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BOCCALINI SARA, PANATTO DONATELLA, MENNINI FRANCESCOSAVERIO, MARCELLUSI ANDREA, BINI CHIARA, AMICIZIA DANIELA, LAI PIEROLUIGI, MICALE ROSANNATINDARA, FRUMENTO DAVIDE, AZZARI CHIARA, RICCI SILVIA, BONITO BENEDETTA, DI PISA GIULIA, IOVINE MARIASILVIA, LODI LORENZO, GIOVANNINI MATTIA, MOSCADELLI ANDREA, PAOLI SONIA, PENNATI BEATRICEMARINA, PISANO LAURA, BECHINI ANGELA, BONANNI PAOLO. [ Health Technology Assessment (HTA) of the introduction of additional cohorts for anti-meningococcal vaccination with quadrivalent conjugate vaccines in Italy]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E1-E128. [PMID: 34622076 PMCID: PMC8452280 DOI: 10.15167/2421-4248/jpmh2021.62.1s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- SARA BOCCALINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
- Autore corrispondente: Sara Boccalini, Dipartimento di Scienze della Salute, Università degli Studi di Firenze, 50134 Firenze, Italia - Tel.: 055-2751084 E-mail:
| | - DONATELLA PANATTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - FRANCESCO SAVERIO MENNINI
- Economic Evaluation and HTA - CEIS (EEHTA - CEIS), Facoltà di Economia, Università di Roma "Tor Vergata"
- Institute for Leadership and Management in Health, Kingston University, London, UK
| | - ANDREA MARCELLUSI
- Economic Evaluation and HTA - CEIS (EEHTA - CEIS), Facoltà di Economia, Università di Roma "Tor Vergata"
| | - CHIARA BINI
- Economic Evaluation and HTA - CEIS (EEHTA - CEIS), Facoltà di Economia, Università di Roma "Tor Vergata"
| | - DANIELA AMICIZIA
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - PIERO LUIGI LAI
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | | | - DAVIDE FRUMENTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - CHIARA AZZARI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - SILVIA RICCI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - BENEDETTA BONITO
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - GIULIA DI PISA
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | | | - LORENZO LODI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - MATTIA GIOVANNINI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - ANDREA MOSCADELLI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - SONIA PAOLI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | | | - LAURA PISANO
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - ANGELA BECHINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - PAOLO BONANNI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
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Boccalini S, Bonanni P, Chiesi F, Pisa GD, Furlan F, Giammarco B, Zanella B, Mandò Tacconi F, Bechini A. The Experience of VaccinarSinToscana Website and the Role of New Media in Promoting Vaccination. Vaccines (Basel) 2020; 8:vaccines8040644. [PMID: 33153005 PMCID: PMC7712014 DOI: 10.3390/vaccines8040644] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/05/2020] [Accepted: 10/29/2020] [Indexed: 02/06/2023] Open
Abstract
The Department of Health Sciences (University of Florence) developed a regional website “VaccinarSinToscana” in order to provide information on vaccines and communicate with the general population, as well as the healthcare community, at a regional and local level. The aim of this paper is to present the VaccinarSinToscana website framework and analyze the three-year activity of the website and the related social network account on Facebook in terms of dissemination and visibility. In the first three years since its launch, the VaccinarSinToscana portal has increased its visibility: the number of single users, visits and single web pages has grown exponentially. Our results also demonstrate how the Facebook account launch contributed enormously to the increase in the visibility of the website. The objective for the future of the VaccinarSinToscana portal is to grow further, in order to reach out to an even wider audience.
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Affiliation(s)
- Sara Boccalini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (P.B.); (B.Z.)
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (P.B.); (B.Z.)
| | - Fabrizio Chiesi
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (F.C.); (G.D.P.); (F.F.); (B.G.)
| | - Giulia Di Pisa
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (F.C.); (G.D.P.); (F.F.); (B.G.)
| | - Federica Furlan
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (F.C.); (G.D.P.); (F.F.); (B.G.)
| | - Barbara Giammarco
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (F.C.); (G.D.P.); (F.F.); (B.G.)
| | - Beatrice Zanella
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (P.B.); (B.Z.)
| | - Francesco Mandò Tacconi
- Nuovo Ospedale delle Apuane, North-West Tuscany LHU (Local Health Authorities), Viale Enrico Mattei, 21, 54100 Marina di Massa, Italy;
| | - Angela Bechini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (P.B.); (B.Z.)
