A network analysis of mechanisms of change during exposures over the course of intensive OCD treatment

Exposure and response prevention (ERP) is an evidence-based treatment for obsessive-compulsive disorder (OCD). Theories for how it works vary in their emphasis on active mechanisms of change. The current study aimed to clarify mechanisms of change in ERP for OCD using network analysis, comparing ERP networks at the start and end of intensive treatment (partial hospital and residential). In our sample of 182 patients, the most central node in both networks was engagement with exposure, which was consistently related to greater understanding of ERP rationale, higher willingness, and less ritualization, accounting for all other variables in the network. There were no significant differences in networks between the start and end of treatment. These results suggest that nonspecific parameters like facilitating engagement in exposures without ritualizing and providing a clear rationale to clients may be key to effective treatment. As such, it may be useful for clinicians to spend adequate time underscoring the need to eliminate rituals to fully engage in exposure tasks and explaining the rationale for ERP prior to doing exposures, regardless of theoretical orientation. Nonetheless, findings represent group-level statistics and more fine-grained idiographic analyses may reveal individual-level differences with respect to central mechanisms of change. Other limitations include demographic homogeneity of our sample.

A daily-level examination of willingness to pregame, blackout, and hook up across drinking days: Associations with respective behavioral outcomes among adolescents and young adults

Research indicates general willingness to drink (i.e., "How willing are you to drink tonight?") fluctuates day-to-day and is associated with daily-level drinking. However, it is unknown whether willingness to engage in specific alcohol-related behaviors is associated with actual engagement in those behaviors above and beyond general willingness to drink at the daily level. The present study examined whether daily-level willingness to engage in specific behaviors (i.e., pre-gaming, blacking out, hooking up) predicted engaging in those respective behaviors on drinking days above and beyond one's general willingness to drink. Participants included adolescents and young adults who were part of a longitudinal ecological momentary assessment (EMA) study on cognitions and alcohol use. Participants (N = 675; 43 % male) who reported drinking on weekend days (i.e., Friday and Saturday [N = 3,727 days]), were included. The study involved a 3-week EMA burst design with bursts occurring quarterly over 12 months. Multilevel logistic regressions indicated on drinking days when participants reported being more willing than their own average to pre-game (OR = 1.77, p <.001), black out (OR = 1.46, p <.05), or drink before hooking up (OR = 1.68, p <.001), they were more likely to pregame, black out, and hook up, respectively, whereas general willingness to drink was not associated with any outcomes at the daily level.Results suggest willingness to engage in specific behaviors may be essential to target in prevention programming in comparison to general willingness to drink when aiming to reduce specific risk behaviors.

Perceptions, attitudes, and willingness of healthcare and frontline workers to participate in an Ebola vaccine trial in Uganda

BACKGROUND

Understanding the knowledge, perception and attitudes towards Ebola vaccines is an important factor in ensuring future use of these vaccines. A qualitative methods study embedded in an Ebola vaccine immunogenicity and safety trial (NCT04028349) was conducted to explore the knowledge and perceptions of healthcare (HCWs) and frontline workers (FLWs), about Ebola vaccines and their willingness to participate or recommend participation in Uganda.

METHOD

We carried out focus group discussions and semi-structured interviews before and after vaccination, with 70 HCWs and FLWs who consented to participate in the trial, and in the qualitative component, from August to September 2019. Data were analysed using thematic content analysis.

RESULTS

Respondents showed good knowledge about Ebola and the vaccines in general, and had wide access to information through several channels, including the study team. On prevention, particular attention was given to effective communication within health facilities. Misconceptions were mainly around route of transmission, animal origin and types of vaccines. Previous fears were based on rumours circulating in the community, mainly about the presence of the virus in the vaccine, side effects and intention to harm (e.g. by "the whites"), ultimately insisting on transparency, trust and involvement of local leaders. Acceptability of participation was motivated by the need to protect self and others, and the willingness to advance research. Majority were willing to recommend participation to their community.

CONCLUSIONS

Overall, information sharing leads to a better understanding and acceptance of vaccine trials and a positive vaccination experience can be a deciding factor in the acceptance of others. Particular attention should be paid to involving the community in addressing misconceptions and fears, while ensuring that participants have access to vaccination sites in terms of transport, and that they are properly accommodated at the study site including staying for a reasonable period of time.

Willingness and hesitancy towards the governmental free human papillomavirus vaccination among parents of eligible adolescent girls in Shenzhen, Southern China

BACKGROUND

Since 2020, China has actively promoted HPV vaccination for eligible adolescent girls through various pilot programmes. This study investigated parental willingness and hesitancy towards the government-sponsored, free human papillomavirus (HPV) vaccination for eligible adolescent girls in Shenzhen, Southern China.

METHODS

From June to August 2022, a cross-sectional survey was conducted with parents of girls entering Grade 7, employing an adapted Vaccine Hesitancy Scale to assess vaccine hesitancy and logistic regression to identify factors influencing willingness to accept the free domestic vaccines.

RESULTS

Although only 3.4% of the 2856 respondents had their daughters vaccinated against HPV prior to the survey, 91.7% were willing to utilise the governmental vaccination services. Parents with children in public schools (χ2 = 20.08, p < 0.001), those with more secure medical insurance (χ2 = 4.97, p = 0.026), and parents who had received an HPV vaccine themselves (χ2 = 28.829, p < 0.001) showed more reluctance towards the free vaccines. Vaccine hesitancy was presented in a mere 2.1% but was a significant predictor of vaccine refusal, even after adjusting for multiple factors (adjusted OR = 15.98, 95% CI: 9.06, 28.20). Notably, about four-fifths of parents of unvaccinated daughters harboured concerns about the safety and efficacy of the domestic vaccine.

CONCLUSIONS

Although parents show a strong inclination to utilise the government vaccination services, their vaccine hesitancy, driven by safety concerns and a preference for imported vaccines, remains a significant barrier for rolling out vaccination coverage. This study highlights the need for multifaceted intervention strategies that address these issues to enhance HPV vaccine uptake effectively.

Significant insights from a National survey in China: PrEP awareness, willingness, uptake, and adherence among YMSM students

INTRODUCTION

Few studies focused on the Pre-Exposure Prophylaxis (PrEP) -related aspects, and the applicability of prior evidence to young men who have sex with men (YMSM) students was unknown. This study aimed to assess the awareness, willingness, uptake, and adherence (AWUA) to PrEP among YMSM students in China and to explore the associated factors with these stages.

METHODS

A cross-sectional survey with a sizable sample of 1151 was conducted among YMSM students aged 16 and above, who self-identified as men who have sex with men(MSM) and resided in mainland China between October 20 and December 20, 2021. The chi-square test and Fisher's exact test were used for univariate analysis, followed by multivariable logistic regression analysis of influencing factors at all levels.

RESULTS

According to the cascade analysis approach, 88.71% of the participants were aware of PrEP, among which 66.7% expressed willingness to use it. Among those who were willing to use PrEP, only 13.80% took it, and of those who took it, 44.68% adhered to it. The students taking PrEP were those with higher education (OR = 4.239, 95% CI: 1.334-13.467), residence in pilot cities (OR = 2.791, 95% CI: 1.498-5.198), residence in high-risk areas (OR = 5.082, 95% CI: 2.224-11.612), engagement in multi-person sexual behavior (OR = 2.186, 95% CI: 1.236-3.867), and substance use (OR = 1.908, 95% CI: 1.167-3.118). Furtherly, students with higher adherence to PrEP were likely to have receptive sexual behaviors (OR = 8.702, 95% CI: 2.070-36.592), absence of substance use (OR = 4.468, 95% CI: 1.371-14.561), and uptake of PrEP through daily oral route. (OR = 7.065, 95% CI: 1.699-29.371).

CONCLUSION

YMSM students exhibit distinct patterns of "high awareness, low willingness, low uptake, and low adherence" to PrEP. Strategies for reduction in the acquisition of HIV prioritizing the current features of utilizing PrEP were urgently warranted.

Influences on clinical trial participation: Enhancing recruitment through a gender lens - A scoping review

Background

Suboptimal clinical trial recruitment contributes to research waste. Evidence suggests there may be gender-based differences in willingness to participate in clinical research. Identifying gender-based differences impacting the willingness of trial participation may assist trial recruitment.

Objectives

To examine factors that influence the willingness of men and women to participate in clinical trials and to identify modifiable factors that may be targeted to optimise trial participation.

Material and methods

Electronic databases were searched with key words relating to 'gender', 'willingness to participate' and 'trial'. Included studies were English language and reported gender-based differences in willingness to participate in clinical trials, or factors that influence a single gender to participate in clinical trials. Studies were excluded if they described the demographic factors of trial participants or if the majority of participants were pregnant. Extracted data were coded, categorized, analysed thematically and interpreted using Arksey and O'Malley's framework.

Results

Sixty-three studies were included. Two main themes were identified: trial characteristics and participant characteristics. A number of gender-based differences moderating willingness to participate were observed although only one, 'concern for self' was found to influence actual trial participation rates between genders.

Conclusion

The relationship between factors influencing willingness to participate in clinical trials is complex. The influence of gender on willingness to participate, while important, may be moderated by other factors including socioeconomic status, ethnicity and health condition. Exploring factors that influence willingness to participate specific to a study cohort likely offers the most promise to optimise trial recruitment of that cohort.

Association between willingness to use an overdose prevention center and probation or parole status among people who use drugs in Rhode Island

BACKGROUND

Overdose prevention centers (OPCs) are being implemented in the United States as a strategy to reduce drug-related mortality and morbidity. Previous studies have suggested that people who use drugs (PWUD) with a history of criminal legal system (CLS) involvement (e.g. current probation/parole) are at greater risk of overdose but may also encounter significant barriers to OPC use. The objective of this study was to explore the association between willingness to use an OPC and probation/parole status in a sample of PWUD in Rhode Island.

