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Doucette EJ, Fullerton MM, Pateman M, Lip A, Houle SKD, Kellner JD, Leal J, MacDonald SE, McNeil D, Tyerman J, Luctkar-Flude M, Davidson S, Constantinescu C. Development and evaluation of virtual simulation games to increase the confidence and self-efficacy of healthcare learners in vaccine communication, advocacy, and promotion. BMC Med Educ 2024; 24:190. [PMID: 38403639 PMCID: PMC10895736 DOI: 10.1186/s12909-024-05169-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Although healthcare providers (HCPs) are the most trusted source of vaccine information, there is a paucity of easily accessible, multidisciplinary educational tools on vaccine communication for them. Virtual simulation games (VSGs) are innovative yet accessible and effective tools in healthcare education. The objectives of our study were to develop VSGs to increase HCP confidence and self-efficacy in vaccine communication, advocacy, and promotion, and evaluate the VSGs' effectiveness using a pre-post self-assessment pilot study. METHODS A multidisciplinary team of experts in medicine, nursing, pharmacy, and simulation development created three VSGs for HCP learners focused on addressing conversations with vaccine hesitant individuals. We evaluated the VSGs with 24 nursing students, 30 pharmacy students, and 18 medical residents who completed surveys and 6-point Likert scale pre-post self-assessments to measure changes in their confidence and self-efficacy. RESULTS There were no significant differences in baseline confidence and self-efficacy across the three HCP disciplines, despite varied levels of education. Post-VSG confidence and self-efficacy (median: 5) were significantly higher than pre-VSG (median: 4-5) for all three HCP disciplines (P ≤ 0.0005), highlighting the effectiveness of the VSGs. Medical residents reported significantly lower post-VSG confidence and self-efficacy than nursing and pharmacy learners despite completing the most significant amount of education. CONCLUSIONS Following the completion of the VSGs, learners in medicine, nursing, and pharmacy showed significant improvement in their self-assessed confidence and self-efficacy in holding vaccine conversations. The VSGs as an educational tool, in combination with existing clinical immunization training, can be used to increase HCP confidence and engagement in vaccine discussions with patients, which may ultimately lead to increased vaccine confidence among patients.
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Affiliation(s)
- Emily J Doucette
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Madison M Fullerton
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- 19 to Zero Inc, Rocky Mountain House, AB, Canada
| | - Margaret Pateman
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- 19 to Zero Inc, Rocky Mountain House, AB, Canada
| | - Alyssa Lip
- Division of Respirology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - James D Kellner
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Jenine Leal
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Antimicrobial Resistance - One Health Consortium, University of Calgary, Calgary, AB, Canada
- Real World Evidence Consortium, University of Calgary, Calgary, AB, Canada
| | - Shannon E MacDonald
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Deborah McNeil
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Maternal Newborn Child and Youth Strategic Clinical Network, Calgary, AB, Canada
| | - Jane Tyerman
- School of Nursing, University of Ottawa, Ottawa, ON, Canada
- Canadian Alliance of Nurse Educators using Simulation (CAN-Sim), Kingston, ON, Canada
| | - Marian Luctkar-Flude
- Canadian Alliance of Nurse Educators using Simulation (CAN-Sim), Kingston, ON, Canada
- School of Nursing, Queen's University, Kingston, ON, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Cora Constantinescu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Pediatric Infectious Diseases, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Fullerton MM, Pateman M, Hasan H, Doucette EJ, Cantarutti S, Koyama A, Weightman AM, Tang T, Coakley A, Currie GR, Fabreau G, Constantinescu C, Marshall DA, Hu J. Barriers experienced by families new to Alberta, Canada when accessing routine-childhood vaccinations. BMC Public Health 2023; 23:1333. [PMID: 37438796 DOI: 10.1186/s12889-023-16258-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 07/06/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND As Canada and other high-income countries continue to welcome newcomers, we aimed to 1) understand newcomer parents' attitudes towards routine-childhood vaccinations (RCVs), and 2) identify barriers newcomer parents face when accessing RCVs in Alberta, Canada. METHODS Between July 6th-August 31st, 2022, we recruited participants from Alberta, Canada to participate in moderated focus group discussions. Inclusion criteria included parents who had lived in Canada for < 5 years with children < 18 years old. Focus groups were transcribed verbatim and analyzed using content and deductive thematic analysis. The capability opportunity motivation behaviour model was used as our conceptual framework. RESULTS Four virtual and three in-person focus groups were conducted with 47 participants. Overall, parents were motivated and willing to vaccinate their children but experienced several barriers related to their capability and opportunity to access RCVs. Five main themes emerged: 1) lack of reputable information about RCVs, 2) language barriers when looking for information and asking questions about RCVs, 3) lack of access to a primary care provider (PCP), 4) lack of affordable and convenient transportation options, and 5) due to the COVID-19 pandemic, lack of available vaccine appointments. Several minor themes were also identified and included barriers such as lack of 1) childcare, vaccine record sharing, PCP follow-up. CONCLUSIONS Our findings highlight that several barriers faced by newcomer families ultimately stem from issues related to accessing information about RCVs and the challenges families face once at vaccination clinics, highlighting opportunities for health systems to better support newcomers in accessing RCVs.