- Correspondence: ; Tel.: +39-055-2751-081
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Why the Anti-Meningococcal B Vaccination during Adolescence Should Be Implemented in Italy: An Overview of Available Evidence. Microorganisms 2020; 8:microorganisms8111681. [PMID: 33138142 PMCID: PMC7692044 DOI: 10.3390/microorganisms8111681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/19/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022] Open
Abstract
Although meningococcal disease has a low incidence in Italy, it is a public health concern owing to its high lethality rate and high frequency of transitory and/or permanent sequelae among survivors. The highest incidence rates are recorded in infants, children and adolescents, and most of the cases are due to Neisseria meningitidis B. In Italy, anti-meningococcal B (anti-MenB) vaccination is free for infants but, despite the considerable disease burden in adolescents, no national recommendation to vaccinate in this age-group is currently available. The aim of this study was to assess the main available scientific evidence to support the Italian health authorities in implementing a program of free anti-MenB vaccination for adolescents. We conducted an overview of the scientific literature on epidemiology, disease burden, immunogenicity and safety of available vaccines, and economic evaluations of vaccination strategies. Each case of invasive meningococcal disease generates a considerable health burden (lethality rate: 9%; up to 60% of patients experience at least one sequela) in terms of impaired quality of life for survivors and high direct and indirect costs (the mean overall cost of acute phase for a single case amounts to about EUR 13,952; the costs for post-acute and the long-term phases may vary widely depending of the type of sequela, reaching an annual cost of about EUR 100,000 in cases of severe neurological damage). Furthermore, vaccination against meningococcus B in adolescence proved cost-effective. The study highlights the need to actively offer the anti-MenB vaccination during adolescence at a national level. This would make it possible to avoid premature deaths and reduce the high costs borne by the National Health Service and by society of supporting survivors who suffer temporary and/or permanent sequelae.
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Boccalini S, Bechini A, Sartor G, Paolini D, Innocenti M, Bonanni P, Panatto D, Lai PL, Zangrillo F, Marchini F, Lecini E, Iovine M, Amicizia D, Landa P. [Health Technology Assessment of meningococcal B vaccine (Trumenba ®) in adolescent in Italy]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E1-E94. [PMID: 32047867 PMCID: PMC7007189 DOI: 10.15167/2421-4248/jpmh2019.60.3s2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- S Boccalini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - A Bechini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - G Sartor
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - D Paolini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - M Innocenti
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - P Bonanni
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - D Panatto
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - P L Lai
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - F Zangrillo
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - F Marchini
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - E Lecini
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - M Iovine
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - D Amicizia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - P Landa
- Dipartimento di Economia, Università degli Studi di Genova
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Edwards EA, Caton H, Lumsden J, Rivas C, Steed L, Pirunsarn Y, Jumbe S, Newby C, Shenvi A, Mazumdar S, Smith JQ, Greenhill D, Griffiths CJ, Walton RT. Creating a Theoretically Grounded, Gamified Health App: Lessons From Developing the Cigbreak Smoking Cessation Mobile Phone Game. JMIR Serious Games 2018; 6:e10252. [PMID: 30497994 PMCID: PMC6293248 DOI: 10.2196/10252] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/25/2018] [Accepted: 07/28/2018] [Indexed: 12/11/2022] Open
Abstract
Background Gaming techniques are increasingly recognized as effective methods for changing behavior and increasing user engagement with mobile phone apps. The rapid uptake of mobile phone games provides an unprecedented opportunity to reach large numbers of people and to influence a wide range of health-related behaviors. However, digital interventions are still nascent in the field of health care, and optimum gamified methods of achieving health behavior change are still being investigated. There is currently a lack of worked methodologies that app developers and health care professionals can follow to facilitate theoretically informed design of gamified health apps. Objective This study aimed to present a series of steps undertaken during the development of Cigbreak, a gamified smoking cessation health app. Methods A systematic and iterative approach was adopted by (1) forming an expert multidisciplinary design team, (2) defining the problem and establishing user preferences, (3) incorporating the evidence base, (4) integrating gamification, (5) adding behavior change techniques, (6) forming a logic model, and (7) user testing. A total of 10 focus groups were conducted with 73 smokers. Results Users found the app an engaging and motivating way to gain smoking cessation advice and a helpful distraction from smoking; 84% (62/73) of smokers said they would play again and recommend it to a friend. Conclusions A dedicated gamified app to promote smoking cessation has the potential to modify smoking behavior and to deliver effective smoking cessation advice. Iterative, collaborative development using evidence-based behavior change techniques and gamification may help to make the game engaging and potentially effective. Gamified health apps developed in this way may have the potential to provide effective and low-cost health interventions in a wide range of clinical settings.