METHODS

This study utilized data from the Rhode Island Prescription and Illicit Drug Study, which enrolled adult PWUD from August 2020 to February 2023. We used Pearson's chi-square and Wilcoxon rank-sum tests to assess bivariate associations between willingness to use an OPC and probation/parole status (current/previous/never), as well as other sociodemographic and behavioral characteristics. In multivariable Poisson analyses, we examined the association between willingness to use an OPC and probation/parole status, adjusting for key sociodemographic and behavioral characteristics.

RESULTS

Among 482 study participants, 67% were male, 56% identified as white, 20% identified as Hispanic/Latine, and the median age was 43 (IQR 35-53). Nearly a quarter (24%) had never been on probation/parole, 44% were not currently on probation/parole but had a lifetime history of probation and parole, and 32% were currently on probation/parole. Most participants (71%) reported willingness to use an OPC, and in both bivariate and multivariable analyses, willingness to use an OPC did not vary by probation/parole status. Crack cocaine use and lifetime non-fatal overdose were associated with greater willingness to use an OPC (all p < 0.05).

CONCLUSIONS

These data demonstrate high willingness to use OPC among PWUD in Rhode Island regardless of CLS-involvement. As OPCs begin to be implemented in Rhode Island, it will be imperative to engage people with CLS-involvement and to ensure access to the OPC and protection against re-incarceration due to potential barriers, such as police surveillance of OPCs.

Willingness to take human papillomavirus vaccine and its associated factors among school adolescent girls: A case of school-based dose one human papillomavirus vaccine campaign in Dire Dawa, Ethiopia

Objective

This study aimed to evaluate the willingness of human papillomavirus vaccine and its associated factors in Dire Dawa in 2022. Ethiopia is undergoing human papillomavirus vaccine implementation in the country with the support of the Global Alliance for Vaccines and Immunization. However, there is a scarcity of data on problems encountered and the receiver's acceptance of the vaccine.

Methods

An institution-based cross-sectional study was conducted among 634 female adolescents from 1 April to 1 May 2022. A simple random sampling technique was used to select study participants. Pretested structured self-administered questionnaires were used to collect data. Data were entered into EPI-data 3.1 and exported to Statistical Package for the Social Sciences version 23.00 software for analysis. Descriptive analysis was conducted to summarize data with text, tables, and figures. A binary logistic regression model was fitted to identify factors associated with the willingness of the human papillomavirus vaccine. Adjusted odds ratios with 95% confidence intervals and p-values less than 0.05 were used to determine the association between independent and dependent variables. Hosmer and Lemeshow test was used to determine model fitness.

Results

The magnitude of human papillomavirus vaccine willingness among adolescent girls was 56% with 95% CI (52.1%-59.9%). Discussion on sexual and reproductive health issues (AOR = 7.67, 95% CI: 3.82, 15.42), adolescent girls who were received permission from their family to take human papillomavirus vaccine (AOR = 4.49, 95% CI: 2.40, 8.43), adolescent girls who had good knowledge on human papillomavirus vaccine (AOR = 5.78, 95% CI: 3.18, 10.15), and adolescent girls who had favorable attitude toward human papillomavirus vaccine (AOR = 3.06, 95% CI: 1.73, 5.43) were positively associated with willingness to take human papillomavirus vaccine.

Conclusion

Knowledge about cervical cancer and the human papillomavirus vaccine as well as willingness to take the human papillomavirus vaccine was low. Factors such as maternal education, adolescents' discussion on sexual and reproductive health issues, parent approval of human papillomavirus vaccine, and knowledge and attitude toward human papillomavirus vaccine were significantly associated with willingness to take the human papillomavirus vaccine. Therefore, public health education regarding cervical cancer and human papillomavirus vaccination is still needed and has to be targeted at not only respondents but also their families.

Factors Associated with Planned Future Use of PrEP in the Next 3 Months and Likelihood to Use PrEP Among Black Cisgender HIV-negative Women in Texas

Identifying and then addressing barriers and leveraging facilitators is important to help increase pre-exposure prophylaxis (PrEP) use among Black women vulnerable to HIV acquisition. The present cross-sectional study examined what factors were associated with future plans to use PrEP, and general likelihood to use it among a convenience sample of 152 adult, Black cisgender women from three metropolitan areas in Texas. The final multivariable logistic regression model revealed that relationship status (aOR = 0.20, 95% CI: 0.05-0.73, p < 0.05), PrEP anticipated stigma (aOR = 0.29, 95% CI: 0.10-0.78, p < 0.05), perceived discrimination (aOR = 0.40, 95% CI: 0.21-0.78, p < 0.01) and interest in learning more about PrEP (aOR = 5.32, 95% CI: 2.60-10.9, p < 0.001) were associated with future plans to use PrEP. The final multivariable linear regression model with maximum likelihood estimation identified that perceived discrimination (β=-0.24, SE: -0.38 - -0.10, p < 0.01), perceived HIV risk (β = 0.33, SE: 0.18-0.49, p < 0.001), willingness to use PrEP with condoms (β = 1.26, SE: 0.94-1.60, p < 0.001), and comfort communicating about PrEP with a provider (β = 0.23, SE: 0.06-0.41, p < 0.01) were associated with general likelihood to use PrEP. Findings reveal key factors that warrant further attention and examination toward improving PrEP use within this population.

Preliminary examination of the perceptions of sustainable horse feeding practices in the Netherlands

The purpose of this study was to determine the perception of sustainability among horse owners in the Netherlands and their willingness to switch to more sustainable feeding practices. A survey was distributed to a target group of horse owners in the Netherlands via social media channels. Data (n = 338 valid responses) were stratified based on yard type and size (small (<20), medium (20-50), and large (>50 horses). Most of the yards were livery yards (68 %) and they were small in size (66 %). The term most commonly associated with sustainability was low environmental impact (61.8 %). All participants (338/338) indicated that they were willing to switch to more sustainable feeding practices. Of the six options offered, the most popular was the use of plastic-free packaging products (60.5 %). This study identified that numerically the greatest change in behavior for the Dutch equestrian community would be achieved by small livery yards (P < 0.001). The potential to modify certain practices might be limited by the size of the equestrian operation, such as the available land for altering pasture management, and the financial aspects of the enterprise. Future research should investigate how the scale and economic considerations of the equestrian business influence its capacity and willingness to adopt more sustainable feeding practices.

Association between willingness to participate in physical and social activities and loneliness in older adults: A stratified analysis by social isolation status

BACKGROUND

This study aimed to examine the relationship between willingness to participate in physical activity (PA) and social activity (SA) and loneliness among community-dwelling older adults and to identify differences depending on whether or not they were socially isolated.

METHOD

This study included 4,590 participants aged 65 years or older. The study used the UCLA Loneliness Scale and a questionnaire to assess the willingness to participate in PA/SA. Social isolation was defined as the presence of two or more of the following conditions: domestic isolation, less social contact, and social disengagement. A binomial logistic regression analysis was conducted with loneliness as the dependent variable and willingness to participate in PA/SA as the independent variable, stratified by social isolation.

RESULTS

Those who experienced loneliness (n=1,595, 34.7%) were significantly more unwilling to participate in PA/SA than those who did not (p<0.05). For those in social isolation (n=321, 7.0%), there was no association between willingness to participate in PA/SA and loneliness [odds ratio (95% confidence interval); PA, 0.89 (0.41-1.92); SA, 0.52 (0.22-1.20)]. Those without social isolation showed no association between willingness to participate in PA and loneliness; however, there was a significant association with willingness to participate in SA [PA, 1.05 (0.81-1.36); SA, 0.54 (0.41-0.72)].

CONCLUSION

Among people without social isolation, the willingness to participate in SA was associated with reduced loneliness. However, the results suggest that environmental factors may limit activity and increase loneliness among people with social isolation, even when willing to participate in PA/SA.

Willingness to accept human papilloma virus vaccination and its associated factors among parents with eligible daughters in Addis Zemen town, Northwest Ethiopia

BACKGROUND

Cervical cancer is one of the most common cancers in women. Evidences show that, routine immunization of girls at age 14 year and immunization of girls at age 9 year through a 5 years extended interval between doses are the most efficient to control the disease. Despite this, there is very little information on parents' willingness to accept the human papilloma virus vaccine. Therefore, assessing willingness to accept human papilloma virus vaccination and its associated factors among parents with eligible daughter will help to designing, implementing and monitoring effectiveness of HPV vaccine immunization program.

METHODS

A community-based cross-sectional study was conducted among 386 parents with eligible daughters from 8July-6August, 2022. The multistage sampling technique was used. Data was collected using an interviewer-administered questionnaire. Responses were coded and entered into the computer using EPI data version 4.606 statistical packages, and SPSS version 23 was used for data analysis. Frequencies, percentages and means were as to describe the study variables in relation to the participants. Bivariable and multivariable logistic regression were employed. The statistical significance was set at a p-value of < 0.05 with its respected odds ratio.

RESULTS

A total of 386 study participants were included in the study. Among participants, 80.3% (95% CI: 76.3, 84) were willing to vaccinate their daughters for HPV vaccination. The parents' willingness was affected by the male parents ([AOR = 3.5; 95% CI (1.673-7.371)], fear of side effects [AOR = 0.385; 95% CI (0.206-0.718)], and with poor awareness on the HPV vaccine [AOR = 0.483; 95% CI (0.259- 0.900)].

CONCLUSION

The study has shown that willingness to accept the HPV vaccine is about 80% and significantly affected with parental sex, information on the HPV vaccine, and fear of side effects. As such, it may be helpful for the health care providers and the health care policy makers to emphasize on providing easily understandable information using mass media and social campaign. In addition giving trainings more targeted to female parents might be important.