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Affiliation(s)
- Madison M Fullerton
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada.
- 19 to Zero Inc, Calgary, AB, Canada.
| | - Margaret Pateman
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- 19 to Zero Inc, Calgary, AB, Canada
| | | | - Emily J Doucette
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Stephen Cantarutti
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, AB, Canada
| | - Amanda Koyama
- Calgary Catholic Immigration Society, Calgary, AB, Canada
| | | | - Theresa Tang
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Annalee Coakley
- Mosaic Refugee Health Clinic, Calgary, AB, Canada
- Department of Family Medicine, University of Calgary, Calgary, AB, Canada
| | - Gillian R Currie
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, AB, Canada
| | - Gabriel Fabreau
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Cora Constantinescu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Pediatric Infectious Diseases, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Deborah A Marshall
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, AB, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jia Hu
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- 19 to Zero Inc, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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3
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Kushniruk A, Benham JL, Lang R, Fullerton MM, Boucher JC, Cornelson K, Oxoby RJ, Constantinescu C, Tang T, Marshall DA, Hu J. Persuasive Messages for Improving Adherence to COVID-19 Prevention Behaviors: Randomized Online Experiment. JMIR Hum Factors 2023; 10:e41328. [PMID: 36508732 PMCID: PMC9972212 DOI: 10.2196/41328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/16/2022] [Accepted: 12/11/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Adherence to nonpharmaceutical interventions for COVID-19, including physical distancing, masking, staying home while sick, and avoiding crowded indoor spaces, remains critical for limiting the spread of COVID-19. OBJECTIVE The aim of this study was to test the effectiveness of using various persuasive appeals (deontological moral frame, empathy, identifiable victim, goal proximity, and reciprocity) at improving intentions to adhere to prevention behaviors. METHODS A randomized online experiment using a representative sample of adult Canadian residents with respect to age, ethnicity, and province of residence was performed from March 3 to March 6, 2021. Participants indicated their intentions to follow public health guidelines, saw one of six flyers featuring a persuasive appeal or no appeal, and then rated their intentions a second time. Known correlates of attitudes toward public health measures were also measured. RESULTS Intentions to adhere to public health measures increased in all appeal conditions. The message featuring an empathy appeal resulted in a greater increase in intentions than the control (no appeal) message. Moreover, the effectiveness of persuasive appeals was moderated by baseline intentions. Deontological, empathy, identifiable victim, and reciprocity appeals improved intentions more than the control message, but only for people with lower baseline intentions to adhere to nonpharmaceutical interventions. CONCLUSIONS Public health marketing campaigns aiming to increase adherence to COVID-19 protective behaviors could achieve modest gains by employing a range of persuasive appeals. However, to maximize impact, it is important that these campaigns be targeted to the right individuals. TRIAL REGISTRATION ClinicalTrials.gov NCT05722106; https://clinicaltrials.gov/ct2/show/NCT05722106.