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Affiliation(s)
- Elizabeth A Edwards
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Hope Caton
- Faculty of Science, Engineering Computing, Kingston University, London, United Kingdom
| | - Jim Lumsden
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom.,School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Carol Rivas
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Social Science Research Unit, University College London, London, United Kingdom
| | - Liz Steed
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Yutthana Pirunsarn
- Faculty of Science, Engineering Computing, Kingston University, London, United Kingdom
| | - Sandra Jumbe
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Chris Newby
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Aditi Shenvi
- Centre for Complexity Science, University of Warwick, Coventry, United Kingdom
| | - Samaresh Mazumdar
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Jim Q Smith
- Department of Statistics, University of Warwick, Coventry, United Kingdom
| | - Darrel Greenhill
- Faculty of Science, Engineering Computing, Kingston University, London, United Kingdom
| | - Chris J Griffiths
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Robert T Walton
- Centre for Primary Care and Public Health, Blizard Institute, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Asthma UK Centre for Applied Research, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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Fadda M, Galimberti E, Fiordelli M, Schulz PJ. Evaluation of a Mobile Phone-Based Intervention to Increase Parents' Knowledge About the Measles-Mumps-Rubella Vaccination and Their Psychological Empowerment: Mixed-Method Approach. JMIR Mhealth Uhealth 2018. [PMID: 29514772 PMCID: PMC5863009 DOI: 10.2196/mhealth.8263] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND There is mixed evidence on the effectiveness of vaccination-related interventions. A major limitation of most intervention studies is that they do not apply randomized controlled trials (RCTs), the method that, over the last 2 decades, has increasingly been considered as the only method to provide proof of the effectiveness of an intervention and, consequently, as the most important instrument in deciding whether to adopt an intervention or not. This study, however, holds that methods other than RCTs also can produce meaningful results. OBJECTIVE The aim of this study was to evaluate 2 mobile phone-based interventions aimed at increasing parents' knowledge of the measles-mumps-rubella (MMR) vaccination (through elements of gamification) and their psychological empowerment (through the use of narratives), respectively. The 2 interventions were part of an RCT. METHODS We conducted 2 studies with the RCT participants: a Web-based survey aimed at assessing their rating of the tool regarding a number of qualities such as usability and usefulness (N=140), and qualitative telephonic interviews to explore participants' experiences with the app (N=60). RESULTS The results of the survey showed that participants receiving the knowledge intervention (alone or together with the empowerment intervention) liked the app significantly better compared with the group that only received the empowerment intervention (F2,137=15.335; P<.001). Parents who were exposed to the empowerment intervention complained that they did not receive useful information but were only invited to make an informed, autonomous MMR vaccination decision. CONCLUSIONS The results suggest that efforts to empower patients should always be accompanied by the provision of factual information. Using a narrative format that promotes parents' identification can be an appropriate strategy, but it should be employed together with the presentation of more points of views and notions regarding, for instance, the risks and benefits of the vaccination at the same time. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number 30768813; http://www.isrctn.com/ ISRCTN30768813 (Archived by WebCite at http://www.webcitation.org/6xOQSJ3w8).
