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Underwood T, Hopkins KL, Sommers T, Howell C, Boehman N, Dockery M, Dubé È, Dhaliwal BK, Kazi AM, Limaye R, Qasim R, Seale H, Kitutu FE, Kanwagi R, Knobler S. Shaping global vaccine acceptance with localized knowledge: a report from the inaugural VARN2022 conference. BMC Proc 2023; 17:26. [PMID: 37798780 PMCID: PMC10552192 DOI: 10.1186/s12919-023-00280-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/07/2023] Open
Abstract
The first conference of the Vaccination Acceptance Research Network, VARN2022: Shaping Global Vaccine Acceptance with Localized Knowledge, was held virtually, from March 1st to 3rd 2022. This inaugural event brought together a global representation of experts to discuss key priorities and opportunities emerging across the ecosystem of vaccine acceptance and demand, from policies to programs and practice. Convened by the Sabin Vaccine Institute, VARN aims to support dialogue among multidisciplinary stakeholders to enhance the uptake of social and behavioral science-based solutions for vaccination decision-makers and implementers. The conference centered around four key themes: 1) Understanding vaccine acceptance and its drivers; 2) One size does not fit all: community- and context-specific approaches to increase vaccine acceptance and demand; 3) Fighting the infodemic and harnessing social media for good; and 4) Frameworks, data integrity and evaluation of best practices. Across the conference, presenters and participants considered the drivers of and strategies to increase vaccine acceptance and demand relating to COVID-19 vaccination and other vaccines across the life-course and across low-, middle- and high-income settings. VARN2022 provided a wealth of evidence from around the world, highlighting the need for human-centered, multi-sectoral and transdisciplinary approaches to improve vaccine acceptance and demand. This report summarizes insights from the diverse presentations and discussions held at VARN2022, which will form a roadmap for future research, policy making, and interventions to improve vaccine acceptance and demand globally.
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Affiliation(s)
| | - Kathryn L Hopkins
- Sabin Vaccine Institute, 2175 K Street NW, Suite 400, Washington DC, 20037, USA
| | - Theresa Sommers
- Sabin Vaccine Institute, 2175 K Street NW, Suite 400, Washington DC, 20037, USA.
| | - Cassidy Howell
- Sabin Vaccine Institute, 2175 K Street NW, Suite 400, Washington DC, 20037, USA
| | - Nicholas Boehman
- Sabin Vaccine Institute, 2175 K Street NW, Suite 400, Washington DC, 20037, USA
| | - Meredith Dockery
- Sabin Vaccine Institute, 2175 K Street NW, Suite 400, Washington DC, 20037, USA
| | - Ève Dubé
- Quebec National Institute of Public Health, Quebec City, Canada
| | - Baldeep K Dhaliwal
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Abdul M Kazi
- Department of Paediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Rupali Limaye
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Rubina Qasim
- Institute of Nursing & Midwifery, Dow University of Health Sciences, Karachi, Pakistan
| | - Holly Seale
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Freddy Eric Kitutu
- Department of Pharmacy, Makerere Unniversity School of Health Sciences, Kampala, Uganda
| | | | - Stacey Knobler
- Sabin Vaccine Institute, 2175 K Street NW, Suite 400, Washington DC, 20037, USA
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Guillaume D, Meyer D, Waheed DEN, Schlieff M, Muralidharan K, Chou VB, Limaye R. Factors influencing the prioritization of vaccines by policymakers in low- and middle-income countries: a scoping review. Health Policy Plan 2023; 38:363-376. [PMID: 36315461 DOI: 10.1093/heapol/czac092] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/27/2022] [Accepted: 10/28/2022] [Indexed: 11/04/2022] Open
Abstract
Vaccination decision making in low- and middle-income countries (LMICs) has become increasingly complex, particularly in the context of numerous competing health challenges. LMICs have to make difficult choices on which vaccines to prioritize for introduction while considering a wide range of factors such as disease burden, vaccine impact, vaccine characteristics, financing and health care infrastructures, whilst adapting to each country's specific contexts. Our scoping review reviewed the factors that influence decision-making among policymakers for the introduction of new vaccines in LMICs. We identified the specific data points that are factored into the decision-making process for new vaccine introduction, whilst also documenting whether there have been any changes in decision-making criteria in new vaccine introduction over the last two decades. A comprehensive database search was conducted using a search strategy consisting of key terms and Medical Subject Headings (MeSH) phrases related to policy, decision-making, vaccine introduction, immunization programmes and LMICs. Articles were screened following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 843 articles were identified, with 34 articles retained after abstract screening, full-text screening and grading with the mixed methods appraisal tool (MMAT). The Burchett framework for new vaccine introduction was used to identify indicators for vaccine-decision making and guided data extraction. Articles in our study represented a diverse range of perspectives and methodologies. Across articles, the importance of the disease, which included disease burden, costs of disease and political prioritization, coupled with economic factors related to vaccine price, affordability and financing were the most common criteria considered for new vaccine introduction. Our review identified two additional criteria in the decision-making process for vaccine introduction that were not included in the Burchett framework: communication and sociocultural considerations. Data from this review can support informed decision-making for vaccine introduction amongst policymakers and stakeholders in LMICs.
