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1.
Front Public Health ; 9: 698111, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34485229

RESUMO

COVID-19 vaccine is regarded as the most promising means of limiting the spread of or eliminating the pandemic. The success of this strategy will rely on the rate of vaccine acceptance globally. The study aims to examine the factors that influence COVID-19 vaccine acceptance, intention, and hesitancy. PubMed was searched comprehensively for articles using the keyword "COVID-19 vaccine surveys." Of the 192 records, 22 studies were eligible for the review. Eighty-two percent of these studies were conducted among the general population. Gender, age, education, and occupation were some of the socio-demographic variables associated with vaccine acceptance. Variables such as trust in authorities, risk perception of COVID-19 infection, vaccine efficacy, current or previous influenza vaccination, and vaccine safety affected vaccine acceptance. Globally, in March 2020, the average vaccine acceptance observed was 86% which dropped to 54% in July 2020 which later increased to 72% in September 2020. Globally, the average rate of vaccine hesitancy in April 2020 was 21%, which increased to 36% in July 2020 and later declined to 16% in October 2020. Large variability in vaccine acceptance and high vaccine hesitancy can influence the efforts to eliminate the COVID-19. Addressing the barriers and facilitators of vaccines will be crucial in implementing effective and tailored interventions to attain maximum vaccine coverage.


Assuntos
COVID-19 , Vacinas , Vacinas contra COVID-19 , Estudos Transversais , Humanos , Intenção , SARS-CoV-2
2.
Sensors (Basel) ; 21(17)2021 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-34502578

RESUMO

With the popularity of financial technology (fintech) chatbots equipped with artificial intelligence, understanding the user's response mechanism can help bankers formulate precise marketing strategies, which is a crucial issue in the social science field. Nevertheless, the user's response mechanism towards financial technology chatbots has been relatively under-investigated. To fill these literature gaps, latent growth curve modeling was adopted by the present research to survey Taiwanese users of fintech chatbots. The present study proposed a customer continuance model to predict continuance intention for fintech chatbots and that cognitive and emotional dimensions positively influence the growth in a user's attitude toward fintech chatbots, which in turn, positively influences continuance intention over time. In total, 401 customers of fintech chatbots were surveyed through three time points to examine the relationship between these variables over six months. The results support the theoretical model of this research and can advance the literature of fintech chatbots and the information technology adoption model.


Assuntos
Inteligência Artificial , Tecnologia , Intenção , Modelos Teóricos , Inquéritos e Questionários
3.
BMC Med Educ ; 21(1): 484, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34503514

RESUMO

BACKGROUND: The outbreak of COVID-19 has led to increased workload and infection risks among medical staff. This situation may influence current medical and health-related students' decision on the choices of their future careers. Hence, this study investigated the impact of COVID-19 on their future career intentions. METHODS: This is a cross-sectional observational study that included medical and health-related students from three universities between October 2020 and January 2021. The study questionnaire was divided into two main sections: Section 1, which comprised students' basic information. And section 2 focused mainly on the impact of COVID-19 pandemic on students' professional intentions. The chi-squared χ2 test was used to compare the responses before and after the pandemic outbreak among Chinese and non-Chinese students. RESULTS: In overall, 1253 students completed the questionnaires. The responses showed that the number of students who preferred clinical medicine, public health, pharmacy and oral medicine increased significantly after the pandemic outbreak. In contrast, the number of students who chose nursing and medical technology decreased significantly. The change mainly occurred in Chinese students, predominantly females. Half of students (50.35%) were more willing to engage in medical and health work after completing their current program. Also, 36.39% of students felt that knowledge was too limited in the pandemic's face and would like to continue studying after graduation to gain more knowledge. Due to the pandemic, 34.18% of students would like a future workplace near their hometown, and 19.63% preferred to work in urban areas. CONCLUSION: The COVID-19 outbreak impacted current medical and health-related students' career planning on their future workplaces and employment time choices. Additionally, the pandemic influenced the intention of Chinese students in choosing their future careers. This study provided the basis for the policymaking, specialty setting of colleges and supplied the medical health department's talent reserve information.


Assuntos
COVID-19 , Estudantes de Medicina , Estudos Transversais , Feminino , Humanos , Intenção , Pandemias , SARS-CoV-2
4.
Euro Surveill ; 26(36)2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34505565

RESUMO

The intention to get the COVID-19 vaccine increased from 48% (November 2020) to 75% (March 2021) as national campaigning in the Netherlands commenced. Using a mixed method approach we identified six vaccination beliefs and two contextual factors informing this increase. Analysis of a national survey confirmed that shifting intentions were a function of shifting beliefs: people with stronger intention to vaccinate were most motivated by protecting others and reopening society; those reluctant were most concerned about side effects.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Intenção , Países Baixos , SARS-CoV-2 , Vacinação
5.
Ann Med ; 53(1): 1419-1428, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34482788