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Affiliation(s)
- Marta Fadda
- Institute of Communication and Health, University of Lugano, Lugano, Switzerland.,Health Ethics and Policy Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Elisa Galimberti
- Institute of Communication and Health, University of Lugano, Lugano, Switzerland
| | - Maddalena Fiordelli
- Institute of Communication and Health, University of Lugano, Lugano, Switzerland
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Panatto D, Amicizia D, Arata L, Lai PL, Gasparini R. A comprehensive analysis of Italian web pages mentioning squalene-based influenza vaccine adjuvants reveals a high prevalence of misinformation. Hum Vaccin Immunother 2018; 14:969-977. [PMID: 29172967 PMCID: PMC5893210 DOI: 10.1080/21645515.2017.1407483] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Squalene-based adjuvants have been included in influenza vaccines since 1997. Despite several advantages of adjuvanted seasonal and pandemic influenza vaccines, laypeople's perception of such formulations may be hesitant or even negative under certain circumstances. Moreover, in Italian, the term “squalene” has the same root as such common words as “shark” (squalo), “squalid” and “squalidness” that tend to have negative connotations. This study aimed to quantitatively and qualitatively analyze a representative sample of Italian web pages mentioning squalene-based adjuvants used in influenza vaccines. Every effort was made to limit the subjectivity of judgments. Eighty-four unique web pages were assessed. A high prevalence (47.6%) of pages with negative or ambiguous attitudes toward squalene-based adjuvants was established. Compared with web pages reporting balanced information on squalene-based adjuvants, those categorized as negative/ambiguous had significantly lower odds of belonging to a professional institution [adjusted odds ratio (aOR) = 0.12, p = .004], and significantly higher odds of containing pictures (aOR = 1.91, p = .034) and being more readable (aOR = 1.34, p = .006). Some differences in wording between positive/neutral and negative/ambiguous web pages were also observed. The most common scientifically unsound claims concerned safety issues and, in particular, claims linking squalene-based adjuvants to the Gulf War Syndrome and autoimmune disorders. Italian users searching the web for information on vaccine adjuvants have a high likelihood of finding unbalanced and misleading material. Information provided by institutional websites should be not only evidence-based but also carefully targeted towards laypeople. Conversely, authors writing for non-institutional websites should avoid sensationalism and provide their readers with more balanced information.
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Affiliation(s)
- Donatella Panatto
- a Department of Health Sciences , University of Genoa , Genoa , Italy.,b Interuniversity Research Center on Influenza and other Transmissible Infections (CIRI-IT), University of Genoa , Genoa , Italy
| | - Daniela Amicizia
- a Department of Health Sciences , University of Genoa , Genoa , Italy.,b Interuniversity Research Center on Influenza and other Transmissible Infections (CIRI-IT), University of Genoa , Genoa , Italy
| | - Lucia Arata
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Piero Luigi Lai
- a Department of Health Sciences , University of Genoa , Genoa , Italy.,b Interuniversity Research Center on Influenza and other Transmissible Infections (CIRI-IT), University of Genoa , Genoa , Italy
| | - Roberto Gasparini
- a Department of Health Sciences , University of Genoa , Genoa , Italy.,b Interuniversity Research Center on Influenza and other Transmissible Infections (CIRI-IT), University of Genoa , Genoa , Italy
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Fadda M, Galimberti E, Fiordelli M, Romanò L, Zanetti A, Schulz PJ. Effectiveness of a smartphone app to increase parents' knowledge and empowerment in the MMR vaccination decision: A randomized controlled trial. Hum Vaccin Immunother 2017; 13:2512-2521. [PMID: 29125783 DOI: 10.1080/21645515.2017.1360456] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Researchers are trying to build evidence for mhealth effectiveness in various fields. However, no evidence yet is showing the effectiveness of mhealth on parents' attitudes and behavior with regard to recommended vaccination of their children. The aim of this study was to look into the effects of 2 smartphone-based interventions targeting MMR vaccination knowledge and psychological empowerment respectively. The interventions used gamification features and videos in combination with text messages. We conducted a 2x2 between-subject factorial randomized controlled trial (absence/presence of knowledge intervention X absence/presence of empowerment intervention) with parents of young children in Italy. We randomly allocated 201 eligible participants to one of the 4 conditions. Data were collected by questionnaires at baseline and posttest. Primary outcomes were MMR vaccination knowledge, psychological empowerment, risk perception, and preferred decisional role; secondary outcomes included MMR vaccination intention, attitude, confidence, and recommendation intention. A significant gain in vaccination knowledge was reported by all experimental groups compared with the control (F(3,179) = 48.58, p < .000), while only those receiving both interventions reported a significant increase in their psychological empowerment (t(179) = -2.79, p = .006). Participants receiving the intervention targeting knowledge reported significantly higher intention to vaccinate (t(179) = 2.111; p = .03) and higher confidence in the decision (t(179) = 2.76; p = .006) compared with the control group. Parent-centered, gamified mobile interventions aimed at providing parents with vaccination-related information can be used to increase their knowledge, their intention to vaccinate as well as their confidence in the vaccination decision.