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Affiliation(s)
| | - Jamie L Benham
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Raynell Lang
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Madison M Fullerton
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jean-Christophe Boucher
- Department of Political Science, School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Kirsten Cornelson
- Department of Economics, University of Notre Dame, Notre Dame, IN, United States
| | - Robert J Oxoby
- Department of Economics, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Cora Constantinescu
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Theresa Tang
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Deborah A Marshall
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jia Hu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Lip A, Pateman M, Fullerton MM, Chen HM, Bailey L, Houle S, Davidson S, Constantinescu C. Vaccine hesitancy educational tools for healthcare providers and trainees: A scoping review. Vaccine 2023; 41:23-35. [PMID: 36437208 PMCID: PMC9688224 DOI: 10.1016/j.vaccine.2022.09.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/27/2022]
Abstract
In the era of vaccine hesitancy, highlighted by the current SARS-CoV2 pandemic, there is an acute need to develop an approach to reduce and address apprehension towards vaccinations. We sought to map and present an overview of existing educational interventions for healthcare providers (HCPs) on strategies to engage in effective vaccine discussion. We applied the Joanna Briggs Institute methodology framework in this scoping review. We searched five relevant databases (MEDLINE, CINAHL, EMBASE, PsycInfo, and SCOPUS) and grey literature through the Google search engine using keywords and subject headings that were systematically identified. We identified 3384 citations in peer-reviewed literature and 41 citations in grey literature. After screening for our inclusion criteria, we included 28 citations from peer reviewed literature and 16 citations from grey literature for analysis. We identified a total of 41 unique education interventions. Interventions were available from multiple disciplines, training levels, clinical settings, and diseases/vaccines. Interventions predominantly centered around two foci: knowledge sharing and communication training. Most interventions identified from peer-reviewed literature were facilitated and were applied with multiple modes of delivery. Interventions from grey literature were more topical and generally self-directed. We identified several gaps in knowledge. Firstly, accessibility and generalizability of interventions was limited. Secondly, distribution of interventions did not adequately address nursing and pharmacy disciplines, and did not cover the breadth of medical specialties for whom vaccine discussions apply. Thirdly, no interventions addressed self monitoring and the clinicians' recognition and management of emotions during difficult conversations. There is a need to address this gap and provide available, credible and comprehensive educational interventions that will support our healthcare providers in effective communication with vaccine hesitant patients.
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Affiliation(s)
- A Lip
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - M Pateman
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada; 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - M M Fullerton
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada; 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - H M Chen
- 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - L Bailey
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - S Houle
- School of Pharmacy, Faculty of Science, University of Waterloo, Waterloo, Ontario, Canada
| | - S Davidson
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - C Constantinescu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Pediatric Infectious Diseases, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Yeo J, Furr Gudmundsen C, Fazel S, Corrigan A, Fullerton MM, Hu J, Jadavji T, Kuhn S, Kassam A, Constantinescu C. A Behavior Change Model to Address Caregiver Hesitancy around COVID-19 Vaccination in Pediatrics. Vaccine 2022; 40:5664-5669. [PMID: 35987872 PMCID: PMC9353609 DOI: 10.1016/j.vaccine.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022]
Abstract
Introduction Many families express hesitancy around immunizing their children against COVID-19. We sought to better understand the perspectives of vaccine hesitant caregivers, and develop targeted recommendations for health care workers and policymakers to engage in more effective vaccine discussions. Methods We conducted semi-structured telephone interviews with 23 caregivers recruited from a pediatric infectious diseases clinic, including a subset of patients referred to discuss vaccine hesitancy. Thematic analysis of the interviews identified themes that were mapped using behavior change models to identify perceived barriers and facilitators towards COVID-19 immunization. Results Barriers and facilitators were mapped to the WHO (World Health Organization) 3C’s (confidence, complacency, convenience) model of vaccine hesitancy as well as the COM-B (capability, opportunity, motivation) behavior change model. Barriers included mistrust in authorities, misperception of the risk of COVID-19 in children, and perceived health contraindications and negative previous vaccine experiences. Facilitators included positive relationships with healthcare workers, the promise of a “return to normal”, and societal pressures to immunize. Conclusions Efforts to increase vaccine uptake in the pediatric population must target specific barriers and facilitators to immunization expressed by caregivers. To address these concerns, we suggest: 1. Educating hesitant caregivers by highlighting the long-term pandemic effects on children and the threat of COVID-19 to children’s health, 2. Building on the trust caregivers have in healthcare workers by involving frontline workers in public health policy, and 3. Harnessing the power of peer pressure by mobilization of societal pressures and establishing COVID-19 vaccination as the norm in children.
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Affiliation(s)
- Jordan Yeo
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Sajjad Fazel
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Alex Corrigan
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Jia Hu
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Taj Jadavji
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Section of Pediatric Infectious Diseases, Alberta Children's Hospital, Calgary, AB, Canada
| | - Susan Kuhn
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Section of Pediatric Infectious Diseases, Alberta Children's Hospital, Calgary, AB, Canada
| | - Aliya Kassam
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Cora Constantinescu
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Section of Pediatric Infectious Diseases, Alberta Children's Hospital, Calgary, AB, Canada.