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Affiliation(s)
- Dominique Guillaume
- International Vaccine Access Center, Johns Hopkins University, 415 N Washington St. 5th floor, Baltimore, MD 21231, USA
- Jhpiego, a Johns Hopkins University Affiliate, 1615 Thames St. # 200, Baltimore, MD 21231, USA
- School of Nursing, Johns Hopkins University, 525 N. Wolfe St., Baltimore, MD 21205, USA
| | - Diane Meyer
- School of Nursing, Johns Hopkins University, 525 N. Wolfe St., Baltimore, MD 21205, USA
- Center for Health Security, Johns Hopkins Bloomberg School of Public Health, 621 E. Pratt St., Baltimore, MD 21201, USA
| | - Dur-E-Nayab Waheed
- Center for the Evaluation of Vaccination, University of Antwerp, Drie Eikenstraat 663, Antwerp, Edegem 2650, Belgium
| | - Meike Schlieff
- International Vaccine Access Center, Johns Hopkins University, 415 N Washington St. 5th floor, Baltimore, MD 21231, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Suite E8527, Baltimore, MD 21205, USA
| | - Kirthini Muralidharan
- International Vaccine Access Center, Johns Hopkins University, 415 N Washington St. 5th floor, Baltimore, MD 21231, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Suite E8527, Baltimore, MD 21205, USA
| | - Victoria B Chou
- International Vaccine Access Center, Johns Hopkins University, 415 N Washington St. 5th floor, Baltimore, MD 21231, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Suite E8527, Baltimore, MD 21205, USA
| | - Rupali Limaye
- International Vaccine Access Center, Johns Hopkins University, 415 N Washington St. 5th floor, Baltimore, MD 21231, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Suite E8527, Baltimore, MD 21205, USA
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Uttekar S, MacDonald N, Orenstein WA, Danchin M, Blaser V, Thomson A, Menning L, Shimp L, Rath B, Limaye R, Esangbedo D, Abeyesekera S, Malue Nielsen S, Mackay S, Purnat T, Duraisamy K, Karthickeyan V, Siddique A, Thacker N. Empowering Health Workers to Build Public Trust in Vaccination: Experience from the International Pediatric Association's Online Vaccine Trust Course, 2020-2021. Vaccine 2023; 41:435-443. [PMID: 36470688 DOI: 10.1016/j.vaccine.2022.11.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND The quality of interactions between health workers (HWs) and caregivers is key in vaccine acceptance. To optimize this, HWs need knowledge about best vaccine communication practices in person and on social media. Most pre-service curricula do not include such approaches. COVID-19 necessitated the International Pediatric Association (IPA) to shift from in-person train the trainer workshops to developing an online Vaccine Trust Course to address these gaps. METHOD The seven-module, 8-hour Vaccine Trust Course was offered online in seven languages and promoted globally. Course outcomes for participants between September 1, 2020 and September 30, 2021 were assessed using enrollment, participation, and completion data; pre-and post-training surveys of attitudes, knowledge, and practice skills; and follow-up practice surveys 3 months post course completion. RESULTS Of the 4,926 participants across 137 countries who registered; 2,381 (48.3 %) started the course, with 1,217 (51.1 %) completing. The majority were 25 - 39 years (57 %), female (57 %), and in pediatrics (70 %); 31 % came from India. 62 % of completers rated course structure/design as excellent, 36 % as good. Over 80 % rated the content as the most valuable aspect. Three months post training, 61 % HWs reported increased empathy towards caregivers, confidence while counseling and increased vaccine acceptance amongst their patients. 21 % identified the course as the only factor in these positive changes. CONCLUSION Shifting from face-to-face to online training due to the COVID-19 pandemic helped increase the global reach of HWs course engagement and uptake. Trained HWs reported increased empathy towards caregivers and confidence while counseling and increased patient vaccine acceptance.