Willingness to take long-acting injectable pre-exposure prophylaxis among men who have sex with men who participated in the CROPrEP study: a cross-sectional online study

INTRODUCTION

Evidence on the willingness of men who have sex with men (MSM) with oral pre-exposure prophylaxis (PrEP) experience, especially those with suboptimal adherence, to take long-acting injectable PrEP (LAI-PrEP) is critical to guide future LAI-PrEP implementation.

OBJECTIVE

The objective was to assess the willingness of MSM with oral PrEP experience to take LAI-PrEP.

METHODS

MSM who participated in the China Real-world Study of Oral PrEP (CROPrEP) were enrolled in this study. Information on the willingness of MSM to take LAI-PrEP and potential correlates was collected using a structured online questionnaire. The main outcomes were the willingness of MSM to take LAI-PrEP and its association with HIV-related behaviours, sexually transmitted infections, and oral PrEP history. Logistic regression was used to identify correlates of the willingness of MSM to take LAI-PrEP.

RESULTS

A total of 612 former CROPrEP participants (FCPs) were included in this study. There were 315 (51.5%) daily oral PrEP (D-PrEP) users and 297 (48.5%) event-driven oral PrEP (ED-PrEP) users at the last follow-up. Most FCPs (77.8%) were willing to take free LAI-PrEP. FCPs with no less than two sexual male partners (aOR = 1.54, [95% CI: 1.04, 2.29], P = 0.031), those with male partners with unknown HIV statuses (aOR = 2.04, [95% CI: 1.31, 3.18], P = 0.002), those with recreational drug use (aOR = 1.58, [95% CI: 1.05, 2.40], P = 0.030), and those with HSV-2 positivity (aOR = 2.15, [95% CI: 1.30, 3.57], P = 0.003) were more willing to take LAI-PrEP, while ED-PrEP users (aOR = 0.66, [95% CI: 0.45, 0.98], P = 0.037) and FCPs with suboptimal oral PrEP adherence (aOR = 0.58, [95% CI: 0.36, 0.94], P = 0.026) were less willing to take LAI-PrEP.

CONCLUSION

LAI-PrEP has good prospects for expanding PrEP coverage. However, FCPs with suboptimal oral PrEP adherence are less likely to take LAI-PrEP. Further intervention and implementation efforts are needed to improve the willingness of MSM to use LAI-PrEP, and sexual health should be considered during the discussion about PrEP initiation.

Determinants of willingness to pay for community-based health insurance scheme among households in rural community of southern Ethiopia

BACKGROUND

Community-based health insurance programs are being acknowledged as effective strategies to attain universal health coverage and mitigate the financial catastrophic shock of the community. Even though Ethiopia has been focusing on the implementation and expansion of a community-based health insurance (CBHI) program since 2011, only a small number of people are enrolled, which might be attributed to a lack of willingness towards the program. The purpose of this study is to determine the willingness to pay for community-based health insurance and associated factors among households in the rural community of Gombora District, Hadiya Zone, southern Ethiopia.

METHODS

Using the multistage systematic random sampling technique, a sample of 421 households was chosen for a community-based cross-sectional study. The desired information was gathered using a pre-tested, structured, interviewer-administered questionnaire. The data was entered using Epi-Data V3.1 and exported to SPSS version 24.0 for statistical analysis. Bivariable and multivariable logistic regression analyses were performed to determine the variables associated with the willingness to pay for community-based health insurance.

RESULTS

The study showed that 67.1% of respondents expressed a willingness to pay for community-based health insurance. The mean amount of money they are willing to pay for the scheme is 178.41 (± 57.21) Ethiopian Birr (ETB), or 6.43 (± 2.06) USD per household per annum in 2020. Based on multiple logistic regression analysis, belonging to Rich household compared to poor (AOR: 2.78, 95% CI: 1.54, 5.03), having a household head who can read and write (AOR: 2.90, 95% CI: 1.39, 6.05), family size greater than five (AOR: 1.76, 95% CI: 1.06, 2.92), indigenous community insurance (iddir) participation (AOR: 2.83, 95% CI: 1.61, 4.96), and the presence of chronic illness (AOR: 1.94, 95% CI: 1.21, 3.12), were significantly associated with the willingness to pay for a CBHI scheme.

CONCLUSION

Households' willingness to pay for a CBHI scheme was found to be significantly influenced by poor household wealth status, household heads who cannot read and write, households with less than or equal to five family members, households who participate in greater or equal to two indigenous community insurance participations, and the absence of chronic illness within the household. Therefore, factors affecting households' willingness to pay should be considered and massive community mobilization needs to be done to strengthen and increase household membership during the implementation of the CBHI scheme, especially in rural areas.

MOTHERS WILLINGNESS TO VACCINATE THEIR IN-SCHOOL ADOLESCENTS AGAINST HPV INFECTION IN LAGOS STATE NIGERIA

Introduction

Human Papillomavirus (HPV) vaccine uptake rates for adolescents are still low in Nigeria despite the availability of safe and effective vaccines. The knowledge and attitudes of mothers to HPV infection and vaccines play a role in adolescents HPV vaccination uptake. This study assessed mothers' willingness to vaccinate their in-school adolescents against HPV infection in Lagos State Nigeria.

Methods

A cross-sectional descriptive study involving mothers of in-school adolescents was conducted using a multi-stage sampling technique. A self-administered questionnaire was used for data collection. Chi square test was used to determine association between categorical variable and the level of significant was set at 5%.

Results

The mean age of the respondents was 43.0 ± 5.8. Majority (92%) had poor knowledge of HPV infection and vaccination. However, majority (79%) of the respondents had a positive attitude to HPV vaccination. More than half (65.8%) of the respondents' were willing to vaccinate their adolescents against HPV. There were statistically significant associations between respondents' number of daughters and attitude about HPV vaccination (p=0.021), previous pap smear screening and willingness to vaccinate their children against HPV (p=0.012) and overall knowledge of HPV vaccination and willingness to vaccinate their children against HPV (p=0.041).

Conclusion

There is a need to increase public awareness and health education of mothers on HPV infection and cervical cancer in order to increase HPV vaccine uptake for their children. Health and education sectors can collaborate to achieve this using school-based HPV education programme.

Knowledge and willingness toward SARS-CoV-2 rapid antigen testing among older adults in China: a nationwide cross-sectional study

BACKGROUND AND AIMS

The end of the zero-COVID-19 policy placed a large number of older adults in China at increased risk of COVID-19 infection. SARS-CoV-2 rapid antigen testing (RAT) is a promising tool for scaling up testing and ensuring that patient management and public health measures can be implemented without delay. We aimed to understand the knowledge and willingness of RAT, and its correlates among older adults in China.

METHODS

A nationwide cross-sectional survey on knowledge and willingness about RAT among older adults in China was conducted between January 14 and 28, 2023, shortly after the end of the zero-COVID-19 policy. An online questionnaire was used to collect information on sociodemographic characteristics, health characteristics, sources to access RAT information, and attitudes toward COVID-19 and its RAT. Logistic regression was used to assess correlates of knowledge of RAT and willingness to take RAT among older adults.

RESULTS

A total of 1030 older adults (494 women and 536 men, mean age 68.7 ± 7.0 years) were recruited. 49.4% of the participants had a high level of RAT knowledge. After adjusting for sociodemographic characteristics, chronic diseases (0.70, 0.49-0.99), learning RAT from new media (5.46, 3.48-8.68) and traditional media (3.35, 2.13-5.34), and perceiving RAT as convenient (4.03, 2.80-5.85) were associated with levels of RAT knowledge. 53.3% of the participants were willing to take RAT. After adjusting for sociodemographic characteristics, learning RAT from new media (8.46, 5.26-14.0) and traditional media (1.63, 1.04-2.55), perceiving RAT as convenient (2.97, 2.10-4.22), and worrying about (re)infection with COVID-19 (2.12, 1.55-2.92) were associated with willingness to take RAT.

CONCLUSION

The levels of RAT knowledge and willingness to take RAT among older adults in China may hinder the scale-up of RAT. Health education about RAT should be strengthened among older adults. Special efforts should be made to integrate traditional and new media to promote RAT among older adults, specifically, for virus susceptibility and the convenience of RAT. Given the reopening of society, our study could inform our response to future novel infectious diseases and aid in the timely scale-up of RAT.

Multidimensional determinants of willingness to pay for community-based health insurance in Ethiopia and its implication towards universal health coverage: A narrative synthesis

Pooling resources to pay for healthcare services and attain universal health coverage is a viable global agenda, especially for underdeveloped health systems. Ethiopia has implemented community-based health insurance (CBHI) since 2011 to improve healthcare funding. However, comprehensive evidence on the demand and determinants of health insurance in Ethiopia is lacking. Therefore, this review aimed at identifying determinants of willingness to pay (WTP) for CBHI in Ethiopia. A narrative review was conducted using search terms from PubMed, Science Direct, Scopus, African Journal Online, and Google Scholar databases. Screening process considered publication year, settings, English language, and study participants. Newcastle Ottawa tool assessed the quality of included studies. A thematic framework was applied. The review protocol was registered in PROSPERO with an ID number CRD42022296840. The review included 10 studies. The synthesis identified 25 determinants of WTP for CBHI in Ethiopia. Socio-demographic and economic, scheme-related, and health-related determinants of WTP for the CBHI were identified. Determinants of household WTP for CBHI in Ethiopia were multi-dimensional. Socio-demographic, socio-economic, scheme-related, and health-related factors are among the common determinants documented. CBHI is thus an alternative and potential source of financing for the healthcare system, primarily for people with low socioeconomic status and a fragile health system. The health system, socioeconomic leaders, and political figures play a significant role in influencing communities towards WTP for CBHI while increasing government spending on health toward UHC.