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6
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Gao G, Lang R, Oxoby RJ, Mourali M, Sheikh H, Fullerton MM, Tang T, Manns BJ, Marshall DA, Hu J, Benham JL. Drivers of downloading and reasons for not downloading COVID-19 contact tracing and exposure notification apps: A national cross-sectional survey. PLoS One 2022; 17:e0269783. [PMID: 35839252 PMCID: PMC9286248 DOI: 10.1371/journal.pone.0269783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 05/29/2022] [Indexed: 11/18/2022] Open
Abstract
Background Bluetooth-enabled smartphone apps have been developed and implemented in different sites globally to help overcome capacity limitations of traditional interview-based COVID-19 contact tracing. Two apps are currently available in Canada: ABTraceTogether exclusively in Alberta and COVID Alert in nine other provinces and territories. This study aims to examine factors associated with downloading of these apps to inform targeted promotion and marketing to increase app uptake. Methods We performed a cross-sectional survey with adult participants (≥18 years old) from an online national panel. Participants were asked if they had downloaded an app and, if applicable, reasons for not downloading. Logistic regression was used to identify sociodemographic factors and trusted information sources associated with downloading and reasons for not downloading. Results Of the included 4,503 respondents (36% response rate), 1,394 (31%) had downloaded an app. Demographic and socioeconomic factors positively associated with app download were: 1) being female, 2) higher household income, 3) higher education level attained, and 4) more liberal political views. The odds of downloading an app were higher for participants who trusted health-related information sources, and lower for those who trusted internet searches, family and friend, or Facebook. The most cited reasons for not downloading were related to data security concerns and perceived lack of benefit from the apps. Interpretation These findings identify sociodemographic segments with the lowest app uptake, reasons for not downloading and trusted information sources to inform targeted promotion and marketing strategies to improve uptake of apps to facilitate contact tracing.
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Affiliation(s)
- Golden Gao
- Department of Family Medicine, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Raynell Lang
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Robert J. Oxoby
- Department of Economics, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Mehdi Mourali
- Haskayne School of Business, University of Calgary, Calgary, AB, Canada
| | - Hasan Sheikh
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Madison M. Fullerton
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Theresa Tang
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Braden J. Manns
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Deborah A. Marshall
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jia Hu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jamie L. Benham
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- * E-mail:
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7
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Fullerton MM, Benham J, Graves A, Fazel S, Doucette EJ, Oxoby RJ, Mourali M, Boucher JC, Constantinescu C, Parsons Leigh J, Tang T, Marshall DA, Hu J, Lang R. Challenges and recommendations for COVID-19 public health messaging: a Canada-wide qualitative study using virtual focus groups. BMJ Open 2022; 12:e054635. [PMID: 35418426 PMCID: PMC9013785 DOI: 10.1136/bmjopen-2021-054635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To understand Canadian's attitudes and current behaviours towards COVID-19 public health measures (PHM), vaccination and current public health messaging, to provide recommendations for a public health intervention. DESIGN Ten focus groups were conducted with 2-7 participants/group in December 2020. Focus groups were transcribed verbatim and analysed using content and inductive thematic analysis. The capability opportunity motivation behaviour Model was used as our conceptual framework. SETTING Focus groups were conducted virtually across Canada. PARTICIPANTS Participants were recruited from a pool of individuals who previously completed a Canada-wide survey conducted by our research team. MAIN OUTCOME MEASURE Key barriers and facilitators towards COVID-19 PHM and vaccination, and recommendations for public health messaging. RESULTS Several themes were identified (1) participants' desire to protect family and friends was the main facilitator for adhering to PHM, while the main barrier was inconsistent PHM messaging and (2) participants were optimistic that the vaccine offers a return to normal, however, worries of vaccine efficacy and effectiveness were the main concerns. Participants felt that current public health messaging is inconsistent, lacks transparency and suggested that messaging should include scientific data presented by a trustworthy source. CONCLUSIONS We suggest six public health messaging recommendations to increase adherence to PHM and vaccination (1) use an unbiased scientist as a spokesperson, (2) openly address any unknowns, (3) more is better when sharing data, (4) use personalised stories to reinforce PHM and vaccinations, (5) humanise the message by calling out contradictions and (6) focus on the data and keep politics out.