RESUMO

INTRODUCTION: Previous studies suggested that almost one-third of U.S. adults did not plan to get a COVID-19 vaccine once it is available to them. The purpose of this study was to examine changes in vaccine intentions and attitudes by sociodemographic characteristics and geographic areas, factors associated with vaccination intent, and reasons for non-vaccination among a nationally representative sample of U.S. adults. METHODS: Data from six waves of the Household Pulse Survey (6 January - 29 March 2021) were analyzed. Differences between January and March were assessed using t-tests. Factors associated with vaccination intent were examined in multivariable logistic regression models. RESULTS: From early January to late March, vaccination receipt of ≥1 dose of the COVID-19 vaccine or intention to definitely get vaccinated increased from 54.7 to 72.3%; however, disparities in vaccination intent continued to exist by age group, race/ethnic groups, and socioeconomic characteristics. Vaccine receipt and the intent were the lowest for region 4 (southeastern U.S.) throughout this period. Adults who had a previous COVID-19 diagnosis or were unsure if they have had COVID-19 were less likely to intend to get vaccinated [prevalence ratio = 0.92 (95%CI: 0.90-0.93) and 0.80 (95%CI: 0.74-0.85), respectively]. The belief that a vaccine is not needed increased by more than five percentage points from early January to late March. CONCLUSION: Intent to definitely get a COVID-19 vaccine increased by almost 18 percentage points from early January to late March; however, younger adults, adults who are non-Hispanic Black or other races, adults of lower socioeconomic status, and adults living in the southeastern U.S. region (Region 4) continue to have higher coverage gaps and levels of vaccine hesitancy. Emphasizing the importance of vaccination among all populations, and removing barriers to vaccines, may lead to a reduction of COVID-19 incidence and bring an end to the pandemic.KEY MESSAGESReceipt of ≥1 dose of the COVID-19 vaccine and intent to probably or definitely get vaccinated increased from early January to late March; however, disparities in vaccine intent continued to exist by age group, race/ethnic groups, and socioeconomic characteristics.Vaccine receipt and the intent were the lowest for region 4 (southeastern U.S.) compared to other regions during this period.Adults who had a previous COVID-19 diagnosis or were unsure if they have had COVID-19 were less likely to intend to get vaccinated; overall, the belief that a vaccine is not needed to be increased by more than 5% points from early January to late March.[Formula: see text].


Assuntos
Vacinas contra COVID-19/uso terapêutico , COVID-19/prevenção & controle , Cobertura Vacinal/tendências , Vacinação/psicologia , Adulto , Idoso , COVID-19/epidemiologia , Feminino , Geografia , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Intenção , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Fatores Socioeconômicos , Estados Unidos/epidemiologia
6.
Trials ; 22(1): 592, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488843