Factors associated with willingness to perform basic life support in the community setting in Yogyakarta, Indonesia

BACKGROUND

Cardiac arrest is one of the fatal medical emergencies which need to be treated immediately. Poor survival rates in the community settings are common because of limited and ineffective bystander basic life support (BLS). This study aimed to identify factors that are associated with the willingness to perform BLS in communities in Yogyakarta, Indonesia METHODS: A descriptive study was conducted with a cross-sectional design. Participants (n = 251) were enrolled from the general population consisting of teachers, security personnel, and police officers recruited through cluster random sampling. Data were gathered using both digital or printed questionnaires. Ordinal logistic regression with adjusted odds ratio (AOR) was used to analyze the association between BLS predictors and willingness to perform BLS.

RESULTS

Most participants were willing to perform BLS for all genders (55.55%). The inability to perform BLS and fear of causing harm were the main barriers to performing BLS accounting for 61.35% and 43.82%, respectively. Compared to other independent predictors, ages 40-59 were found to be the highest predictors of willingness to perform BLS (AOR:1.44) followed by experience of seeing real or simulation of the emergency case (AOR:1.38) CONCLUSIONS: More than half of the respondents were eager to perform BLS although some barriers were also found. This study provides some understanding of the predictor factors associated with BLS performance and shows respondents with some training or experience were more likely to perform BLS. The results inform policymakers to develop a strategic plan for increasing willingness to apply BLS in the community. WC:250.

Willingness to receive and recommend hypothetical mpox vaccination and associated factors in Chinese adults: a community-based survey in Shenzhen, China

OBJECTIVES

China may face new threats to public health due to the increased risk of imported mpox (monkeypox) cases. However, research gaps exist in the acceptance of mpox vaccination and potential associated factors in the Chinese population.

STUDY DESIGN

We conducted a cross-sectional study targeting community residents in Shenzhen, China, from August 5 to September 7 2022.

METHODS

A self-administered questionnaire was used to collect information about demographic and health characteristics, mpox-related perceptions, and attitudes towards mpox vaccination. Multivariable logistic regression models were applied to detect the factors associated with willingness to receive and recommend mpox vaccination.

RESULTS

A total of 2293 community residents were included in the analyses (average age: 34.03, female: 72.6%). Among the participants, 76.9% were aware of mpox, 62.1% were aware of the global mpox outbreak, but only 53.6% had a high knowledge level of mpox. Males had a higher proportion of high knowledge (56.9% vs 52.3%, P＜0.05) and a lower proportion of high worry (30.2% vs 45.4%, P＜0.05) than females. Approximately 69.1% of the participants were willing to vaccinate against mpox, and 69.6% were willing to recommend mpox vaccination to people around them, in which no gender difference was found. The obstacle reported most among people hesitant to receive vaccination was concerning the safety and side-effects, whereas it changed to be concerning the suitability due to individual health differences among people hesitant to recommend mpox vaccines. Factors associated with the willingness to receive and recommend mpox vaccination included having a history of influenza vaccination, having a history of COVID-19 vaccination, being aware of the global mpox outbreak, having a high knowledge level of mpox, and having a high level of mpox-related worry.

CONCLUSIONS

This study identified a moderate willingness to receive and recommend mpox vaccination among Chinese adults. Without gender differences, willingness to receive and recommend mpox vaccination was significantly associated with mpox-related perceptions, such as awareness, knowledge, and worry. Authoritative and up-to-date information is needed to help the general population improve public confidence in mpox vaccines in China.

Knowledge, perception, and willingness to provide telepharmacy services among pharmacy students: a multicenter cross-sectional study in Indonesia

INTRODUCTION

The coronavirus disease 2019 (COVID-19) pandemic accelerated the provision of telepharmacy services. However, little is known about the knowledge, perception, and willingness of pharmacy students as future key players in telepharmacy adoption to provide such a service, particularly in a setting without well-established telepharmacy services before the COVID-19 pandemic.

OBJECTIVE

With this survey we aimed to assess the level of knowledge, perception, and willingness to provide telepharmacy services and to identify associated factors among pharmacy students in Indonesia.

METHODS

We applied a multicenter cross-sectional study design with convenience sampling technique among pharmacy students in three public universities in Bandung City, Surabaya City, and Special Region of Yogyakarta, Indonesia. The knowledge, perception, and willingness to provide telepharmacy services were assessed using an online questionnaire. Ordinal regression analysis was performed to determine factors associated with a high knowledge level, whereas binary logistic regression analyses were performed to determine factors associated with a positive perception of telepharmacy services. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported.

RESULTS

Among 313 respondents, 83.4% were female, and the mean age was 20 years. Although only 13.2% showed a high knowledge level, 66.5% showed a positive perception of telepharmacy services and 97.4% were willing to provide telepharmacy services in the future. An increase in age (OR 1.33; 95% CI 1.14-1.54) and being advance in smartphone usage (OR 5.21; 95% CI 2.03-13.42) are associated with an increased likelihood of having a high knowledge level about telepharmacy services. Male students had a lower likelihood of having a positive perception of telepharmacy services than females (OR 0.46; 95% CI 0.24-0.85).

CONCLUSION

Despite limited knowledge of telepharmacy, the majority of pharmacy students reported a positive perception and willingness to provide telepharmacy services in their future careers. Therefore, telepharmacy practice models must be included as a subject course in the curriculum, better preparing future pharmacists to perform their roles effectively. Furthermore, student-specific factors such as age and expertise in smartphone usage that associated with knowledge and gender that associated with perception should be considered to facilitate telepharmacy adoption in Indonesia.

Why healthcare providers are not vaccinated? A qualitative study during the COVID-19 pandemic in Iran

BACKGROUND

Vaccination has been effective in controlling contagious diseases, especially among high-risk groups such as medical staff. Their unwillingness to be vaccinated might adversely affect individual and public health. This study aimed to explore the factors related to the refusal of COVID-19 vaccines among health service providers.

METHODS

A qualitative study was conducted on 28 healthcare providers in Mashhad, Northeast of Iran from March to June 2022. The method of data collection was face-to-face interviews. The purposive method was used for sampling. Data collection continued until the saturation was reached. To analyze the data, the content analysis method was applied, and Maxqda (version 10) software was used.

RESULTS

By analyzing interview transcripts, six themes and ten sub-themes were extracted. Factors that explained employees' reluctance to be vaccinated against COVID-19 were the opinion of peers, lack of trust in vaccines, fear of vaccination, mistrust to the government and health authorities, low perceived risk of coronavirus disease, and the contradictions of traditional and modern medicine in their approach to controlling the disease.

CONCLUSIONS

Among healthcare workers, concerns about the side effects of vaccines were the most influential factors in refusing vaccination. Providing reliable information about vaccines and their safety is key to increasing the trust of health workers in vaccination and facilitating its acceptance.

Knowledge about stem cell sources and obstacles in donation of bone marrow and peripheral blood stem cells: a cross-sectional survey from Ha'il city to track the prospects of regenerative medicine in Saudi Arabia

BACKGROUND

Promoting stem cell donation behaviors could be crucial in advancing stem cell-based treatment, research and improving public health in Saudi Arabia. Donation of stem cells can be considered an act of social welfare just like blood donation because stem-cell-based therapies are emerging as a hope for those suffering from chronic health conditions and/or terminal illnesses.

AIM

This study aims at assessing levels of awareness about sources of stem-cells, donor organizations and predictors of stem cell donation behavior in target population.

METHODS

The study employed a cross-sectional online survey method. The study sample comprises 1325 educated Saudi people living in Ha'il city. The survey questionnaire collected data about respondents' demographic background, awareness about various sources of stem cells and stem-cell donor registries, willingness to donate stem cells, registration status and obstacles in stem cell donation registration. Percentages, Chi-square analysis and Odd Ratios were computed to analyze the data.

RESULTS

In this sample, (n = 696; 52%) were males and (n = 629; 48%) were females. Although (n = 1308; 98%) percent of respondents reported willingness to donate stem cell, less than one percent (n = 6; 0.5) were registered with Saudi Stem Cell Registry. Over 50% of respondents hold inaccurate perceptions about sources of stem cell. Odd Ratio (OR) values from binary logistic regression model identified four factors as significant predictors of non-registration status. These included (i) unaware about donor agencies and procedures (OR = 10.07; p < 0.05), (ii) unaware about possibility to donate stem cells (OR = 8.08; p < 0.05) (iii) concerns about impact on health (OR = 10.01; p < 0.05) and (iv) have health issues that does not permit donation (OR = 10.50; p < 0.05).

CONCLUSION

Stem cell registrations can be enhanced through appropriate health education programs that focus on increasing awareness about donation procedures, trustworthy donor organizations and reducing people apprehensions related to donation.

Artificial intelligence in pharmacy practice: Attitude and willingness of the community pharmacists and the barriers for its implementation

BACKGROUND

Artificial intelligence (AI) is the capacity of machines to perform tasks that ordinarily require human intelligence. AI can be utilized in various pharmaceutical applications with less time and cost.

OBJECTIVES

To evaluate community pharmacists' willingness and attitudes towards the adoption of AI technology at pharmacy settings, and the barriers that hinder AI implementation.

METHODS

This cross-sectional study was conducted among community pharmacists in Jordan using an online-based questionnaire. In addition to socio-demographics, the survey assessed pharmacists' willingness, attitudes, and barriers to AI adoption in pharmacy. Binary logistic regression was conducted to find the variables that are independently associated with willingness and attitude towards AI implementation.