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Affiliation(s)
| | - Noni MacDonald
- Department of Pediatrics, Dalhousie University, IWK Health Centre, 5850/5980 University Ave, Halifax, Nova Scotia B3K 6R8, Canada
| | | | - Margie Danchin
- Murdoch Children's Research Institute, Flemington Road, Parkville, Victoria 3052, Australia; The University of Melbourne, Parkville, Victoria, Australia; Royal Children's Hospital, Parkville, Victoria, Australia
| | - Vince Blaser
- Sabin Vaccine Institute, Washington, DC 20037, United States
| | | | | | - Lora Shimp
- John Snow, Inc., 2733 Crystal Drive, 4th Floor, Arlington, VA 22202, United States
| | - Barbara Rath
- Vaccine Safety Initiative, Berlin, Germany; Université de Bourgogne Franche Comté, 32 Av. de l'Observatoire, 25000 Besançon, France
| | - Rupali Limaye
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., E5521, Baltimore, MD 21205, United States
| | | | | | - Siff Malue Nielsen
- World Health Organization Regional Office for Europe, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark
| | | | - Tina Purnat
- World Health Organization, Geneva, Switzerland
| | | | | | - Aninda Siddique
- University of Toronto, 27 King's College Cir, Toronto, ON M5S 1A1, Canada
| | - Naveen Thacker
- International Pediatric Association, Gandhidham, Gujarat, India; Deep Child Hospital and Research Centre, Plot No. 208, Sector 1A, Gandhidham, Gujarat, India.
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Waheed DEN, Bolio A, Guillaume D, Sidibe A, Morgan C, Karafillakis E, Holloway M, Van Damme P, Limaye R, Vorsters A. Planning, implementation, and sustaining high coverage of human papillomavirus (HPV) vaccination programs: What works in the context of low-resource countries? Front Public Health 2023; 11:1112981. [PMID: 37124764 PMCID: PMC10140426 DOI: 10.3389/fpubh.2023.1112981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/17/2023] [Indexed: 05/02/2023] Open
Abstract
Cervical cancer due to human papillomavirus (HPV) infection is a leading cause of mortality among women in low-resource settings. Many Sub-Saharan African countries have introduced HPV vaccination programs at the national level in the last few years. However, countries are struggling to maintain sustainable coverage. This study focuses on the introduction and sustainability challenges, context-specific key lessons learned, and mechanisms of action to achieve high sustainable coverage from low and lower-middle-income countries (LLMICs) that have introduced HPV vaccination programs by collating evidence from a literature review and key informant interviews. Local data availability was a challenge across countries, with the lack or absence of registries, data collection and reporting mechanisms. Multi-sectoral coordination and early involvement of key stakeholders were cited as an integral part of HPV programs and facilitators for sustainable coverage. Key informants identified periodic sensitization and training as critical due to high staff turnover. Health workforce mobilization was fundamental to ensure that the health workforce is aware of the disease etiology, eligibility requirements, and can dispel misinformation. Schools were reported to be an ideal sustainable platform for vaccination. However, this required teachers to be trained, which was often not considered in the programs. District-level staff were often poorly informed and lacked the technical and logistic capacity to support vaccination rounds and data collection. To improve the sustainability of HPV vaccination programs, there is a need for timely microplanning, efficient preparedness assessment, assessing training approaches, periodic training, finding innovative ways to achieve equity and adoption of a bottom-up approach to ensure that processes between districts and central level are well-connected and resources are distributed efficiently.
