correction, and Condition 2 -recommended (theory-based) information correction, mainly communicating information transparently and addressing the public's concerns. The study included (n = 243) graduate students from the Faculty of Social Welfare and Health Sciences at Haifa University. RESULTS: A statistically significant difference was found in the reliability level attributed to information correction by the Health Ministry between the Control condition and Experimental condition (sig<0.001), with the average reliability level of the subjects in Condition 2 (M = 5.68) being considerably higher than the average reliability level of subjects in Condition 1 (4.64). A significant difference was found between Condition 1 and Condition 2 (sig<0.001), with the average satisfaction from the Health Ministry's response of Condition 2 subjects (M = 5.75) being significantly higher than the average satisfaction level of Condition 1 subjects (4.66). Similarly, when we tested the pro and hesitant groups separately, we found that both preferred the response presented in Condition 2. CONCLUSION: It is very important for the organizations to correct misinformation transparently, and to address the emotional aspects for both the pro-vaccination and the hesitant groups. The pro-vaccination group is not a captive audience, and it too requires a full response that addresses the public's fears and concerns.

The Role of Parental Mediation and Peer Norms on the Likelihood of Cyberbullying.

Cyberbullying is a disturbing behavior associated with the use of communication technologies among adolescents. Many studies have been devoted to the activities of cyber victims as risk factors, while others have considered parental mediation a protective factor. However, there is a paucity of studies investigating the joint contribution of parental mediation, peer norms and risky online activities to the likelihood of being bullied on the Internet. To fill this gap, we conducted a study among a representative sample of 495 sixth to eleventh grade adolescents. We measured risky behavior online with items indicating the frequency of posting personal details, sending an insulting message and meeting face-to-face with a stranger met online. Respondents reported their perceptions about their peers. attitudes toward these risky online behaviors. We also measured three types of parental mediation: active guidance, restrictive supervision and non-intervention. Binary logistic regression findings show that risky online behaviors and peer norms regarding these behaviors had a significant effect, suggesting that the likelihood of being bullied on the Internet is associated with both risky behavior online and the norms prevalent within the adolescents. peer group. Restrictive supervision had a significant effect, implying that parents who feel their children are being bullied online may increase their oversight. The results emphasize the critical role of peers and the declining influence of parents in adolescence.

Gender Differences in the Factors Explaining Risky Behavior Online.

In searching for the social and cognitive antecedents of risky online behaviors, some studies have relied on the theory of planned behavior. According to the theory, three components serve as predictors of a given behavior-attitudes toward the behavior (beliefs that people hold about a given behavior), subjective norms (perceptions of what significant others think about the behavior) and perceived behavior control (perceptions about the ease or difficulty of engaging in a particular behavior). However, none of these studies considered the possibility that these factors work differently for boys and girls. We constructed models of the possible antecedents (attitudes, subjective norms and perceived behavior control) of risky behavior online and tested them using a representative sample of 495 sixth to eleventh grade students (46 % female) in a large city in Israel. We measured risky behavior online with items indicating the frequency of posting personal details, sending an insulting message and meeting face-to-face with a stranger met online. Structural equation modeling revealed that peers' subjective norms (beliefs that friends approve of engaging in risky online behaviors), parents' subjective norms (beliefs that parents accept involvement in risky online behaviors) and perceived behavior control were related to boys' risky behavior online, whereas for girls, only parents' subjective norms had such an association. Expanding the models to include other factors underscored that family factors were most strongly associated with girls' risky behavior online.

Ethnic origin and access to electronic health services.

E-health holds the promise of changing the delivery of health care by extending and enhancing its reach, and democratizing and improving the access of disadvantaged groups to health care services. This study investigated ethnic inequalities in access to e-health information, communication and electronic services in Israel. Based on the diversification hypothesis, we expected that disadvantaged ethnic groups would be more likely to use e-health services to compensate for their lack of social capital. Data gathered from a representative sample of Internet users in Israel (n=1371) provided partial support for the hypothesis, indicating that in multicultural societies, disadvantaged groups are more motivated than the majority group to use the Internet to access medical information. However, despite expectations, minority groups were less likely to access e-health services. Implications of the findings are discussed.

Social and political determinants of vaccine hesitancy: Lessons learned from the H1N1 pandemic of 2009-2010.

BACKGROUND: Public acceptance of vaccination programs is essential for vaccine preventable diseases. However, increasing sectors of the population have expressed hesitancy about participating in such programs, leading to the re-emergence of vaccine preventable diseases. In this study we rely on a recreancy hypothesis to test the association between confidence in the government and local hospitals and the willingness to take the vaccine. METHODS: A secondary analysis of a survey that used a large sample of the U.S. population conducted in October 2009 was used (N = 968). RESULTS: The results indicate that 36.1% of the respondents expressed willingness to be vaccinated. Those with the greatest trust in the government were the most likely to be vaccinated (43.4%), and those least confident were the least willing (15.8%). From the ones reporting being confident in the local health system, 38.4% were willing to be vaccinated, and from those not confident, only 23.5% were willing to be vaccinated. CONCLUSION: The decision to get vaccinated in the midst of a contagious outbreak involves many considerations. Trust in the government's technical and organization skill to deal with the infectious outbreak along with trust in medical organizations predict the adoption of recommended protection measures. The results indicate that public compliance with vaccination plans in health crisis requires the development of social and institutional trust.

Confidence in government and vaccination willingness in the USA.

The most recent internationally widespread disease outbreak occurred during the flu season of 2009 and 2010. On April 2009, the first cases of influenza A (H1N1) (Popularly called, Swine Flu) were confirmed in the USA and UK following a novel virus that was first identified in Mexico. As the virus spread rapidly, the risk of morbidity and mortality increased in several countries. In this paper, we rely on the social cognitive theory of risk to assess the willingness of the US public to comply with vaccination and reduce the risk of sickness and death from the flu. We conduct a secondary data analysis of the Pew Research for the People and Press October 2009 and investigate the factors associated with willingness to take the swine flu vaccine (n = 1000). The findings indicate that the decision to take the swine flu vaccination was highly polarized across partisan lines. Controlling for education, income and demographic factors, the likelihood of taking the vaccine was associated with party identification. Individuals that identified themselves as Democrats were more likely to be willing to take the swine vaccine than individuals that identify themselves as Republicans and Independents. Confidence in the ability of the government to deal with the swine flu crisis seems to explain party identification differences in the willingness to take the vaccine. The implications of the findings are discussed.