RESUMO

OBJECTIVES: Vaccine hesitancy is a major hurdle for stopping the COVID-19 pandemic. Recently, fear of vaccine side effects created widespread concern and paused global vaccination efforts. Many studies find that how medical risks are framed and communicated can influence individuals' perceptions and behavior, yet there is little evidence on how the communication of COVID-19 vaccine side-effect risks influences vaccine intentions. The primary objective of our study is to evaluate how the framing of vaccine-side effect risks impacts individuals' vaccine intentions and perceptions of vaccine safety. The study will assess the impact of 3 dimensions of side-effect framing: 1. Qualitative risk labels: Determine whether attaching a qualitative risk label (e.g. adding "very low risk" next to the actual numerical risk) impacts individuals' willingness to take a vaccine and their perceptions of its safety. 2. Comparison groups: Determine how framing side-effect risks in comparison to other causes of mortality (COVID-19 mortality and motor vehicle mortality) impacts individuals' willingness to take a vaccine and their perceptions of its safety. 3. How the comparison risks are presented: Determine whether comparisons to other causes of mortality are presented on an absolute or relative scale impacts individuals' willingness to take a vaccine and their perceptions of its safety. Secondarily, we will also randomize a subset of individuals to receive the "status-quo" framing, where the vaccine side-effect risks are presented like how they were presented in the media. We will then compare vaccine intentions and perceptions of vaccine safety between the status-quo and the pooled intervention group samples to provide some insight into how "harmful" the status-quo framing was. Ultimately, we believe that our results will provide the some of the first experimental evidence on how the communication of COVID-19 vaccine risks may impact the public's willingness to be vaccinated and can inform future efforts to increase vaccination rates. TRIAL DESIGN: Our study is an online-based randomized controlled trial designed to evaluate the effect of different vaccine side-effect framings on COVID-19 vaccine intentions and perceived safety for a hypothetical COVID-19 vaccine. Using a factorial design, we will experimentally assess the impact of 3 risk framing strategies, varying whether the risk is presented: (1) with a qualitative label, (2) whether the risk is presented with a comparison risk, and (3) for comparison cases, whether the comparison is in absolute or relative terms. We will also randomize a portion of respondents to a status quo framing where the side effect risk mimics the media's communication in early April 2021. PARTICIPANTS: This will be an online study setting. We will use Prolific to recruit participants and host our study on the Gorilla platform. To be eligible, participants must be 18 years old or over (male, female, or other), have current residence in the US or UK, and be able to speak English. Participants will be excluded from the study if they do not meet our inclusion criteria. INTERVENTION AND COMPARATOR: Our study content will consist of five pages presented to individuals online. Page 1 will explain the purpose of the study and contain the consent information. Page 2 will contain basic sociodemographic questions, including participants' age, sex, and schooling level. Page 3 will set up the experiment by telling individuals that we will describe a hypothetical new COVID-19 vaccine and that we would like to know how likely they would be to take the vaccine and how safe they think the vaccine is. On this page, we will also encourage individuals to respond truthfully and remind them that their answers are confidential and cannot be linked back to any personal identifying information. Page 4 will be the main experimental slide, where we will present individuals with information on the vaccine, varying how the vaccination risk is communicated based on which experimental framing arm they are randomized to. We will factorially randomize across the following factors in the following order (separately by country). First, we will determine whether individuals are randomized to the status quo framing, or the intervention framings (1500 respondents to the status quo, and 4500 to the intervention). Among those randomized to the intervention framing, we will randomize (equal allocation) whether the side effect is presented without a comparison, with a comparison to COVID-19 mortality, or with a comparison to motor vehicle mortality. We will then factorially randomize (equal allocation) whether the risk is presented with a qualitative risk label or not (e.g. "very low risk"). To ensure that the factors are independent of one another, we will do this by randomizing individuals to the risk labels within strata of the comparison group factor. Lastly, among those randomized to the comparison group, we will factorially randomize whether the risk is presented as an absolute or relative comparison. As previously, we will ensure independence by doing this randomization within strata of comparison group*risk labelling. This entire design is visualized in the full protocol. The experimental text for each arm is: Arm 1: With regards to side effects, so far 8 individuals have developed potentially life-threatening blood clots. This is among the approximately 7 million adults that have received the vaccine so far. Arm 2: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots. Arm 3: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots (very low risk). Arm 4: Text for USA participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots. As a reference, 170 out of every 100,000 unvaccinated Americans died of COVID-19 based on data from the past year. Text for UK participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots. As a reference, 108 out of every 100,000 unvaccinated individuals in the UK died of COVID-19 based on data from the past year. Arm 5: Text for USA participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots. As a reference, this is 1/170th of the risk of COVID-19 mortality among unvaccinated Americans based on data from the past year. Text for UK participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots. As a reference, this is 1/108th of the risk of COVID-19 mortality among unvaccinated individuals in the UK based on data from the past year. Arm 6: Text for USA participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots (very low risk). As a reference, 170 out of every 100,000 unvaccinated Americans died of COVID-19 based on data from the past year. Text for UK participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots (very low risk). As a reference, 108 out of every 100,000 unvaccinated individuals in the UK died of COVID-19 based on data from the past year. Arm 7: Text for USA participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots (very low risk). As a reference, this is 1/170th of the risk of COVID-19 mortality among unvaccinated Americans based on data from the past year. Text for UK participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots (very low risk). As a reference, this is 1/108th of the risk of COVID-19 mortality among unvaccinated individuals in the UK based on data from the past year. Arm 8: Text for USA participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots. As a reference, 12 out of every 100,000 Americans died in a motor vehicle accident based on data from the past year. Text for UK participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots. As a reference, 2.6 out of every 100,000 individuals in the UK died in a motor vehicle accident based on data from the past year. Arm 9: Text for USA participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots. As a reference, this is 1/12th of the risk of dying in a motor vehicle accident based on data from the past year. Text for UK participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots. As a reference, this is almost 1/4th of the risk of dying in a motor vehicle accident based on data from the past year. Arm 10: Text for USA participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots (very low risk). As a reference, 12 out of every 100,000 Americans died in a motor vehicle accident based on data from the past year. Text for UK participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots (very low risk). As a reference, 2.6 out of every 100,000 individuals in the UK died in a motor vehicle accident based on data from the past year. Arm 11: Text for USA participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots (very low risk). As a reference, this is 1/12th of the risk of dying in a motor vehicle accident based on data from the past year. Text for UK participants: With regards to side effects, 1 out of 100,000 vaccinated individuals may develop serious blood clots (very low risk). As a reference, this is nearly 1/4th of the risk of dying in a motor vehicle accidentbased on data from the past year. The risk information will be presented on a single page along with the two main outcome questions. Lastly, for individuals that reported that they are unlikely or unsure about whether they would take the vaccine, the final page will ask them their reason (question based on a recently published study of COVID-19 vaccine hesitancy). MAIN OUTCOMES: Our primary outcome is individuals' willingness to take the hypothetical COVID-19 vaccine. We will measure this outcome by asking, "How likely would you be to take this vaccine?" allowing individuals to choose from a four-point Likert response of "Unlikely, Unsure leaning towards unlikely, Unsure leaning towards likely, Very likely." This outcome variable, including the categories and phrasing, is based on a recently published study on COVID-19 vaccine hesitancy conducted by researchers with the Vaccine Hesitance Project at the London School of Hygiene and Tropical Medicine. Our secondary outcome is individuals' perceived safety of the vaccine. We will assess this outcome by asking individuals, "How safe do you feel this vaccine is?" allowing them to choose answers ranging from 1-10 where 1 is extremely unsafe, and 10 is extremely safe. Both outcomes will be measured at the time of the questionnaire. Participants can take up to 45 min to complete the questions but will not be able to go back and change their responses after submitting their questionnaire. RANDOMIZATION: Using a web-based randomization algorithm, Gorilla will randomly allocate participants to each of the experimental arms. Gorilla allows for two randomization options - independent randomization of each individual based on a probability draw and balanced randomization, which randomizes without replacement such that among groups of respondents a fixed proportion will end up in each experimental arm. We will use the "balanced randomization" option to ensure that our experimental arms are balanced. Participants will be randomized based on the allocations described above. BLINDING: Because Prolific handles the interaction between the study investigators and participants, the participants will be completely anonymous to the study investigators. The outcome measures will be self-reported and submitted anonymously. All persons in the study team will be blinded to the group allocation. NUMBERS TO BE RANDOMIZED: We will randomize 6000 participants per country for a total sample of 12000 individuals. TRIAL STATUS: The protocol version number is 1.0 and the date is July 14, 2021. Recruitment is expected to begin on 26 July 2021 and end by August 10, 2021. TRIAL REGISTRATION: The study and its outcomes were registered at the German Clinical Trials Register ( www.drks.de ) on July 12th, 2021: # DRKS00025551 . FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Full_Protocol_20Jul2021) In the interest of expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