RESULTS

The present study enrolled 401 pharmacist participants. The median age was 30 (29-33) years. Most of the pharmacists were females (66.6%), had bachelor's degree of pharmacy (56.1%), had low-income (54.6%), and had one to five years of experience (35.9%). The pharmacists showed good willingness and attitude towards AI implementation at pharmacy (n = 401). The most common barriers to AI were lack of AI-related software and hardware (79.2%), the need for human supervision (76.4%), and the high running cost of AI (74.6%). Longer weekly working hours (attitude: OR = 1.072, 95% C.I (1.040-1.104), P < 0.001, willingness: OR = 1.069, 95% Cl. 1.039-1.009, P-value = 0.011), and higher knowledge of AI applications (attitude: OR = 1.697, 95%Cl (1.327-2.170), willingness: OR = 1.790, 95%Cl. (1.396-2.297), P-value < 0.001 for both) were significantly associated with better willingness and attitude towards AI, whereas greater years of experience (OR = 20.859, 95% Cl (5.241-83.017), P-value < 0.001) were associated with higher willingness. In contrast, pharmacists with high income (OR = 0.382, 95% Cl. (0.183-0.795), P-value = 0.010), and those with<10 visitors (OR = 0.172, 95% Cl. (0.035-0.838), P-value = 0.029) or 31-50 visitors daily (OR = 0.392, 95% Cl. (0.162-0.944), P-value = 0.037) had less willingness to adopt AI.

CONCLUSIONS

Despite the pharmacists' positive willingness and attitudes toward AI, several barriers were identified, highlighting the importance of providing educational and training programs to improve pharmacists' knowledge of AI, as well as ensuring adequate funding support to overcome the issue of AI high operating costs.

Measuring behavioral and social drivers of COVID-19 vaccination in health workers in Eastern and Southern Africa

BACKGROUND

In 2021, twenty out of twenty-one countries in the Eastern and Southern Africa (ESA) region introduced COVID-19 vaccines. With variable willingness to uptake vaccines across countries, the aim of the present study was to better understand factors that impact behavioral and social drivers of vaccination (BeSD). Using the theory-based "increasing vaccination model", the drivers Thinking & Feeling, Social Processes, Motivation, and Practical Issues were adapted to the COVID-19 context and utilized in a cross-country assessment.

METHODS

Data was collected on 27.240 health workers in Kenya, Malawi, Mozambique, South Africa and South Sudan. This was done by administering a survey of seven target questions via the UNICEF Internet of Good Things (IoGT) online platform between February and August 2021.

RESULTS

Findings showed a gap between perceived importance and trust in vaccines: Most health workers thought Covid-19 vaccination was very important for their health, while less than 30% trusted it very much. The pro-vaccination social and work norm was not well established since almost 66% of all respondents would take the vaccine if recommended to them, but only 49% thought most adults would, and only 48% thought their co-workers would. Access was highlighted as a crucial barrier, with less than a quarter reporting that accessing vaccination services for themselves would be very easy. Women exhibited slightly lower scores than men across the board. When testing the associations between drivers in Kenya and South Africa, it appears that when target interventions are developed for specific age groups, social norms become the main drivers of intention to get vaccinated.

CONCLUSIONS

The present study revealed various key relations with demographic variables that would help immunization programmes and implementing partners to develop targeted interventions. First, there is a serious gap between perceived importance of COVID-19 vaccines and how much trust people in them. Second, problems with access are still rather serious and solving this would strongly benefit those who demand a vaccine, Third, the role of social norms is the most important predictor of willingness when considering age differences.

Willingness toward psychosocial support during cancer treatment: a critical yet challenging construct in psychosocial care

Psychosocial distress screening, mandated by the American College Surgeons' Commission on Cancer, continues to be implemented across cancer centers nationwide. Although measuring distress is critical to identifying patients who may benefit from additional support, several studies suggest that distress screening may not actually increase patients' utilization of psychosocial services. While various investigators have identified barriers that may impede effective implementation of distress screening, we posit that patients' intrinsic motivation, which we term patients' willingness, may be the biggest predictor for whether cancer patients choose to engage with psychosocial services. In this commentary, we define patient willingness towards psychosocial services as a novel construct, distinct from the intention toward a certain behavior described across pre-existing models of health behavior change. Further, we offer a critical perspective of models of intervention design that focus on acceptability and feasibility as preliminary outcomes thought to encompass the willingness construct described herein. Finally, we summarize several health service models that successfully integrate psychosocial services alongside routine oncology care. Overall, we present an innovative model that acknowledges barriers and facilitators and underscores the critical role of willingness in health behavior change. Consideration of patients' willingness toward psychosocial care will move the field of psychosocial oncology forward in clinical practice, policy initiatives, and study design.

Family Circle and Willingness to Subscribe to Community-based Health Insurance (CBHI) for the Elderly in a Rural Community in South-South Nigeria

BACKGROUND

The older people in most rural communities depend on family members to provide resources for their healthcare. However, such payments for health services are mostly out of pocket. In trying to protect the health of elderly persons who by nature are prone to high morbidity, other younger family members may be contacted for financial support for their healthcare through contributions to the Community based Health Insurance (CBHI). This study assessed the willingness of the significant other in the family to subscribe to the CBHI for the elderly person within the family.

METHODS

A cross-sectional survey was used to study 358 elderly people, and their significant other (identified by using the family circle tool). The respondents were selected by a multistage sampling technique from nine clusters of villages within the community. The data were generated with an interviewer-administered semi-structured questionnaire. For the significant other that lived outside the community phone call was used for the interview. Descriptive and inferential analyses were done using SPSS 22.

RESULTS

Majority of the significant others (97.8%) were aged less than 60 years and mostly female (67.9%) and had attained the tertiary level of education (75.4%). Most of the significant others were civil servants (83.0%); 94.7% were Christians; 87.4% were married, and 83.2% lived in urban locations. Only 7.5% were aware of CBHI and 56.7% were willing to buy N10,000 (naira) subscriptions for CBHI. Socio-demographic characteristics that were significantly associated with willingness to subscribe for CBHI were age < 60 years (p=0.040), tertiary education (p<0.001), occupation (p<0.001), religion (p=0.008), marital status (p<0.001), place of residence (p<0.001) and monthly income (p<0.001).

CONCLUSION

There is a need to create awareness of CBHI in communities, as the majority of the significant others identified in this study were ready to subscribe to CBHI for the elderly members of their families at a convenient cost.

Willingness of college students aged 10 to 24 years to get vaccinated against COVID-19 disease: a cross-sectional study in South-East Nigeria

Background

Willingness to be vaccinated against COVID-19 is a topical issue that may change the course and distribution of the pandemic in the country.

Objectives

This study was aimed to determine the willingness to receive the COVID-19 vaccine among college adolescents and associated factors.

Methodology

This was a cross-sectional study carried out among one thousand college adolescents in six secondary schools in Enugu from April to August 2021. A pretested, self-administered questionnaire was used for data collection. Data entry and analysis were done using IBM Statistical Package for Social Sciences (SPSS) statistical software version 25. Descriptive statistics were used to describe college adolescents' characteristics. Categorical variables were reported as frequencies and percentages. Predictors of willingness to vaccinate were assessed using binary logistic regression.

Results

A minor proportion of the respondents, 13.2% (153) were willing to receive the COVID-19 vaccine. The respondents who were males were 1.6 times more willing to receive the COVID-19 vaccination when compared with those who were females. (AOR=1.6, 95%CI: 1.1- 2.3). The respondents who were aware they could be infected with COVID-19 were twice more likely to receive COVID-19 vaccination when compared with those who felt they could not be infected. (AOR=2.0, 95%CI: 1.1-3.1). The respondents who had good knowledge of COVID-19 vaccination were 2.2 times more likely to receive COVID-19 vaccination when compared with those who had poor knowledge. (AOR=2.2, 955CI: 1.5-3.3).

Conclusion

A small fraction of college adolescents were willing to receive the COVID-19 vaccine. Male gender, knowledge of vaccine and possibility of transmitting infection are predictors of willingness to receive the vaccination.

Evaluating Rural Ethiopian Youths' Willingness and Competency to Promote Literacy Regarding G × E Influences on Podoconiosis

INTRODUCTION

Engaging youth as peer educators has yet to be considered to promote literacy concerning conjoint genetic and environmental (G × E) influences on health conditions. Whether youth living in low- and middle-income countries (LMICs) could and would be willing to serve as lay educators of G × E education is unclear.

METHODS

A cross-sectional survey of youth living in Southern Ethiopia was conducted from August to September 2017. Trained data collectors administered the survey on 377 randomly selected youth who ranged in age from 15 to 24; 52% were female and 95% reported having some formal education. Self-reported willingness and a constructed competency score were assessed. Bivariate analyses tested for factors associated with willingness and competency to serve as lay G × E literacy builders.

RESULTS

Competency and willingness were significantly greater (p < 0.05) for youth who were male, had some formal education, and had civic or leadership experience. Differences in median willingness were significant for youth who scored as more competent versus those who scored as less competent (p < 0.001). There were no characteristics that moderated the association of competency with willingness.

CONCLUSION

Youth peer educator programs hold promise for disseminating improved G Χ E literacy and reducing stigma associated with deterministic misunderstandings. Thoughtful recruitment and training strategies will be needed to ensure that the broadest representation of youth in LMIC contexts has the opportunity to serve in this role, particularly girls and those without formal education.

Willingness to COVID-19 vaccination: Empirical evidence from EU

The unforgettable COVID-19 shock is most likely to be reversed by a viable vaccination strategy. In this paper, we investigate willingness to be vaccinated (WTV) against the COVID-19. Current trends suggest that only around 73% of EU inhabitants (15 and +) were immunized, with more than 104 million people still warranted to be immunized. Vaccine reluctance is a key impediment to conducting immunization programs in the setting of a pandemic. We provide first of its kind empirical evidence on the citizens (N = 11,932) of the EU-27 by employing the recent data from the European Commission. Based on the survey responses, controlling for the correlations in the error terms, we utilize a simulated multivariate probit regression model. Our results show that amongst all the statistically significant drivers of the WTV, the positive perception (vaccination works and has no side effects); R&D information (clarity on how vaccination is developed, tested, authorized) has the largest impact on the WTV. We find that the group of variables on social feedback (Positive perception; social adoption and pressure), and on trustworthy sources of information (R&D info; medical advice) are to be considered for WTV policy. The counteracting policy gaps that act against WTV include vaccination governance dissatisfaction, perception of long-term side effects, growing mistrust in information sources, uncertainty between safety and efficacy, education level, and risky age group. Strategies based on the outcomes of this study are needed to address public acceptance and willingness to vaccinate during a pandemic. This research is novel and offers authorities in-depth insights into the challenges and solutions regarding the COVID-19 pandemic and thus to its end via stimulation of the WTV.