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Affiliation(s)
- Dur-E-Nayab Waheed
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium
- *Correspondence: Dur-E-Nayab Waheed,
| | - Ana Bolio
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Dominique Guillaume
- Jhpiego, The Johns Hopkins University Affiliate, Baltimore, MD, United States
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Center for Infectious Disease and Nursing Innovation, School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Anissa Sidibe
- Department of Vaccine Programmes, Gavi, the Vaccine Alliance, Geneva, Switzerland
| | - Christopher Morgan
- Jhpiego, The Johns Hopkins University Affiliate, Baltimore, MD, United States
- Nossal Institute for Global Health, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Emilie Karafillakis
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Megan Holloway
- Department of Vaccine Programmes, Gavi, the Vaccine Alliance, Geneva, Switzerland
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium
| | - Rupali Limaye
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Alex Vorsters
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium
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Guillaume D, Waheed DEN, Schlieff M, Muralidharan K, Vorsters A, Limaye R. Key decision-making factors for human papillomavirus (HPV) vaccine program introduction in low-and-middle-income-countries: Global and national stakeholder perspectives. Hum Vaccin Immunother 2022; 18:2150454. [PMID: 36485172 PMCID: PMC9766470 DOI: 10.1080/21645515.2022.2150454] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Low-and-middle-income countries (LMICs) experience a high burden of cervical cancer. The human papillomavirus (HPV) vaccine prevents high-risk strains of HPV that cause cervical cancer; however, the integration of HPV vaccines into national immunization programs within many LMICs has been suboptimal. Our study evaluated key factors that drive the decision-making process for the implementation of HPV vaccine programs in LMICs. Stakeholder analysis and semi-structured in-depth interviews were conducted with national and global stakeholders. Interview data were analyzed through qualitative descriptive methods. Findings from our study revealed the decision-making process for HPV vaccines requires the involvement of multiple institutions and stakeholders from national and global levels, with decision-making being a country-specific process. Partner considerations, locally driven processes, availability of data, and infrastructure and resource considerations were found to be critical factors in the decision-making process. Future programs should evaluate the best approaches for investing in initiatives to enhance coordination, ensure vaccine introduction is locally driven, increase the availability of data needed for decision-making, and equip countries with the necessary resources to guide country decision-making in the face of increasingly complex decision-making environments.
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Affiliation(s)
- Dominique Guillaume
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Jhpiego, A Johns Hopkins University Affiliate, Baltimore, MD, USA,School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Dur-e-Nayab Waheed
- Center for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium,HPV Prevention and Control Board, University of Antwerp, Antwerp, Belgium
| | - Meike Schlieff
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kirthini Muralidharan
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alex Vorsters
- Center for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium,HPV Prevention and Control Board, University of Antwerp, Antwerp, Belgium
| | - Rupali Limaye
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,CONTACT Rupali Limaye International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
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Weiger C, Moran MB, Kennedy RD, Limaye R, Cohen J. Beliefs and Characteristics Associated With Believing Nicotine Causes Cancer: A Descriptive Analysis to Inform Corrective Message Content and Priority Audiences. Nicotine Tob Res 2022; 24:1264-1272. [PMID: 35385112 PMCID: PMC9278833 DOI: 10.1093/ntr/ntac060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/27/2022] [Accepted: 03/02/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Many cigarette smokers want to quit but have not. Switching to noncombustible products can reduce disease risk, but misperceptions that nicotine causes cancer might impact relative harm perceptions about noncombustible products and considering switching. Identifying which smokers are most likely to hold this misperception and associated beliefs can inform the content of and priority audiences for corrective messaging. METHODS Bivariable log binomial models were run on a sample of 9,013 adult established smokers from Wave 3 of the Population Assessment of Tobacco and Health. Post hoc testing identified groups and beliefs associated with significantly higher-than-average prevalence of the misperception. RESULTS About 61.2% of smokers believe nicotine causes cancer or don't know. Non-Hispanic Black (PR: 2.09) and