Assuntos
COVID-19 , Vacinas , Adolescente , Adulto , Vacinas contra COVID-19 , Feminino , Humanos , Intenção , Masculino , Pandemias , Ensaios Clínicos Controlados Aleatórios como Assunto , SARS-CoV-2 , Resultado do Tratamento , Reino Unido , Estados Unidos , Vacinas/efeitos adversos
7.
JMIR Mhealth Uhealth ; 9(9): e27021, 2021 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-34499044

RESUMO

BACKGROUND: An increasing number of mobile health (mHealth) apps are becoming available for download and use on mobile devices. Even with the increase in availability and use of mHealth apps, there has still not been a lot of research into understanding the intention to use this kind of apps. OBJECTIVE: The purpose of this study was to investigate a technology acceptance model (TAM) that has been specially designed for primary health care applications. METHODS: The proposed model is an extension of the TAM, and was empirically tested using data obtained from a survey of mHealth app users (n=310). The research analyzed 2 additional external factors: promotion of health and health benefits. Data were analyzed with a PLS-SEM software and confirmed that gender moderates the adoption of mHealth apps in Spain. The explanatory capacity (R2 for behavioral intention to use) of the proposed model was 76.4%. Likewise, the relationships of the external constructs of the extended TAM were found to be significant. RESULTS: The results show the importance of healthy habits developed by using mHealth apps. In addition, communication campaigns for these apps should be aimed at transferring the usefulness of eHealth as an agent for transforming attitudes; additionally, as more health benefits are obtained, ease of use becomes greater. Perceived usefulness (PU; ß=.415, t0.001;4999=3.442, P=.001), attitude toward using (ß=.301, t0.01;499=2.299, P=.02), and promotion of health (ß=.210, t0.05;499=2.108, P=.03) were found to have a statistically significant impact on behavior intention to use eHealth apps (R2=76.4%). Perceived ease of use (PEOU; ß=.179, t0.01;499=2.623, P=.009) and PU (ß=.755, t0.001;499=12.888, P<.001) were found to have a statistically significant impact on attitude toward using (R2>=78.2%). Furthermore, PEOU (ß=.203, t0.01;499=2.810, P=.005), health benefits (ß=.448, t0.001;499=4.010, P<.001), and promotion of health (ß=.281, t0.01;499=2.393, P=.01) exerted a significant impact on PU (R2=72.7%). Finally, health benefits (ß=.640, t0.001;499=14.948, P<.001) had a statistically significant impact on PEOU (R2=40.9%), while promotion of health (ß=.865, t0.001;499=29.943, P<.001) significantly influenced health benefits (R2=74.7%). CONCLUSIONS: mHealth apps could be used to predict the behavior of patients in the face of recommendations to prevent pandemics, such as COVID-19 or SARS, and to track users' symptoms while they stay at home. Gender is a determining factor that influences the intention to use mHealth apps, so perhaps different interfaces and utilities could be designed according to gender.