Indonesia

One of the efforts to control the COVID-19 pandemic is through vaccination, which is targeted to build immunity and prevent severe disease and finally to control transmission. This study aimed to analyze the perception of and the willingness to receive the COVID-19 vaccine among citizens of Medan. This research is an analytic study with a cross-sectional research design. Data collection was carried out from 16 April 2021 to 18 April 2021 by having participants fill out a Google Forms questionnaire. The population in this study was adults and elderly citizens in Medan who had not yet been vaccinated against COVID-19, and the sample was taken by consecutive sampling technique, which was the group of people who met the inclusion and exclusion criteria. The measurements of perceptions of and willingness to receive the COVID-19 vaccine used a previously validated questionnaire. The data was processed using SPSS. Data analysis used the Chi-square test (p<0.05). This study indicates that 31.8% of respondents positively perceive the COVID-19 vaccine. In comparison, 68.2% of respondents have a negative perception. On willingness to receive the vaccine, 80.2% accepted being vaccinated, 5.2% did not, and 4.6% had not decided whether to be vaccinated. There is a relationship between perception and willingness to undergo COVID-19 vaccination.

Awareness of HPV and HPV vaccines, acceptance to vaccination and its influence factors among parents of adolescents 9 to 18 years of age in China: A cross-sectional study

BACKGROUND

Vaccination uptake rates for adolescents are still low in China despite safe and effective human papillomavirus vaccines being available. The awareness and attitudes of parents to HPV vaccines play a decisive role in adolescents' HPV vaccination uptake.

METHODS

A cross-sectional study was conducted from March, 2022 to May, 2022 using an anonymous questionnaire among parents of 9 to 18 years of age from 73 cities in 23 provinces in mainland China. Demographic characteristics of parents, their knowledge and attitudes about HPV and HPV vaccination, as well as factors influencing HPV vaccination in adolescents were assessed.

RESULTS

More than two-thirds of parents heard of HPV (75.5%) and HPV vaccines (84.7%). Of these participants, mothers (83.8%) were in the majority. Parents willing to vaccinate themselves and their children against HPV were 84.9% and 87.6%, respectively. Parents were more likely to vaccinate their daughters against HPV than their sons (P < 0.001). Parents who had heard of the HPV vaccines (P = 0.028) or had vaccinated themselves (P < 0.001) were more likely to have HPV vaccination for their children. Parents who accepted the price of the HPV vaccines (P = 0.005) were more likely to have their children vaccinated against HPV.

CONCLUSIONS

Children's gender, awareness of the HPV vaccines, parental HPV vaccination, and the price of the HPV vaccines are likely to be the reason for parents' vaccine hesitancy for adolescents.

PRACTICE IMPLICATIONS

Nurses have a critical role in identifying parental hesitancy and providing individualized education to expand the parental awareness and knowledge and encourage on-time adolescents vaccination.

The willingness and attitudes of speech-language pathologists towards the use of mobile health technology: a survey study

BACKGROUND

Mobile health (mHealth) technology could be used in different ways to treat various speech and language disorders. The attitude of speech-language pathologists (SLPs) towards this technology and their willingness to use it can play a significant role in the success of the therapies they provide. This study was conducted to investigate the willingness and attitude of SLPs towards the use of mHealth technology.

METHODS

This cross-sectional study was conducted from September 2021 to April 2022 in Iran. A researcher-made questionnaire consisting of three parts (information related to demographic variables, attitude and willingness) was designed based on the past studies, and then given to all SLPs throughout Iran. Data were analyzed by SPSS software, using descriptive and inferential statistics (frequency, mean, Fisher's exact test, and analysis of variance). Also, the SLPs' willingness to use the desired technology was interpreted as a percentage as follows: 0-20% = not at all willing, 21-40% = slightly willing, 41-60% = moderately willing, 61-80% = highly willing, and above 80% = extremely willing.

RESULTS

One hundred sixty speech-language pathologists from all over Iran participated in this study. The results showed that the willingness of 65.25% of SLPs to use the mentioned technology was at a good level, and according to the mentioned category, they had a high willingness to use this technology. In regard to the attitude of SLPs, the findings showed that SLPs believed that patients receive a higher quality of care during in-person visits than through mHealth technology. Also, this survey showed that SLPs were more inclined to use this technology to answer patients' questions. Non-payment of services provided through mHealth technology and privacy concerns were the reasons for the lack of use of this technology by SLPs.

CONCLUSIONS

SLPs are willing to use mHealth technology after solving the related challenges, including payment of costs and privacy concerns. However, SLPs believed that this technology will not be a suitable alternative to face-to-face sessions.

Attitudes and willingness toward out-of-hospital CPR and AED: A questionnaire study among Chinese middle school students

Objectives

This study's purpose was to assess the attitudes and willingness of middle school students to perform cardiopulmonary resuscitation (CPR) and to use automated external defibrillator (AED) in emergencies, and to evaluate the overall effects of first aid training.

Results

Middle school students demonstrated a high willingness to learn CPR (95.87%) and AED (77.90%). However, the rate of CPR (9.87%) and AED (3.51%) training was relatively low. These trainings could improve their confidence while facing emergencies. Their main concerns were "Lack of first aid knowledge", "Lack of confidence in rescue skills" and "Fear of hurting the patient".

Conclusions

Chinese middle school students are willing to learn CPR and AED skills, but relative trainings are insufficient and should be reinforced.

Willingness to provide informal care to older adults in Germany: a discrete choice experiment

As the German population is continually aging and the majority of older adults still wish to 'age in place', the need for informal care provided by family and friends will correspondingly continue to increase. In addition, while the need for formal (professional) care services is also likely to increase, the supply already does not meet the demand in Germany today. The aim of our study is the elicitation of people's willingness to provide informal care by means of a discrete choice experiment. The self-complete postal survey was disseminated to a random sample of the German general population in Lower Saxony. Data cleansing resulted in a final sample size of 280 participants. A conditional logit and a latent class model were estimated. All attributes were judged as highly relevant by the respondents. The results revealed that an increase in the care hours per day had the greatest negative impact overall on the willingness to provide informal care in our sample. The marginal willingness-to-accept for 1 h of informal care was €14.54 when having to provide informal care for 8 h in reference to 2 h per day. This value is considerably higher than the national minimum wage of €9.82. A three-class latent class model revealed preference heterogeneity. While a monetary compensation is often discussed to increase the willingness and availability of informal care in a country, our results show that this statement could not be generalized within our entire sample.

The coverage of SARS-CoV-2 vaccination and the willingness to receive the SARS-CoV-2 variant vaccine among employees in China

BACKGROUND

COVID-19, which is caused by SARS-CoV-2, is a major global health threat. The dominant variant of SARS-CoV-2 has changed over time due to continuous evolution. We aimed to evaluate the coverage of SARS-CoV-2 vaccination among employees in China, explore their willingness to receive the SARS-CoV-2 variant vaccine and examine the potential factors influencing vaccination coverage and willingness.

METHODS

A cross-sectional epidemiological survey was conducted online from January 1, 2022, to January 30, 2022. The information collected in the survey included sociodemographic characteristics, lifestyle habits, vaccination coverage, willingness to be vaccinated against SARS-CoV-2 variants and the reasons for vaccination and willingness. Multivariable logistic regression models were used to assess the associations of potential factors with the rate of vaccination and the willingness to be vaccinated.

RESULTS

Among 62,395 eligible participants, the coverage of SARS-CoV-2 vaccination was 98.9% for at least one dose and 70.1% for a booster. The great majority of vaccinated individuals (94.4%) voluntarily received the vaccine. A total of 60,694 respondents (97.7%) were willing to be vaccinated against SARS-CoV-2 variants, mainly due to confidence in the effectiveness of vaccines (92.8%). A total of 1431 respondents were unwilling to be vaccinated, mainly because of concerns about the adverse effects of vaccines (77.6%). Longer education duration was associated with a higher rate of SARS-CoV-2 vaccination and willingness to be vaccinated. General or poor health status and having no history of influenza vaccination were associated with a lower rate of SARS-CoV-2 vaccination and willingness to be vaccinated. Additionally, we observed a significant positive association of abuse experience with the willingness to be vaccinated.

CONCLUSION

Although the rate of SARS-CoV-2 vaccination and the willingness to be vaccinated were relatively high in the study population, there were still some respondents with vaccine hesitancy. Relevant strategies based on significant related factors should be developed and implemented to encourage vaccination.

Predictors of receiving COVID-19 vaccine among adult population in Iran: an observational study

BACKGROUND

Vaccination is one of the best ways to stop the transmission of coronavirus disease 2019 (COVID-19). In this regard, uunderstanding the features related to the intention of different populations to receive the COVID-19 vaccine is essential for an effective vaccination program. This study aimed to investigate the vaccination intention predictors in the general adult population of Iran.

METHODS

A cross-sectional, web-based survey was conducted on social networks, including Telegram, WhatsApp, LinkedIn, Instagram, and Facebook. Multinomial logistic regression models were used to investigate predictors associated with the intention to receive COVID-19 vaccines, including sociodemographic characteristics, trust, worry, sources of information, and conspiracy beliefs. The main outcomes included unwillingness, undecidedness, and intention to receive the COVID-19 vaccine.