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Affiliation(s)
- Madison M Fullerton
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Jamie Benham
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Sajjad Fazel
- Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada
| | - Emily J Doucette
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Robert J Oxoby
- Department of Economics, University of Calgary, Calgary, Alberta, Canada
| | - Mehdi Mourali
- Haskayne School of Business, University of Calgary, Calgary, Alberta, Canada
| | | | - Cora Constantinescu
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | | | - Theresa Tang
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Deborah A Marshall
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jia Hu
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Raynell Lang
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
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8
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Benham JL, Atabati O, Oxoby RJ, Mourali M, Shaffer B, Sheikh H, Boucher JC, Constantinescu C, Parsons Leigh J, Ivers NM, Ratzan SC, Fullerton MM, Tang T, Manns BJ, Marshall DA, Hu J, Lang R. COVID-19 Vaccine-Related Attitudes and Beliefs in Canada: National Cross-sectional Survey and Cluster Analysis. JMIR Public Health Surveill 2021; 7:e30424. [PMID: 34779784 PMCID: PMC8709417 DOI: 10.2196/30424] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 10/07/2021] [Accepted: 11/11/2021] [Indexed: 01/03/2023] Open
Abstract
Background There are concerns that vaccine hesitancy may impede COVID-19 vaccine rollout and prevent the achievement of herd immunity. Vaccine hesitancy is a delay in acceptance or refusal of vaccines despite their availability. Objective We aimed to identify which people are more and less likely to take a COVID-19 vaccine and factors associated with vaccine hesitancy to inform public health messaging. Methods A Canadian cross-sectional survey was conducted in Canada in October and November 2020, prior to the regulatory approval of the COVID-19 vaccines. Vaccine hesitancy was measured by respondents answering the question “what would you do if a COVID-19 vaccine were available to you?” Negative binomial regression was used to identify the factors associated with vaccine hesitancy. Cluster analysis was performed to identify distinct clusters based on intention to take a COVID-19 vaccine, beliefs about COVID-19 and COVID-19 vaccines, and adherence to nonpharmaceutical interventions. Results Of 4498 participants, 2876 (63.9%) reported COVID-19 vaccine hesitancy. Vaccine hesitancy was significantly associated with (1) younger age (18-39 years), (2) lower education, and (3) non-Liberal political leaning. Participants that reported vaccine hesitancy were less likely to believe that a COVID-19 vaccine would end the pandemic or that the benefits of a COVID-19 vaccine outweighed the risks. Individuals with vaccine hesitancy had higher prevalence of being concerned about vaccine side effects, lower prevalence of being influenced by peers or health care professionals, and lower prevalence of trust in government institutions. Conclusions These findings can be used to inform targeted public health messaging to combat vaccine hesitancy as COVID-19 vaccine administration continues. Messaging related to preventing COVID among friends and family, highlighting the benefits, emphasizing safety and efficacy of COVID-19 vaccination, and ensuring that health care workers are knowledgeable and supported in their vaccination counselling may be effective for vaccine-hesitant populations.
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Affiliation(s)
- Jamie L Benham
- Department of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Omid Atabati
- Department of Economics, University of Calgary, Calgary, AB, Canada
| | - Robert J Oxoby
- Department of Economics, University of Calgary, Calgary, AB, Canada
| | - Mehdi Mourali
- Haskayne School of Business, University of Calgary, Calgary, AB, Canada
| | - Blake Shaffer
- Department of Economics, University of Calgary, Calgary, AB, Canada
| | - Hasan Sheikh
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Jean-Christophe Boucher
- School of Public Policy and Department of Political Sciences, University of Calgary, Calgary, AB, Canada
| | - Cora Constantinescu
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | | | - Noah M Ivers
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - Scott C Ratzan
- School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Madison M Fullerton
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Theresa Tang
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Braden J Manns
- Department of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Deborah A Marshall
- Department of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Jia Hu
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Raynell Lang
- Department of Medicine, University of Calgary, Calgary, AB, Canada
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9
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Lang R, Atabati O, Oxoby RJ, Mourali M, Shaffer B, Sheikh H, Fullerton MM, Tang T, Leigh JP, Manns BJ, Marshall DA, Ivers NM, Ratzan SC, Hu J, Benham JL. Characterization of non-adopters of COVID-19 non-pharmaceutical interventions through a national cross-sectional survey to assess attitudes and behaviours. Sci Rep 2021; 11:21751. [PMID: 34741109 PMCID: PMC8571421 DOI: 10.1038/s41598-021-01279-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 10/25/2021] [Indexed: 01/27/2023] Open
Abstract
Adoption of non-pharmaceutical interventions (NPIs) remains critical to curtail the spread of COVID-19. Using self-reported adherence to NPIs in Canada, assessed through a national cross-sectional survey of 4498 respondents, we aimed to identify and characterize non-adopters of NPIs, evaluating their attitudes and behaviours to understand barriers and facilitators of adoption. A cluster analysis was used to group adopters separately from non-adopters of NPIs. Associations with sociodemographic factors, attitudes towards COVID-19 and the public health response were assessed using logistic regression models comparing non-adopters to adopters. Of the 4498 respondents, 994 (22%) were clustered as non-adopters. Sociodemographic factors significantly associated with the non-adoption cluster were: (1) being male, (2) age 18–34 years, (3) Albertans, (4) lower education level and (5) higher conservative political leaning. Participants who expressed low concern for COVID-19 and distrust towards several institutions had greater odds of being non-adopters. This information characterizes individuals at greatest odds for non-adoption of NPIs to inform targeted marketing interventions.