Assuntos
COVID-19 , Aplicativos Móveis , Telemedicina , Humanos , Intenção , SARS-CoV-2
8.
Artigo em Inglês | MEDLINE | ID: mdl-34501799

RESUMO

The speed and innovation of the COVID-19 vaccine development has been accompanied by insecurity and skepticism. Young adults' attitude to vaccination remains under investigation, although herd immunity cannot be reached without them. The HEalth in Students during the Corona pandemic study (HES-C) provided the opportunity to investigate vaccination intention in 1478 students in the sixth survey wave (January 2021), including vaccination intention, psychological antecedents of vaccine hesitancy, trust in government's vaccination strategy, and vaccination history. Associations with vaccination intention were analyzed with multivariate ordinal regression and predicted margins were calculated adjusting for gender, age, anxiety, health profession, and subjective health status. A third was decided (yes 25.1%, no 7.6%), and 68% were unsure about getting the COVID-19 vaccine when available. Next to demographic characteristics, vaccination history (influenza vaccination OR = 1.39; 95% CI: 1.06-1.83, travel vaccination OR = 1.29; 95% CI: 1.04-1.60), trust in vaccination strategy (OR = 2.40; 95% CI: 1.89-3.05), and 5C dimensions were associated with vaccination intention: confidence (OR = 2.52; 95% CI: 2.09-3.03), complacency (OR = 0.79; 95% CI: 0.66-0.96), calculation (OR = 0.79; 95% CI: 0.70-0.89), constraints (OR = 1.18; 95% CI: 0.99-1.41), and collective responsibility (OR = 4.47; 95% CI: 3.69-5.40). Addressing psychological antecedents and strengthening trust in official strategies through targeted campaigns and interventions may increase decisiveness and result in higher vaccination rates.


Assuntos
COVID-19 , Universidades , Vacinas contra COVID-19 , Estudos Transversais , Humanos , Intenção , SARS-CoV-2 , Estudantes , Suíça/epidemiologia , Vacinação , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-34501932

RESUMO

BACKGROUND: During the COVID-19 crisis, an apparent growth in vaccine hesitancy has been noticed due to different factors and reasons. Therefore, this scoping review was performed to determine the prevalence of intention to use COVID-19 vaccines among adults aged 18-60, and to identify the demographic, social, and contextual factors that influence the intention to use COVID-19 vaccines. METHODS: This scoping review was conducted by using the methodological framework for scoping review outlined by Arksey and O'Malley. A search strategy was carried out on four electronic databases: PubMed, Scopus, CINAHL, and PsycINFO. All peer-reviewed articles published between November 2019 and December 2020 were reviewed. Data were extracted to identify the prevalence of, and factors that influence, the intention to use COVID-19 vaccines. RESULTS: A total of 48 relevant articles were identified for inclusion in the review. Outcomes presented fell into seven themes: demographics, social factors, vaccination beliefs and attitudes, vaccine-related perceptions, health-related perceptions, perceived barriers, and vaccine recommendations. Age, gender, education level, race/ethnicity, vaccine safety and effectiveness, influenza vaccination history, and self-protection from COVID-19 were the most prominent factors associated with intention to use COVID-19 vaccines. Furthermore, the majority of studies (n = 34/48) reported a relatively high prevalence of intention to get vaccinated against COVID-19, with a range from 60% to 93%. CONCLUSION: This scoping review enables the creation of demographic, social, and contextual constructs associated with intention to vaccinate among the adult population. These factors are likely to play a major role in any targeted vaccination programs, particularly COVID-19 vaccination. Thus, our review suggests focusing on the development of strategies to promote the intention to get vaccinated against COVID-19 and to overcome vaccine hesitancy and refusal. These strategies could include transparent communication, social media engagement, and the initiation of education programs.


Assuntos
COVID-19 , Vacinas contra Influenza , Adulto , Vacinas contra COVID-19 , Humanos , Intenção , Prevalência , SARS-CoV-2 , Vacinação
10.
Front Public Health ; 9: 684683, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34497791

RESUMO

A growing body of scientific studies has been published to inform responses to the ongoing coronavirus pandemic, and some have claimed that cigarette smoking has a beneficial or mixed effect on the prevention and treatment of COVID-19. The presentation of such findings, unfortunately, has created an infodemic. This study integrated the theory of planned behavior and the health belief model and incorporated findings on addiction from the medical literature to predict cessation intention and support for tobacco control measures in the context of the COVID-19 infodemic. The study found that cessation intention partially mediated the effect of perceived severity and fully mediated the effects of perceived benefits, self-efficacy, and addiction on support for control measures. In addition, a positively-valenced message of the effect of smoking on the prevention and treatment of COVID-19 vs. a mixedly-valenced message was significant in predicting cessation intention, and the positively-valenced message of smoking indirectly predicted support for tobacco control measures. Perceived susceptibility, barriers, and subjective norms, however, exerted neither direct nor indirect effects on the two outcome variables.