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Affiliation(s)
- Marta Fadda
- a Institute of Communication and Health, Faculty of Communication Science , University of Lugano , Lugano , Switzerland
| | - Elisa Galimberti
- a Institute of Communication and Health, Faculty of Communication Science , University of Lugano , Lugano , Switzerland
| | - Maddalena Fiordelli
- a Institute of Communication and Health, Faculty of Communication Science , University of Lugano , Lugano , Switzerland
| | - Luisa Romanò
- b Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - Alessandro Zanetti
- b Department of Biomedical Sciences for Health , University of Milan , Milan , Italy
| | - Peter J Schulz
- a Institute of Communication and Health, Faculty of Communication Science , University of Lugano , Lugano , Switzerland
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9
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Safety and perception: What are the greatest enemies of HPV vaccination programmes? Vaccine 2017; 36:5424-5429. [PMID: 28610824 DOI: 10.1016/j.vaccine.2017.05.071] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/05/2017] [Accepted: 05/24/2017] [Indexed: 12/11/2022]
Abstract
Vaccines stimulate a person's immune system to produce an adequate reaction against a specific infectious agent; i.e. the person is protected from that disease without having to get it first. As vaccines are administrated to healthy subjects, they are held to the highest standards of safety. Regarding human papillomavirus (HPV) vaccines, at present three prophylactic vaccines are licensed (bivalent HPV 16/18, quadrivalent HPV 6/11/16/18 and the nonovalent HPV 6/11/16/18/31/33/45/52/58 vaccine). Pre- and post-licensure studies (i.e. not yet for nonovalent HPV vaccine) confirm that HPV vaccines are generally safe and well-tolerated, site injections symptoms are the most common adverse events (AEs) reported, and pain is the most frequently referred local symptom. Serious AEs are rare and not associated with severe sequelae, at least no vaccine-related deaths have occurred. Despite these scientific evidences, it is still difficult to explain to the population the importance of a good vaccination programme. There are many determinants for HPV vaccines hesitancy which represent a barrier that must be overcome in order to increase vaccine coverage, including psychological reactions, religious or cultural aspects, and fear of possible AEs (demyelinating diseases, Complex Regional Pain Syndrome - CRPS, or Postural Orthostatic Tachycardia Syndrome - POTS). A weak communication strategy which frequently suffers due to spread of unverified news by media and websites may lead to the failure of a vaccination programme. Such a situation happened in Japan (2013), due to which a great number of women remain vulnerable to HPV-related cancers. In order to resolve the issues around HPV vaccines acceptance, it is necessary to use good communication strategies. Multicomponent and dialogue-based interventions seem to be the most effective, especially if an adequate language is used, customized according to the vaccination programme target.
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Meleo-Erwin Z, Basch C, MacLean SA, Scheibner C, Cadorett V. "To each his own": Discussions of vaccine decision-making in top parenting blogs. Hum Vaccin Immunother 2017; 13:1895-1901. [PMID: 28481675 PMCID: PMC5557216 DOI: 10.1080/21645515.2017.1321182] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Although social media provides a way for people to congregate with like-minded others, it can also play a role in spreading misinformation about public health interventions. Previous research demonstrates that parents who use the Internet to gather information on vaccination are more likely to hold anti-vaccination beliefs. There has been little examination of vaccination decision-making discussions on parenting blogs. This study seeks to fill that gap. Posts and comments on the top 25 top parenting blogs were analyzed using a mixed-method approach. Comments were analyzed using deductive coding scheme that examined whether content areas of interest were present or absent in vaccination discussions. Posts were coded inductively using a thematic analysis. Posts and comments were further coded as strongly vaccine-discouraging, vaccine-ambivalent, or strongly vaccine-encouraging. Finally, posts were grouped by year of publication and comments were analyzed within each group to examine the evolution of vaccination decision-making discussions in the parenting blogosphere over the past decade. Fifty-two percent of posts were categorized as strongly vaccine-discouraging and were most commonly associated with expressions of individual liberty. Comments were nearly 3 times as likely to strongly discourage vaccination than to strongly encourage it. Comments on the oldest posts (2006–2009), were more likely to strongly discourage vaccination (p = 0.008), whereas comments on newer posts (2013–2015), were more likely to strongly encourage vaccination (p = 0.003). These findings suggest there is a need for public health professionals to understand the concerns being expressed in these forums, and develop innovative ways to dispel anti-vaccination myths, as these views may create obstacles in the meeting the goals of the public health agenda.