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Affiliation(s)
- Raynell Lang
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Omid Atabati
- Department of Economics, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Robert J Oxoby
- Department of Economics, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Mehdi Mourali
- Haskayne School of Business, University of Calgary, Calgary, AB, Canada
| | - Blake Shaffer
- Department of Economics, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Hasan Sheikh
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Madison M Fullerton
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Theresa Tang
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jeanna Parsons Leigh
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada.,Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
| | - Braden J Manns
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Deborah A Marshall
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Noah M Ivers
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Scott C Ratzan
- City University of New York Graduate School of Public Health & Health Policy, New York, NY, USA
| | - Jia Hu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jamie L Benham
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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10
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Boucher JC, Cornelson K, Benham JL, Fullerton MM, Tang T, Constantinescu C, Mourali M, Oxoby RJ, Marshall DA, Hemmati H, Badami A, Hu J, Lang R. Analyzing Social Media to Explore the Attitudes and Behaviors Following the Announcement of Successful COVID-19 Vaccine Trials: Infodemiology Study. ACTA ACUST UNITED AC 2021; 1:e28800. [PMID: 34447924 PMCID: PMC8363124 DOI: 10.2196/28800] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/09/2021] [Accepted: 07/07/2021] [Indexed: 01/14/2023]
Abstract
Background The rollout of COVID-19 vaccines has brought vaccine hesitancy to the forefront in managing this pandemic. COVID-19 vaccine hesitancy is fundamentally different from that of other vaccines due to the new technologies being used, rapid development, and widespread global distribution. Attitudes on vaccines are largely driven by online information, particularly information on social media. The first step toward influencing attitudes about immunization is understanding the current patterns of communication that characterize the immunization debate on social media platforms. Objective We aimed to evaluate societal attitudes, communication trends, and barriers to COVID-19 vaccine uptake through social media content analysis to inform communication strategies promoting vaccine acceptance. Methods Social network analysis (SNA) and unsupervised machine learning were used to characterize COVID-19 vaccine content on Twitter globally. Tweets published in English and French were collected through the Twitter application programming interface between November 19 and 26, 2020, just following the announcement of initial COVID-19 vaccine trials. SNA was used to identify social media clusters expressing mistrustful opinions on COVID-19 vaccination. Based on the SNA results, an unsupervised machine learning approach to natural language processing using a sentence-level algorithm transfer function to detect semantic textual similarity was performed in order to identify the main themes of vaccine hesitancy. Results The tweets (n=636,516) identified that the main themes driving the vaccine hesitancy conversation were concerns of safety, efficacy, and freedom, and mistrust in institutions (either the government or multinational corporations). A main theme was the safety and efficacy of mRNA technology and side effects. The conversation around efficacy was that vaccines were unlikely to completely rid the population of COVID-19, polymerase chain reaction testing is flawed, and there is no indication of long-term T-cell immunity for COVID-19. Nearly one-third (45,628/146,191, 31.2%) of the conversations on COVID-19 vaccine hesitancy clusters expressed concerns for freedom or mistrust of institutions (either the government or multinational corporations) and nearly a quarter (34,756/146,191, 23.8%) expressed criticism toward the government’s handling of the pandemic. Conclusions Social media content analysis combined with social network analysis provides insights into the themes of the vaccination conversation on Twitter. The themes of safety, efficacy, and trust in institutions will need to be considered, as targeted outreach programs and intervention strategies are deployed on Twitter to improve the uptake of COVID-19 vaccination.