Assuntos
COVID-19 , Abandono do Hábito de Fumar , Estudos Transversais , Humanos , Intenção , SARS-CoV-2 , Fumar/efeitos adversos , Inquéritos e Questionários
11.
Front Public Health ; 9: 710508, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34497793

RESUMO

Background: The objectives of this study were to investigate risk perceptions and travel intention among the general public in Taiwan during the COVID-19 outbreak. Methods: This study used a cross-sectional online survey to collect data. The questionnaire was disseminated via the social media platform (LINE and Facebook) to the general public. Results: A total of 3,237 complete responses were received, of whom 5.8% (95% CI 5.1-6.7) of the participants reported intent to travel to overseas countries with an apparent community spread and 5.5% (95% CI 4.7-6.3) reported intent to travel to other overseas countries in the next 1 month. A relatively higher proportion (46.5%; 95% CI 44.7-48.2) reported intention for domestic travelling. Participants who viewed travelling to only be risky for older adults or those with medical conditions (OR = 2.19; 95% CI 1.38-3.47) and who perceived that one will not get infected if one takes recommended precautionary measures (OR = 3.12; 95% CI 1.85-5.27) reported higher travelling intention to overseas countries with an apparent community spread. Conclusions: Overall, the findings suggest that risk perceptions were depicted as a strong influence of travel intentions.


Assuntos
COVID-19 , Intenção , Idoso , Estudos Transversais , Humanos , Percepção , SARS-CoV-2
12.
BMJ Open ; 11(8): e045395, 2021 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-34408029

RESUMO

OBJECTIVE: This paper examines the impact on doctors' attitudes towards the General Medical Council (GMC) and on professional behaviours (reflective practice and raising concerns) following the Dr Bawa-Garba case. DESIGN: A cross-sectional survey designed using the theoretical lens of the theory of planned behaviour (TPB) was administered from September 2017 to February 2019. By chance, this coincided with critical events in the Dr Bawa-Garba case. SETTING: Primary and secondary care settings across a broad geographical spread in England. PARTICIPANTS: 474 doctors. OUTCOME MEASURES: Attitudes towards the GMC and two professional behaviours in TPB dimensions. RESULTS: Attitudes towards the GMC became more negative during the period that the Medical Practitioners Tribunal Service and GMC suspended and subsequently erased Dr Bawa-Garba from the medical register. Specifically, confidence that doctors are well regulated by the GMC and that the GMC's disciplinary procedures produce fair outcomes was rated more negatively. After this period, overall attitudes start to recover and soon returned close to baseline; however, confidence in how the GMC regulates doctors and their disciplinary procedures improved but still remained below baseline. There was no change in doctors' attitudes or intention to reflect or raise concerns. CONCLUSIONS: The lack of change in doctors' attitudes towards the GMC's guidance, the approachability of the regulator, defensive practice and professional behaviours as a response to the Dr Bawa-Garba case demonstrates the resilient and indelible nature of medical professionalism. At the time, professional bodies reported that repairing doctors' trust and confidence would take time and a significant effort to restore. However, this study suggests that attitudes are more fluid. Despite the high-profile nature of this case and concerns articulated by medical bodies regarding its impact on trust, the actual decline in doctors' overall attitudes towards the GMC was relatively short lived and had no measurable impact on professionalism.


Assuntos
Médicos , Atitude do Pessoal de Saúde , Estudos Transversais , Humanos , Intenção , Profissionalismo
13.
BMJ Open ; 11(8): e047575, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34413101

RESUMO

BACKGROUND: We can improve healthcare services by better understanding current provision. One way to understand this is by linking data sets from clinical and national audits, national registries and other National Health Service (NHS) encounter data. However, getting to the point of having linked national data sets is challenging. OBJECTIVE: We describe our experience of the data application and linkage process for our study 'LAUNCHES QI', and the time, processes and resource requirements involved. To help others planning similar projects, we highlight challenges encountered and advice for applications in the current system as well as suggestions for system improvements. FINDINGS: The study set up for LAUNCHES QI began in March 2018, and the process through to data acquisition took 2.5 years. Several challenges were encountered, including the amount of information required (often duplicate information in different formats across applications), lack of clarity on processes, resource constraints that limit an audit's capacity to fulfil requests and the unexpected amount of time required from the study team. It is incredibly difficult to estimate the resources needed ahead of time, and yet necessary to do so as early on as funding applications. Early decisions can have a significant impact during latter stages and be hard to change, yet it is difficult to get specific information at the beginning of the process. CONCLUSIONS: The current system is incredibly complex, arduous and slow, stifling innovation and delaying scientific progress. NHS data can inform and improve health services and we believe there is an ethical responsibility to use it to do so. Streamlining the number of applications required for accessing data for health services research and providing clarity to data controllers could facilitate the maintenance of stringent governance, while accelerating scientific studies and progress, leading to swifter application of findings and improvements in healthcare.


Assuntos
Intenção , Medicina Estatal , Atenção à Saúde , Pesquisa sobre Serviços de Saúde
14.
Artigo em Inglês | MEDLINE | ID: mdl-34444354

RESUMO

Exposure to self-directed violence (SDV) is a public health issue. Prevention trains third parties to identify SDV risk and provide help. However, we know little about the range of help provided to those who engage in SDV. The current study used a cross-sectional online survey of 1031 adolescents and emerging adults to learn about their SDV exposure, intent and attempts to help, and barriers to helping. Most participants reported SDV exposure, commonly by a peer, and provided help. Regression analyses showed that intent to help was predicted by social norms and having knowledge of resources, and such knowledge (but not social norms) was also related to actual helping behaviors. Qualitative analysis of short open-ended questions on the survey documented a range of barriers to helping. Findings support but also encourage revision of theoretical models of helping upon which prevention programs are based.