RESULTS

Out of 780 respondents, 481 (61.6%) reported an intention to be vaccinated, 214 (27.4%) expressed their undecided status, and 85 (10.9%) reported unwillingness to receive any type of COVID-19 vaccine. A higher age (OR undecided = 0.97, 95% CI (0.96-0.99)), (OR unwilling = 0.97, 95% CI (0.95-0.99)); exposure with COVID-19 (OR unwilling = 0.82, 95% CI (0.76-0.89)), (OR undecided = 0.87, 95% CI (0.83-0.93)) were positively associated with vaccination intentions. No/low trust in vaccines, institutions, concerns about the future of the pandemic, and conspiracy beliefs were strongly and negatively associated with COVID-19 vaccination intentions.

CONCLUSION

Most Iranians intended to get a COVID-19 vaccine. Higher vaccine acceptance needs to consider demographic features, exposure history, confidence in vaccines, trust in institutions, concerns, and conspiracy beliefs of people.

A Qualitative Comparative Analysis to explore the predictors of individuals' willingness towards vaccination

The emergence of COVID-19 traumatized individuals from all walks of life and while the demand for vaccines increased exponentially, the authorities seem to encounter greater challenges on their road to create herd immunity. Governments initiated numerous campaigns to influence individuals to opt for vaccination and India being a diverse country makes it difficult to understand the motivating factors for getting COVID-19 vaccination. The study aimed to explore the predictors of individuals' willingness to get vaccinated using Qualitative Comparative Analysis (QCA). After screening using the vaccine hesitancy scale, a semi-structured interview was conducted among 30 respondents from India. Crisp Set QCA was utilized to analyse the data which lead to nine conditions. A solution combination of seven conditions showed a consistency of 1 and coverage of 0.6. They included knowledge about vaccines, perceived severity of the COVID-19 virus, family and peer influence, media and health department's influence, a sense of social responsibility, trust in the authorities and vaccine efficacy. This study contributes to the relevance of QCA's use in psychological research, especially to identify predictors of willingness to immunize. The findings of this study would help in designing appropriate interventions to enhance willingness to get vaccinated.

Knowledge and Willingness to Accept Vasectomy as a Method of Family Planning among Married Male Workers in the University of Nigeria, Enugu Campus, Enugu State, Nigeria

BACKGROUND

Vasectomy is a safe and effective contraceptive option available to men, yet the practice is very low. The study aimed to assess the knowledge and willingness to accept vasectomy as a method of family planning among male married workers in a university in Enugu, Nigeria.

METHODS

This was a cross-sectional study conducted among 405 male married workers in a tertiary institution in Enugu, Nigeria. Samples were selected using multistage sampling technique. Data was collected using pretested structured questionnaire and analyzed using proportion, chi - square and logistic regression. Statistical significance was set at < 0.05.

RESULTS

Very few of the respondents, 10.6% had good knowledge of vasectomy and about 20.7% showed willingness to accept vasectomy as a contraceptive option. Educational level (AOR = 2.441, C.I = 1.158 - 5.146), wife support (AOR = 0.201, C.I = 0.071 - 0.571) and completed family size (AOR = 0.063, P = 0.030 - 0.136) were found to be the predictors of willingness to use vasectomy as a contraceptive among male workers of University of Nigeria, Enugu.

CONCLUSION

Knowledge of vasectomy and willingness to accept it as a contraceptive were found to be poor. Awareness campaign and health education on vasectomy and ensuring that family planning services are attended by couples with completed family size will improve knowledge and willingness to accept vasectomy.

Attitudes of Lebanese community-dwelling older adults towards deprescribing using the rPATD tool

OBJECTIVES

To assess the attitude of community-dwelling Lebanese older adults towards deprescribing using the Revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire and to determine patient-related factors that impact their willingness for deprescribing.

METHODS

A cross-sectional face-to-face survey was conducted in Lebanon over the period extending between October 2021 and March 2022 using the validated Arabic version of the rPATD questionnaire. It included ambulatory older adults who were 65 years of age or older, presenting to the community pharmacy, taking at least one chronic medication, and having intact cognition.

KEY FINDINGS

Of the 400 patients approached 300 (87%) agreed to participate. The mean age of participants was 65 (range 65-85 years) and 148 (56.3%) were females. The mean number of medications taken per patient was 5.8 ± 2.67 (range 1-18) and polypharmacy was reported among 188 patients (71.8%). Nearly all of study subjects 233 (89.0%) were willing to discontinue one or more of their regular medications if their physician said it was possible. The multivariate logistic regression analysis showed that the appropriateness of medications factor (OR= 3.9, 95% CI 1.308, 12.16, p=0.015) and patients' concern about stopping the medications factor (OR=0.116, 95% CI 0.033, 0.40, p = 0.001) were significantly associated with patients' willingness to deprescribe.

CONCLUSION

A noteworthy percentage of the Lebanese older outpatients were willing to stop one or more of their regular medications if their doctor recommends so. Patients' belief in appropriateness of medications and concerns about stopping were noted to significantly influence their willingness to deprescribe in this sample population.

Smartphone Ownership and the Willingness to receive Mobile Health Services among Patients with Hypertension in Nigeria

BACKGROUND

There are traditional barriers to accessing quality hypertension care in sub-Saharan Africa. Mobile phone technology is increasingly being used to overcome these barriers. This study assessed smartphone ownership and the willingness to receive mobile health services among patients with hypertension in Nigeria.

METHODS

Four hundred and twenty-seven (427) patients with hypertension were recruited from two tertiary health institutions in Ekiti State, Nigeria. Questionnaires were fed into the Open Data Kit form, which was used to take data on mobile phone ownership, the willingness to receive and the preferred type of mobile phone-based hypertension health care services.

RESULTS

Males were 37.2%. Mean age was 60.6 ± 15.3 years. Of the participants, 48.7% owned smartphones, 21.1% had regular internet subscription on their phones, 94.8% were willing to receive and pay mobile health services. Phone calls (48.0%) and text messages (31.6%) were the most preferred modes of receiving hypertension-related health education. Age category of 45-64 years was the only predictor of willingness to receive mobile health services.

CONCLUSION

All our participants owned mobile phones, with 48.7% being smartphones and almost all the participants were willing to receive and pay for mobile health services for prevention, treatment and information on hypertension. Middle age was the only predictor of willingness to receive mobile health, and the most preferred choices were through phone calls and text messages. The above information will guide in the design of favourable mHealth interventions that will be ideal for our study population.

Exploration of the external and internal factors that affected learning effectiveness for the students: a questionnaire survey

Learning effectiveness may be affected by internal and external factors, including personal attitude, motivations, learning skills, learning environment and peer pressure. This study sought to explore potential factors on students who majored in medical technology. The 106 students who completed their internship at Chang Gung Memorial Hospital were enrolled in this study. A written questionnaire was analyzed to explore the relationship between potential factors and learning effectiveness. The strength of relationship between the outcome and each factor was evaluated using Spearman correlation coefficients. A multiple linear regression model was constructed to assess how those factors affected learning effectiveness altogether. The results indicated that the learning effectiveness of the students mainly depended on three factors: the "extracurricular studies" and "willingness to cooperate" were positively associated with learning effectiveness. However, the "weakened motivation due to uncertainty" is negatively associated with learning effectiveness. We suggested that the educators can understand the uncertainty of students about the future. Additionally, the projects that require joint cooperation and discussion need to be given. The most important thing is that students should be able to integrate the learning content instead of rote.

Willingness to receive the COVID-19 vaccine among HIV positive men who have sex with men in China: a cross-sectional study

BACKGROUND

People living with HIV(PLWH) are deemed more vulnerable to the SARS-CoV-2 infection than the uninfected population. Vaccination is an effective measure for COVID-19 control, yet, little knowledge exists about the willingness of men who have sex with men (MSM) living with HIV in China to be vaccinated.

METHODS

This cross-sectional study evaluated the willingness of MSM living with HIV to receive COVID-19 vaccination in six cities of Guangdong, China, from July to September 2020. Factors associated with willingness to receive COVID-19 vaccination using multivariable logistic regression.

RESULTS

In total, we recruited 944 HIV-positive MSM with a mean age of 29.2 ± 7.7 years. Of all participants, 92.4% of them were willing to receive the COVID-19 vaccine. Participants who were separated, divorced, or widowed (adjusted OR: 5.29, 95%CI: 1.02-27.48), had an annual income higher than 9,000 USD (adjusted OR: 1.70, 95%CI: 1.01-2.86), had ever taken an HIV self-test (adjusted OR: 1.78, 95%CI: 1.07-2.95), had ever disclosed sexual orientation to a doctor/nurse (adjusted OR: 3.16, 95%CI: 1.33-7.50), had ever disclosed sexual orientation to others besides their male partners (adjusted OR: 2.18, 95%CI: 1.29-3.69) were more willing to receive the vaccine. Sex with a female partner in the past six months decreased the likelihood of willingness to receive the vaccine (adjusted OR: 0.40, 95%CI: 0.17-0.95). Economic burden, worry that my health condition could not bear the risk of receiving COVID-19 vaccines, and concern that the vaccination would affect the immune status and antiretroviral therapy were the main reasons for unwillingness to receive vaccination.

CONCLUSION

Our study showed that HIV-positive MSM had a high willingness to receive the COVID-19 vaccination. Targeted interventions such as health education should be conducted among MSM with HIV infection to enhance COVID-19 vaccine uptake.

Willingness of parents of 9-to-18-year-old females in China to vaccinate their daughters with HPV vaccine

OBJECTIVE

To assess knowledge about HPV and HPV vaccine, willingness to have their daughters receive HPV vaccine, and factors associated with knowledge and willingness among parents of females 9 to 18 years of age in China.