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Affiliation(s)
- Jean-Christophe Boucher
- School of Public Policy and Department of Political Science University of Calgary Calgary, AB Canada
| | - Kirsten Cornelson
- Department of Economics University of Notre Dame Notre Dame, IN United States
| | - Jamie L Benham
- Department of Medicine Cumming School of Medicine University of Calgary Calgary, AB Canada.,Department of Community Health Sciences Cumming School of Medicine University of Calgary Calgary, AB Canada
| | - Madison M Fullerton
- Department of Community Health Sciences Cumming School of Medicine University of Calgary Calgary, AB Canada
| | - Theresa Tang
- Department of Community Health Sciences Cumming School of Medicine University of Calgary Calgary, AB Canada
| | | | - Mehdi Mourali
- Haskayne School of Business University of Calgary Calgary, AB Canada
| | - Robert J Oxoby
- Department of Economics Faculty of Arts University of Calgary Calgary, AB Canada
| | - Deborah A Marshall
- Department of Medicine Cumming School of Medicine University of Calgary Calgary, AB Canada.,Department of Community Health Sciences Cumming School of Medicine University of Calgary Calgary, AB Canada
| | - Hadi Hemmati
- Department of Electrical and Computer Engineering Schulich Faculty of Engineering University of Calgary Calgary, AB Canada
| | - Abbas Badami
- Department of Electrical and Computer Engineering Schulich Faculty of Engineering University of Calgary Calgary, AB Canada
| | - Jia Hu
- Department of Community Health Sciences Cumming School of Medicine University of Calgary Calgary, AB Canada
| | - Raynell Lang
- Department of Medicine Cumming School of Medicine University of Calgary Calgary, AB Canada
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11
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Lang R, Benham JL, Atabati O, Hollis A, Tombe T, Shaffer B, Burns KK, MacKean G, Léveillé T, McCormack B, Sheikh H, Fullerton MM, Tang T, Boucher JC, Constantinescu C, Mourali M, Manns BJ, Marshall DA, Hu J, Oxoby RJ. Attitudes, behaviours and barriers to public health measures for COVID-19: a survey to inform public health messaging. BMC Public Health 2021; 21:765. [PMID: 33882896 PMCID: PMC8058588 DOI: 10.1186/s12889-021-10790-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/24/2021] [Indexed: 02/06/2023] Open
Abstract
Background Public support of public health measures including physical distancing, masking, staying home while sick, avoiding crowded indoor spaces and contact tracing/exposure notification applications remains critical for reducing spread of COVID-19. The aim of our work was to understand current behaviours and attitudes towards public health measures as well as barriers individuals face in following public health measures. We also sought to identify attitudes persons have regarding a COVID-19 vaccine and reasons why they may not accept a vaccine. Methods A cross-sectional online survey was conducted in August 2020, in Alberta, Canada in persons 18 years and older. This survey evaluated current behaviours, barriers and attitudes towards public health measures and a COVID-19 vaccine. Cluster analysis was used to identify key patterns that summarize data variations among observations. Results Of the 60 total respondents, the majority of persons were always or often physically distancing (73%), masking (65%) and staying home while sick (67%). Bars/pubs/lounges or nightclubs were visited rarely or never by 63% of respondents. Persons identified staying home while sick to provide the highest benefit (83%) in reducing spread of COVID-19. There were a large proportion of persons who had not downloaded or used a contact tracing/exposure notification app (77%) and who would not receive a COVID-19 vaccine when available (20%) or were unsure (12%). Reporting health authorities as most trusted sources of health information was associated with greater percentage of potential uptake of vaccine but not related to contact tracing app download and use. Individuals with lower concern of getting and spreading COVID-19 showed the least uptake of public health measures except for avoiding public places such as bars. Lower concern regarding COVID-19 was also associated with more negative responses to taking a potential COVID-19 vaccine. Conclusion These results suggest informational frames and themes focusing on individual risks, highlighting concern for COVID-19 and targeting improving trust for health authorities may be most effective in increasing public health measures. With the ultimate goal of preventing spread of COVID-19, understanding persons’ attitudes towards both public health measures and a COVID-19 vaccine remains critical to addressing barriers and implementing targeted interventions and messaging to improve uptake. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10790-0.
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Affiliation(s)
- Raynell Lang
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jamie L Benham
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Omid Atabati
- Department of Economics, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Aidan Hollis
- Department of Economics, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Trevor Tombe
- Department of Economics, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Blake Shaffer
- Department of Economics, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Katharina Kovacs Burns
- Primary Data Support, Data & Analytics, Alberta Health Services, Calgary, AB, Canada.,School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Gail MacKean
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tova Léveillé
- Primary Data Support, Data & Analytics, Alberta Health Services, Calgary, AB, Canada
| | - Brandi McCormack
- Primary Data Support, Data & Analytics, Alberta Health Services, Calgary, AB, Canada
| | - Hasan Sheikh
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Madison M Fullerton
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Theresa Tang
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jean-Christophe Boucher
- School of Public Policy and Department of Political Science, University of Calgary, Calgary, AB, Canada
| | - Cora Constantinescu
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mehdi Mourali
- Haskayne School of Business, University of Calgary, Calgary, AB, Canada
| | - Braden J Manns