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Affiliation(s)
- Zoë Meleo-Erwin
- a Department of Public Health , William Paterson University , Wayne , NJ , USA
| | - Corey Basch
- b Department of Public Health , William Paterson University , Wayne , NJ , USA
| | - Sarah A MacLean
- c Department of Epidemiology, Mailman School of Public Health , Columbia University , New York , NY , USA
| | - Courtney Scheibner
- d Bloustein Center for Survey Research , Rutgers University , New Brunswick , NJ , USA
| | - Valerie Cadorett
- e Department of Public Health , William Paterson University , Wayne , NJ , USA
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Seeber L, Conrad T, Hoppe C, Obermeier P, Chen X, Karsch K, Muehlhans S, Tief F, Boettcher S, Diedrich S, Schweiger B, Rath B. Educating parents about the vaccination status of their children: A user-centered mobile application. Prev Med Rep 2017; 5:241-250. [PMID: 28127527 PMCID: PMC5257187 DOI: 10.1016/j.pmedr.2017.01.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 01/06/2017] [Accepted: 01/08/2017] [Indexed: 01/05/2023] Open
Abstract
Parents are often uncertain about the vaccination status of their children. In times of vaccine hesitancy, vaccination programs could benefit from active patient participation. The Vaccination App (VAccApp) was developed by the Vienna Vaccine Safety Initiative, enabling parents to learn about the vaccination status of their children, including 25 different routine, special indication and travel vaccines listed in the WHO Immunization Certificate of Vaccination (WHO-ICV). Between 2012 and 2014, the VAccApp was validated in a hospital-based quality management program in Berlin, Germany, in collaboration with the Robert Koch Institute. Parents of 178 children were asked to transfer the immunization data of their children from the WHO-ICV into the VAccApp. The respective WHO-ICV was photocopied for independent, professional data entry (gold standard). Demonstrating the status quo in vaccine information reporting, a Recall Group of 278 parents underwent structured interviews for verbal immunization histories, without the respective WHO-ICV. Only 9% of the Recall Group were able to provide a complete vaccination status; on average 39% of the questions were answered correctly. Using the WHO-ICV with the help of the VAccApp resulted in 62% of parents providing a complete vaccination status; on average 95% of the questions were answered correctly. After using the VAccApp, parents were more likely to remember key aspects of the vaccination history. User-friendly mobile applications empower parents to take a closer look at the vaccination record, thereby taking an active role in providing accurate vaccination histories. Parents may become motivated to ask informed questions and to keep vaccinations up-to-date.
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Key Words
- ED, emergency department
- Electronic health records
- Immunization
- Mobile health
- Patient education
- Patient empowerment
- QM, quality management
- RSV, respiratory syncytial virus
- SOP, standard operating procedure
- VAccApp, Vaccination App, a mobile application for vaccination histories
- VPD, vaccine-preventable disease
- Vaccination history
- ViVI, Vienna Vaccine Safety Initiative
- WHO, World Health Organization
- WHO-ICV, International Certificate of Vaccination, issued by the World Health Organization
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Affiliation(s)
- Lea Seeber
- Department of Pediatrics, Charité University Medical Center, Augustenburger Platz 1, 13353 Berlin, Germany; Vienna Vaccine Safety Initiative, Berlin, Germany
| | - Tim Conrad
- Department of Mathematics and Computer Sciences, Freie University, Arnimallee 14, 14195 Berlin, Germany
| | - Christian Hoppe
- Department of Pediatrics, Charité University Medical Center, Augustenburger Platz 1, 13353 Berlin, Germany; Vienna Vaccine Safety Initiative, Berlin, Germany; Department of Mathematics and Computer Sciences, Freie University, Arnimallee 14, 14195 Berlin, Germany
| | - Patrick Obermeier
- Department of Pediatrics, Charité University Medical Center, Augustenburger Platz 1, 13353 Berlin, Germany; Vienna Vaccine Safety Initiative, Berlin, Germany
| | - Xi Chen
- Department of Pediatrics, Charité University Medical Center, Augustenburger Platz 1, 13353 Berlin, Germany; Vienna Vaccine Safety Initiative, Berlin, Germany
| | - Katharina Karsch