METHODS

We conducted a cross-sectional survey of parents with daughters 9 to 18 years of age in four provinces of China using a self-administered questionnaire. We used multivariable regression analyses to determine factors associated with willingness vaccinate.

RESULTS

We received completed surveys from 5,215 parents. Among respondents, 846 (16.24 %) had a high level of knowledge about HPV (total score ≥ 5). High level of HPV knowledge was associated with having daughters who were <15 years old; having experience paying out-of-pocket for other vaccines; being a mother; having higher educational achievement; being a medical staff member; being in a higher-income category; and residing in an urban area. There were 2,419 (46.39 %) parents who were willing to vaccinate their daughter against HPV and 2,757 (52.87 %) who were willing to receive vaccine themselves (for female respondents) or indicated willingness of their spouse to be vaccinated (for male respondents). Willingness of mothers to be vaccinated was associated with daughters' age being greater than 14 years; having previously purchased self-paid vaccines; having higher educational achievement; being in a higher-income category; having a higher level of knowledge; and residing in an urban area. Parental willingness to vaccinate daughters was associated with daughters' age being greater than 14 years, age of parents younger 40, a history of purchasing self-paid vaccines; higher educational achievement; having a higher level of knowledge; being willing to receive HPV vaccine (themselves or their spouse); and residing in an urban area.

CONCLUSIONS

Level of knowledge and willingness to have daughters vaccinated with HPV vaccine are low among Chinese parents. For universal HPV vaccination of females 9-18 years of age, it is necessary to educate parents about HPV and HPV vaccine, and to reduce the price of HPV vaccine.

Prevalence and factors associated with utilization of ayurvedic drugs during COVID-19. A community-based cross-sectional study

Background

COVID-19 pandemic emerged as a major public health emergency. Ayurvedic medicines are not generally considered as conventional medicine. Hence, we aimed to assess the prevalence of utilization of Ayurveda as prophylaxis for COVID-19 during the pandemic, factors associated with utilization, and willingness to use Ayurvedic medicines in future prospects.

Methods

This cross-sectional analytical study was conducted in urban Bengaluru, India from April to May 2022. The sample size of the study was 427. Systematic random sampling was done and data were collected using a validated semi-structured questionnaire.

Results

The mean (SD) age of the participants was 38.9 (±14.08) years. The proportion of utilization of ayurvedic medicines was 22.5% (n = 96, 95% CI 18.6-26.7) and social class was significantly associated with non-utilization (p = 0.042). Among the utilizers, 66% of them used Ayurvedic medicines for prevention/post-COVID ailments. More than half (55%, 95% CI 49.7-59.4) of the individuals were willing to use Ayurvedic medicines in the future and level of education was associated with unwillingness (p=0.010).

Conclusion

Nearly three-fourth of the participants were not utilized Ayurvedic medicines during COVID-19 pandemic. Strengthening ayurvedic services and improving awareness may increase the utilization in the community. An integrated health system approach at the policy level is pivotal in mainstreaming Ayurvedic medicines.

PERCEPTION AND WILLINGNESS TO THE UPTAKE OF COVID-19 VACCINE AMONG HOUSEHOLD-HEADS IN A RURAL COMMUNITY OF SOUTH-WESTERN NIGERIA

Background

The COVID-19 pandemic and its vaccine have been met with varying perceptions that may have both negative and positive effects on the willingness to uptake the COVID-19 vaccine. The study is set to determine the perception and willingness of the household heads to the uptake of COVID-19 vaccine in a rural community in Southwestern, Nigeria.

Materials and Methods

A cross-sectional study was carried out among 409 household heads selected through a multistage sampling technique. The instrument of data collection was a semi-structured interviewer-administered questionnaire using the Health Belief model constructs. Data were analyzed with IBM SPSS version 21.0 and Pearson's Chi-square test was used to determine the association between perception and willingness to uptake vaccine. P<0.05 was taken as significant at 95% confidence interval.

Results

The majority of the unvaccinated respondents in the study were not willing to take the COVID-19 vaccine (60.1%). There was a poor perception of the susceptibility/severity of unvaccinated respondents to COVID-19 infection and a poor perception of the benefit/barrier to the uptake of the COVID-19 vaccine. Perception of susceptibility and severity of COVID-19 infection were statistically related to the willingness to uptake the COVID-19 vaccine.

Conclusion

There should be an increase in awareness campaigns to change the perception of people positively to COVID-19 infection and uptake of the COVID-19 vaccine.

Wheelchair users' perceptions of a system enabling them to traverse rough terrain controlling their own wheelchair

We recently developed a dynamic mimicking system that mounts a user's wheelchair onto a carrier platform capable of performing required manoeuvres using the wheelchair's own controls. Two wheelchair user studies were performed to evaluate users' perception of their own wheelchair and the proposed system. The first user study included ten wheelchair users who were interviewed in order to map their current perceptions toward their wheelchair and their views about its shortcomings when traversing rough terrains. In the second study, the system was explained to 33 participants who were then exposed to three simulations of its main features. Participants were interviewed and the experimenter wrote down their answers, which were analysed using IBM SPSS Statistics 27 software. The conclusions are that special consideration should be given to motorized wheelchair users, and that the designers of the system should include a user interface that explains and demonstrates the system to users.

Acceptance of COVID-19 vaccine among healthcare workers in Africa, systematic review and meta-analysis

Objectives

This study is intended to assess healthcare workers' acceptance of the COVID-19 vaccine in Africa.

Study design

Systematic review and meta-analysis.

Method

The search was done using: PubMed, HINARI and Web of Science, African OnLine, and other gray and online repositories of Universities in Africa. All included articles were extracted and appraised using the standard data extraction sheet format of JOANNA Briggs Institute. Cochran Q test and I2 statistics test were used to test the heterogeneity of the studies. A Funnel plot and Egger's test were used to detect the publication bias of included studies. A Forest plot was used to present the pooled prevalence acceptance of the COVID-19 vaccine.

Result

In this systematic review and meta-analysis thirteen cross-sectional studies and one nationwide survey with a total population of 23,739 were included. The pooled estimated prevalence of healthcare workers' acceptance of the COVID-19 vaccine in Africa was 56.59 (95%CI; 46.26-66.92; I2 = 99.6%, p = 0.000). Subgroup analysis was done using the regions in Africa, willingness to accept the COVID-19 vaccine was highest in the South African region accounting for 74.64 (95%CI; 44.16-105.11) followed by the North African region at 66.68 (95% CI; 50.74-82.62).

Conclusion

The overall acceptance of the COVID-19 vaccine among healthcare workers in Africa was low. Thus, further duties should be unwavering to improve the COVID-19 vaccine acceptance by healthcare workers, through consistent and committed efforts in improving political commitment, amending strategies, improving awareness, and disclosing information about the safety, side effects, and effectiveness of the COVID-19 vaccine.

Willingness and motivations towards volunteering during the COVID-19 pandemic: A cross-sectional survey among final year medical students in Lagos, Nigeria

Introduction

Increasing manpower capacity to meet the demands in the healthcare system is important during health emergencies. Medical students have roles to play during a pandemic but their involvement in these duties should be voluntary. The objective of this study was to assess the willingness and motivations of final year medical students in Lagos, Nigeria towards volunteering during the COVID-19 pandemic.

Methods

A descriptive cross-sectional study was conducted among medical students in their sixth (final) year of study at the two public Universities in Lagos, Nigeria using total population sampling technique. A web-based questionnaire was used for data collection and data were analysed using SPSS. Logistic regression analysis was used to predict the willingness to volunteer.

Results

The mean age of the respondents was 23.4 years ± 2.6SD and 62.6% were female. About 65.9% of the medical students were willing to volunteer. Motivational factors which include self-rated good health status [OR: 2.1(95%CI: 1.16-3.6)], self-rated competence to work as a COVID-19 volunteer [OR: 6.5(95%CI: 3.61-11.54)] and availability of adequate protection and personal protective equipment [OR: 3.3(95%CI: 1.74-6.33)] significantly increased the odds of willingness to volunteer after controlling for other variables. Respondents' opinions on settings where medical students can serve as volunteers during the COVID-19 pandemic include case management (21.7%) and telemedicine (85.8%).

Conclusion

Medical students are willing to volunteer during the COVID-19 pandemic. There is a need to prepare and motivate the final year medical students by developing their skills to improve their competence and by providing adequate protection for the willing students to function as volunteers.

Willingness to accept herpes zoster vaccines and the influencing factors in China

BACKGROUND

Herpes zoster increases the burden on the elderly in an aging society. Although an effective vaccine licensed by China Food and Drug Administration in 2019 was introduced into the market in June 2020, the willingness and influencing factors of herpes zoster vaccines in Chinese adults ≥ 50-years-old during coronavirus disease-2019 pandemic are yet to be elucidated.

METHODS

An online questionnaire survey was conducted using a simple random sampling method in October 2021 for viewers of the broadcast program. A binary logistic regression and multiple response analysis were conducted for herpes zoster vaccine and vaccination willingness. Pareto's graphs were plotted to present the multiple-choice questions of influencing factors.

RESULTS

A total of 3838 eligible participants were included in this study. Among them, 43.02% intended to be vaccinated, including 10.34% self-reported about receiving at least one shot of shingles vaccine, 30.22% declined, and 26.76% were hesitant. This population comprised a large proportion of middle-aged and older people (≥ 50-years-old) who have not experienced an episode of herpes zoster (54.98%) or are unaware of the virus (33.22%). The strongest determinants of vaccine hesitancy among older people were education background of Master's degree or above compared to senior high or equivalent and below, personal monthly income < 3000 RMB compared to 3000-5999 RMB, and living in a rural area.

CONCLUSIONS

The willingness to get shingles vaccines can be improved further. Professional education and credible recommendation might prompt the elderly to improve their willingness and reassure them of the safety and efficacy of the vaccine. Also, accessibility and affordability should also be improved in the future.