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Deborah A Marshall
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jia Hu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Robert J Oxoby
- Department of Economics, Faculty of Arts, University of Calgary, Calgary, AB, Canada
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12
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Fullerton MM, Passfield L, MacInnis MJ, Iannetta D, Murias JM. Prior exercise impairs subsequent performance in an intensity- and duration-dependent manner. Appl Physiol Nutr Metab 2021; 46:976-985. [PMID: 33641346 DOI: 10.1139/apnm-2020-0689] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Prior constant-load exercise performed for 30-min at or above maximal lactate steady state (MLSSp) significantly impairs subsequent time-to-task failure (TTF) compared with TTF performed without prior exercise. We tested the hypothesis that TTF would decrease in relation to the intensity and the duration of prior exercise compared with a baseline TTF trial. Eleven individuals (6 males, 5 females, aged 28 ± 8 yrs) completed the following tests on a cycle ergometer (randomly assigned after MLSSp was determined): (i) a ramp-incremental test; (ii) a baseline TTF trial performed at 80% of peak power (TTFb); (iii) five 30-min constant-PO rides at 5% below lactate threshold (LT-5%), halfway between LT and MLSSp (Delta50), 5% below MLSSp (MLSS-5%), MLSSp, and 5% above MLSSp (MLSS+5%); and (iv) 15- and 45-min rides at MLSSp (MLSS15 and MLSS45, respectively). Each condition was immediately followed by a TTF trial at 80% of peak power. Compared with TTFb (330 ± 52 s), there was 8.0 ± 24.1, 23.6 ± 20.2, 41.0 ± 14.8, 52.2 ± 18.9, and 75.4 ± 7.4% reduction in TTF following LT-5%, Delta50, MLSS-5%, MLSSp, and MLSS+5%, respectively. Following MLSS15 and MLSS45 there were 29.0 ± 20.1 and 69.4 ± 19.6% reductions in TTF, respectively (P < 0.05). It is concluded that TTF is reduced following prior exercise of varying duration at MLSSp and at submaximal intensities below MLSS. Novelty: Prior constant-PO exercise, performed at intensities below MLSSp, reduces subsequent TTF performance. Subsequent TTF performance is reduced in a linear fashion following an increase in the duration of constant-PO exercise at MLSSp.
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Affiliation(s)
| | - Louis Passfield
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,School of Sport and Exercise Sciences, University of Kent, Canterbury, United Kingdom
| | | | - Danilo Iannetta
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Juan M Murias
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
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13
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Benham JL, Lang R, Kovacs Burns K, MacKean G, Léveillé T, McCormack B, Sheikh H, Fullerton MM, Tang T, Boucher JC, Constantinescu C, Mourali M, Oxoby RJ, Manns BJ, Hu J, Marshall DA. Attitudes, current behaviours and barriers to public health measures that reduce COVID-19 transmission: A qualitative study to inform public health messaging. PLoS One 2021; 16:e0246941. [PMID: 33606782 PMCID: PMC7895406 DOI: 10.1371/journal.pone.0246941] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/29/2021] [Indexed: 12/21/2022] Open
Abstract
Public health measures to reduce COVID-19 transmission include masking in public places, physical distancing, staying home when ill, avoiding high-risk locations, using a contact tracing app, and being willing to take a COVID-19 vaccine. However, adoption of these measures varies greatly. We aimed to improve health messaging to increase adherence to public health behaviours to reduce COVID-19 transmission by: 1) determining attitudes towards public health measures and current behaviours; 2) identifying barriers to following public health measures; and, 3) identifying public health communication strategies. We recruited participants from a random panel of 3000 phone numbers across Alberta to fill a predetermined quota: age (18-29; 30-59; 60+ years), geographic location (urban; rural), and whether they had school-age children. Two researchers coded and themed all transcripts. We performed content analysis and in-depth thematic analysis. Nine focus groups were conducted with 2-8 participants/group in August-September, 2020. Several themes were identified: 1) importance of public health measures; 2) compliance with public health measures; 3) critiques of public health messaging; and 4) suggestions for improving public health messaging. Physical distancing and masking were seen as more important than using a contact tracing app. There were mixed views around willingness to take COVID-19 vaccine. Current public health messaging was perceived as conflicting. Participants felt that consistent messaging and using social media to reach younger people would be helpful. In conclusion, these findings provide insights that can be used to inform targeted (e.g., by age, current behaviour) public health communications to encourage behaviors that reduce COVID-19 transmission.
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Affiliation(s)
- Jamie L. Benham
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Raynell Lang
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Katharina Kovacs Burns
- Data & Analytics, Alberta Health Services, Calgary, AB, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Gail MacKean
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tova Léveillé
- Data & Analytics, Alberta Health Services, Calgary, AB, Canada
| | | | - Hasan Sheikh
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Madison M. Fullerton
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Theresa Tang
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jean-Christophe Boucher
- School of Public Policy and Department of Political Science, University of Calgary, Calgary, AB, Canada
| | - Cora Constantinescu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mehdi Mourali
- Haskayne School of Business, University of Calgary, Calgary, AB, Canada
| | - Robert J. Oxoby
- Department of Economics, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Braden J. Manns
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jia Hu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Deborah A. Marshall
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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