Assuntos
Comportamento de Ajuda , Intenção , Adolescente , Adulto , Estudos Transversais , Humanos , Inquéritos e Questionários , Violência/prevenção & controle
15.
Artigo em Inglês | MEDLINE | ID: mdl-34444359

RESUMO

A growing number of young people tend to regard their pets as their surrogate children, yet research examining the relationship between pet attachment and fertility intention remains scarce. Moreover, individuals' fertility intention is affected by economic resources. Therefore, we conducted two studies to examine the interaction effect of pet attachment and subjective socioeconomic status (SES) on childbearing-aged individuals' fertility intention. In Study 1, we utilized questionnaires to measure Chinese pet owners' pet attachment, subjective SES, and fertility intention. In Study 2, participants' pet attachment was experimentally manipulated by reading articles about the benefits of petkeeping. The results of the two studies consistently demonstrated that the effect of pet attachment on fertility intention was moderated by subjective SES. Specifically, pet attachment was negatively associated with fertility intention when individuals had a high level of subjective SES, whereas this effect disappeared when individuals had low subjective SES. These findings suggest an explanation for why individuals with high subjective SES delay or even opt out of childbearing. The limitations and implications of the current study are discussed.


Assuntos
Intenção , Classe Social , Adolescente , Idoso , Animais , Criança , Fertilidade , Humanos , Renda , Animais de Estimação , Inquéritos e Questionários
16.
JMIR Mhealth Uhealth ; 9(8): e26845, 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34459745

RESUMO

BACKGROUND: Considering the increasing demand for health services by older people and the ongoing COVID-19 pandemic, digital health is commonly viewed to offer a pathway to provide safe and affordable health services for older adults, thus enabling self-management of their health while health care systems are struggling. However, several factors cause older people to be particularly reluctant to adopt digital health technologies such as mobile health (mHealth) tools. In addition to previously studied technology acceptance factors, those related to perceived risks of mHealth use (eg, leakage of sensitive information or receiving incorrect health recommendations) may further diminish mHealth adoption by older adults. OBJECTIVE: The aim of this study was to explore the relationship between perceived risks of using mHealth applications and the intention to use these applications among older adults. METHODS: We designed a cross-sectional study wherein a questionnaire was used to collect data from participants aged 65 years and older in the Netherlands. Perceived risk was divided into four constructs: privacy risk, performance risk, legal concern, and trust. Linear regression analyses were performed to determine the associations between these perceived risk constructs and the intention to use mHealth applications. RESULTS: Linear regression per perceived risk factor showed that each of the four constructs is significantly associated with the intention to use mobile medical applications among older adults (adjusted for age, sex, education, and health status). Performance risk (ß=-.266; P=<.001), legal concern (ß=-.125; P=.007), and privacy risk (ß=-.100; P=.03) were found to be negatively correlated to intention to use mHealth applications, whereas trust (ß=.352; P=<.001) was found to be positively correlated to the intention to use mHealth applications. CONCLUSIONS: Performance risk, legal concern, and privacy risk as perceived by older adults may substantially and significantly decrease their intention to use mHealth applications. Trust may significantly and positively affect this intention. Health care professionals, designers of mHealth applications, and policy makers can use these findings to diminish performance risks, and tailor campaigns and applications to address legal and privacy concerns and promote mHealth uptake and health care access for older adults, especially during the COVID-19 pandemic.


Assuntos
COVID-19 , Telemedicina , Idoso , Estudos Transversais , Humanos , Intenção , Países Baixos , Pandemias , SARS-CoV-2
17.
Artigo em Inglês | MEDLINE | ID: mdl-34444103

RESUMO

Background: Warning apps can provide personalized public warnings, but research on their appraisal and impact on compliance is scarce. This study introduces a virtual city framework to examine affective reactions when receiving an app-based warning, and subsequent behavioral intentions. Methods: In an online experiment, 276 participants (M = 41.07, SD = 16.44, 62.0% female) were randomly allocated to one of eight groups (warning vs. no warning, thunderstorm vs. no thunderstorm, video vs. vignette). Participants were guided through a virtual city by a mock-up touristic app (t1). Then, the app issued a warning about an impending thunderstorm (t2), followed by a virtual thunderstorm (t3). The virtual city tour was presented via vignettes or videos. ANCOVAs were used to investigate trajectories of momentary anxiety, hierarchical regressions analyzed the impact of momentary anxiety on information seeking. Results: Participants who received a warning message and were confronted with a thunderstorm showed the highest increase in momentary anxiety, which predicted information seeking intentions. Conclusions: The findings underscore the importance of affective appraisal in processing warning messages. The virtual city framework is able to differentiate the impact of warning versus event in an online context, and thus promising for future warning research in virtual settings.