- Department of Pediatrics, Charité University Medical Center, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Susann Muehlhans
- Department of Pediatrics, Charité University Medical Center, Augustenburger Platz 1, 13353 Berlin, Germany; Vienna Vaccine Safety Initiative, Berlin, Germany
| | - Franziska Tief
- Department of Pediatrics, Charité University Medical Center, Augustenburger Platz 1, 13353 Berlin, Germany; Vienna Vaccine Safety Initiative, Berlin, Germany
| | - Sindy Boettcher
- National Reference Center for Poliomyelitis and Enteroviruses, Robert Koch Institute, Seestr. 10, 13353 Berlin, Germany
| | - Sabine Diedrich
- National Reference Center for Poliomyelitis and Enteroviruses, Robert Koch Institute, Seestr. 10, 13353 Berlin, Germany
| | - Brunhilde Schweiger
- National Reference Center for Influenza, Robert Koch Institute, Seestr. 10, 13353 Berlin, Germany
| | - Barbara Rath
- Department of Pediatrics, Charité University Medical Center, Augustenburger Platz 1, 13353 Berlin, Germany; Vienna Vaccine Safety Initiative, Berlin, Germany; The University of Nottingham School of Medicine, Hucknall Road, Nottingham NG51PB, UK
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12
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Panatto D, Domnich A, Gasparini R, Bonanni P, Icardi G, Amicizia D, Arata L, Carozzo S, Signori A, Bechini A, Boccalini S. An eHealth Project on Invasive Pneumococcal Disease: Comprehensive Evaluation of a Promotional Campaign. J Med Internet Res 2016; 18:e316. [PMID: 27913372 PMCID: PMC5161781 DOI: 10.2196/jmir.6205] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/10/2016] [Accepted: 10/12/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The recently launched Pneumo Rischio eHealth project, which consists of an app, a website, and social networking activity, is aimed at increasing public awareness of invasive pneumococcal disease (IPD). The launch of this project was prompted by the inadequate awareness of IPD among both laypeople and health care workers, the heavy socioeconomic burden of IPD, and the far from optimal vaccination coverage in Italy, despite the availability of safe and effective vaccines. OBJECTIVE The objectives of our study were to analyze trends in Pneumo Rischio usage before and after a promotional campaign, to characterize its end users, and to assess its user-rated quality. METHODS At 7 months after launching Pneumo Rischio, we established a 4-month marketing campaign to promote the project. This intervention used various approaches and channels, including both traditional and digital marketing strategies. To highlight usage trends, we used different techniques of time series analysis and modeling, including a modified Mann-Kendall test, change-point detection, and segmented negative binomial regression of interrupted time series. Users were characterized in terms of demographics and IPD risk categories. Customer-rated quality was evaluated by means of a standardized tool in a sample of app users. RESULTS Over 1 year, the app was accessed by 9295 users and the website was accessed by 143,993 users, while the project's Facebook page had 1216 fans. The promotional intervention was highly effective in increasing the daily number of users. In particular, the Mann-Kendall trend test revealed a significant (P ≤.01) increasing trend in both app and website users, while change-point detection analysis showed that the first significant change corresponded to the start of the promotional campaign. Regression analysis showed a significant immediate effect of the intervention, with a mean increase in daily numbers of users of 1562% (95% CI 456%-4870%) for the app and 620% (95% CI 176%-1777%) for the website. Similarly, the postintervention daily trend in the number of users was positive, with a relative increase of 0.9% (95% CI 0.0%-1.8%) for the app and 1.4% (95% CI 0.7%-2.1%) for the website. Demographics differed between app and website users and Facebook fans. A total of 69.15% (10,793/15,608) of users could be defined as being at risk of IPD, while 4729 users expressed intentions to ask their doctor for further information on IPD. The mean app quality score assigned by end users was approximately 79.5% (397/500). CONCLUSIONS Despite its specific topic, Pneumo Rischio was accessed by a considerable number of users, who ranked it as a high-quality project. In order to reach their target populations, however, such projects should be promoted.