Assuntos
Aplicativos Móveis , Feminino , Humanos , Intenção , Masculino , Tempo (Meteorologia)
18.
Artigo em Inglês | MEDLINE | ID: mdl-34444170

RESUMO

Consumers often come across cues of infectious disease in daily life, such as diners coughing in restaurants, commuters sneezing on the bus, or recent news reports about the spread of infectious diseases. In this study, four experiments were conducted to explore the role of infectious disease cues on consumers' purchase intention for environmentally friendly products (eco-friendly products), as well as the moderating effects of consumers' sense of power and anti-disease intervention. According to the results, infectious disease cues enhance consumers' intent to purchase eco-friendly products, and perceived uncertainty and need to belong played a chain-mediated role in the relationship between infectious disease cues and this purchase intention. Consumers' sense of power moderated the relationship between infectious disease cues and purchase intention. The purchase intention of consumers with a low sense of power (vs. high sense of power) was significantly enhanced when the infectious disease cues were highlighted. Anti-disease interventions also have a moderating effect on the relationship between infectious disease cues and purchase intention. When anti-disease intervention (such as wearing an anti-bacterial mask against airborne diseases) was adopted, consumers' willingness to purchase eco-friendly products decreased.


Assuntos
Doenças Transmissíveis , Intenção , Comportamento do Consumidor , Sinais (Psicologia) , Humanos , Inquéritos e Questionários
19.
BMC Med Inform Decis Mak ; 21(1): 228, 2021 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-34332570

RESUMO

OBJECTIVES: In France, about 30% of the population refuses COVID-19 vaccination outright, and 9 to 40% are hesitant. We developed and evaluated an interactive web tool providing transparent and reliable information on the benefits and risks of COVID-19 vaccination. METHODS: The most recent scientific data at the time of the study were implemented into an interactive web tool offering individualized information on the risks of COVID-19 infection-related events versus vaccination-related serious adverse events. The tool was evaluated during a before-and-after impact study nested in ComPaRe, a French e-cohort of adult patients with chronic conditions. Primary outcome was the proportion of patients intending to receive vaccination after using the tool, among those not intending to receive it at baseline. RESULTS: Between January 8 and 14, 2021, we enrolled 3152 patients in the study [mean age 55.2 (SD: 16.9), 52.9% women and 63% with ≥ 2 chronic conditions]. Before consulting the tool, 961 (30.5%) refused to be vaccinated until further data on efficacy/safety was obtained and 239 (7.5%) outright refused vaccination. Among these 1200 patients, 96 (8.0%, number needed to treat: 12.5) changed their mind after consulting the tool and would subsequently accept vaccination. CONCLUSIONS: Our interactive web tool represents a scalable method to help increase the intent to receive COVID-19 vaccination among patients with chronic conditions and address vaccine hesitancy. Since April 2021, our tool has been embedded on the official webpage of the French Government for COVID-19 information.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Adulto , Feminino , França , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Vacinação
20.
PLoS One ; 16(8): e0256495, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34411185

RESUMO

Social distancing measures implemented by governments worldwide during the COVID-19 pandemic have proven an effective intervention to control the transmission of SARS-CoV-2. There is a growing literature on predictors of adherence behaviours to social distancing measures, however, there are no comprehensive insights into the nature and types of non-adherence behaviours. To address this gap in the literature, we studied non-adherence in terms of counts of infringements and people's accounts on their behaviours in a sample of North London residents. We focused on the following social distancing rules: keeping 2 mts. distancing, meeting family and friends, and going out for non-essential reasons. A mixed-methods explanatory sequential design was used comprising an online survey (May 1-31, 2020) followed by semi-structured in-depth interviews held with a purposive sample of survey respondents (August 5 -September 21, 2020). A negative binomial regression model (quantitative) and Framework Analysis (qualitative) were undertaken.681 individuals completed the survey, and 30 individuals were interviewed. We integrated survey and interview findings following three levels of the Social Ecological model: individual, interpersonal and community levels. We identified non-adherence behaviours as unintentional (barriers beyond individual's control) and intentional (deliberate decision). Unintentional adherence was reported by interviewees as, lack of controllability in keeping 2 mts. distancing, environmental constraints, social responsibility towards the community and feeling low risk. Intentional non-adherence was statistically associated with and reported as lack of trust in Government, support from friends, and lack of knowledge about rules. In addition, interviewees reported individual risk assessment and decision making on the extent to following the rules, and perceived lack of adherence in the local area. Our findings indicate that unintentional and intentional non-adherence should be improved by Government partnerships with local communities to build trust in social distancing measures; tailored messaging to young adults emphasising the need of protecting others whilst clarifying the risk of transmission; and ensuring COVID-secured environments by working with environmental health officers.


Assuntos
COVID-19/prevenção & controle , Intenção , Pandemias/prevenção & controle , Cooperação do Paciente , Distanciamento Físico , SARS-CoV-2 , Adulto , Idoso , COVID-19/psicologia , Estudos Transversais , Feminino , Humanos , Londres/epidemiologia , Masculino , Pessoa de Meia-Idade , Modelos Teóricos
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