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Affiliation(s)
| | | | | | - Paolo Bonanni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Daniela Amicizia
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Lucia Arata
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Stefano Carozzo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Alessio Signori
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Angela Bechini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, Florence, Italy
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Bobian M, Kandinov A, El-Kashlan N, Svider PF, Folbe AJ, Mayerhoff R, Eloy JA, Raza SN. Mobile applications and patient education: Are currently available GERD mobile apps sufficient? Laryngoscope 2016; 127:1775-1779. [DOI: 10.1002/lary.26341] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 08/27/2016] [Accepted: 08/31/2016] [Indexed: 12/28/2022]
Affiliation(s)
- Michael Bobian
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
| | - Aron Kandinov
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
| | - Nour El-Kashlan
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
| | - Peter F. Svider
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
| | - Adam J. Folbe
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
- Department of Neurosurgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
- Barbara Ann Karmanos Cancer Institute; Detroit Michigan U.S.A
| | - Ross Mayerhoff
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
- Barbara Ann Karmanos Cancer Institute; Detroit Michigan U.S.A
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery; Rutgers New Jersey Medical School; Newark New Jersey U.S.A
- Department of Neurological Surgery; Rutgers New Jersey Medical School; Newark New Jersey U.S.A
- Department of Ophthalmology and Visual Science; Rutgers New Jersey Medical School; Newark New Jersey U.S.A
- Center for Skull Base and Pituitary Surgery; Neurological Institute of New Jersey; Newark New Jersey U.S.A
| | - S. Naweed Raza
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan U.S.A
- Barbara Ann Karmanos Cancer Institute; Detroit Michigan U.S.A
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14
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Gasparini R, Amicizia D, Lai P, Panatto D. Influenza vaccination: from epidemiological aspects and advances in research to dissent and vaccination policies. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2016; 57:E1-4. [PMID: 27346933 PMCID: PMC4910436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Influenza is a serious public health problem, since seasonal epidemics affect approximately 5-10% of the population and thus give rise to a heavy social and healthcare burden. The heavy burden of disease is due to several factors, one of which is the biological features of the pathogen. Indeed influenza viruses display high mutation rates and undergo frequent genetic reassortment. Minor variations cause seasonal epidemics and major variations, which result from the hybridization of viruses typical of different animal species, can lead to pandemics. Vaccination remains the most efficacious means of mitigating the harmful healthcare and social effects of influenza. Influenza vaccines have evolved over time in order to offer broader protection against circulating strains. Trivalent vaccines containing two A viruses and one B virus are currently available. However, given the co-circulation of both B virus lineages (B/Yamagata and B/Victoria), quadrivalent vaccines have recently been developed. The new quadrivalent vaccines constitute a great advance, in that they can offer broader strain coverage. Despite the availability of effective and safe influenza vaccines, the Italian public's trust in vaccination has declined and, in the last few years, influenza vaccination coverage rates have decreased both among the elderly and among at-risk adults. It is therefore necessary that users, in their own interests, regain trust in this important means of disease prevention. In order to mitigate the damage wreaked by influenza, it seems important to: (i) improve clinical-epidemiological and virological surveillance of the disease; (ii) promote the development of new efficacious vaccines, as has recently been done through the introduction of the quadrivalent vaccine; (iii) extend free vaccination to the entire population, as in the US and Canada; (iv) ensure that general healthcare professionals are properly informed and always updated with regard to vaccination; (v) promote public campaigns to raise the population's awareness of the importance of vaccination; (vi) inform politicians and other decision-makers of scientific results in the field of vaccination; (vii) fight the antivaccination lobbies with every available weapon.
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Affiliation(s)
- R. Gasparini
- Roberto Gasparini, Department of Health Sciences, via Pastore 1, 16132 Genoa, Italy - Tel. +39 010 3538527 - Fax +39 010 3538541 - E-mail:
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15
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Rosselli R, Martini M, Bragazzi N. The old and the new: vaccine hesitancy in the era of the Web 2.0. Challenges and opportunities. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2016; 57:E47-50. [PMID: 27346940 PMCID: PMC4910443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The phenomenon known as vaccine hesitancy (a term that includes the concepts of indecision, uncertainty, delay and reluctance) is complex, closely linked to social contexts, and has different determinants: historical period, geographical area, political situation, complacency, convenience and confidence in vaccines. The World Health Organization (WHO) recommends that vaccine hesitancy and any proxy of it should be constantly monitored. Given the growing importance and pervasiveness of information and communication technologies (ICTs), the new media could be exploited in order to track lay-people's perceptions of vaccination in real time, thereby enabling health-care workers to actively engage citizens and to plan ad hoc communication strategies. Analysis of so-called "sentiments" expressed through the new media (such as Twitter) and the real-time tracking of web-related activities enabled by Google Trends, combined with the administration of specific online "surveys" on well-defined themes to target groups (such as health-care workers), could constitute a "Fast data monitoring system" that yields a snapshot of perceptions of vaccination in a given place and at a specific time. This type of dashboard could be a strategic tool that enables public services to organize targeted communication actions aimed at containing vaccine hesitancy.
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Affiliation(s)
- R. Rosselli
- Local Health Unit of Genoa (LHA 3), Genoa, Italy;,Roberto Rosselli, Local Health Unit of Genoa (LHA 3), via Operai 80, 16149 Genoa, Italy - Tel. +39 010 8497126 - E-mail:
| | - M. Martini
- Section of History of Medicine and Bioethics, Department of Health Sciences (DISSAL), University of Genoa, Italy
| | - N.L. Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Italy
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