Hispanic (PR: 1.73) smokers, as well as those making under $10,000 a year (PR: 1.36) had significantly higher-than-average prevalence of the misperception. Smokers who had recently used ENDS or smokeless tobacco had significantly lower-than-average prevalence of the misperception (PR: 0.70 and 0.63, respectively). Prevalence of nicotine misperceptions was significantly higher-than-average among those who recognized all ten smoking-caused diseases (PR: 1.34), believed additive-free cigarettes were more harmful than regular cigarettes (PR: 1.71), or did not report subjective norms supporting noncombustible use (PR: 1.05). CONCLUSION High perceived threat of tobacco may be overgeneralized to nicotine. High prevalence of the misperception among Non-Hispanic Black and low-income smokers is concerning, considering existing health disparities. Messaging should attempt to correct the misperception that nicotine causes cancer. Inferential reasoning after message exposure should assess accuracy of relative harm perceptions. IMPLICATIONS The current study supports the need for corrective messaging to address the misperception that nicotine causes cancer. Identifying that nicotine misperceptions are associated with higher harm perceptions about tobacco suggests that there may be unintended consequences of high perceived harm of tobacco that need to be addressed. As nicotine misperceptions are significantly more prevalent among those already at higher risk of tobacco caused diseases, care should be taken to ensure equity in message dissemination.
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Affiliation(s)
- Caitlin Weiger
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA
| | - Meghan Bridgid Moran
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA
| | - Ryan David Kennedy
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, 2213 McElderry St., 4th Floor, Baltimore, MD, USA
| | - Rupali Limaye
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USA
| | - Joanna Cohen
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, 2213 McElderry St., 4th Floor, Baltimore, MD, USA
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Latkin C, Dayton L, Yi G, Jaleel A, Nwosu C, Limaye R. COVID-19 vaccine delay: An examination of United States residents' intention to delay vaccine uptake. Hum Vaccin Immunother 2021; 17:2903-2913. [PMID: 34014130 DOI: 10.1080/21645515.2021.1917234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The current study examines differences between COVID-19 vaccine intention and delay. A survey was administered to 585 US respondents in late November 2020 as part of an online longitudinal study. Respondents provided information on whether they would obtain a COVID-19 vaccine, once available, and how long they intended to wait before obtaining it. In the negative intention group, 3.4% reported waiting a few weeks, 34.0% waiting a few months, and 62.6% never getting vaccinated. In multivariable models, social norms were a significant and independent predictor of all vaccine delay and intention models. Vaccine delay was associated with low levels of worry about becoming infected with COVID-19, political conservatism, concerns about vaccine side effects, and low levels of believing a vaccine would be effective. Negative vaccine intentions were associated with worries about becoming infected with COVID-19, concerns about vaccine side effects, beliefs that the vaccines were developed too quickly, and low endorsement of the altruistic belief that older people should have vaccination priority. The study results highlight the importance of a multifactorial approach to assessing vaccine attitudes. The findings suggest that uptake programs should focus on enhancing pro-vaccine norms.
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Affiliation(s)
- Carl Latkin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.,Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lauren Dayton
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Grace Yi
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Afareen Jaleel
- Krieger School of Arts & Science, Johns Hopkins University, Baltimore, MD, USA
| | - Chikaodinaka Nwosu
- Krieger School of Arts & Science, Johns Hopkins University, Baltimore, MD, USA
| | - Rupali Limaye
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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OLeary ST, Ellingson M, Spina C, Brewer SE, Quick L, Chamberlain A, Limaye R, Orenstein W, Salmon D, Omer S. 2735. Improving Uptake of Maternal Immunizations in the Obstetric Care Setting Through an Adaptation of the CDC’s Immunization Quality Improvement Program (AFIX). Open Forum Infect Dis 2019. [PMCID: PMC6809483 DOI: 10.1093/ofid/ofz360.2413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Methods Results Conclusion Disclosures
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Affiliation(s)
- Sean T OLeary
- University of Colorado School of Medicine, Denver, Colorado
| | | | | | | | - Lori Quick
- Colorado Department of Public Health and Environment, Denver, Colorado
| | | | - Rupali Limaye
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Daniel Salmon
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Page KR, Grieb SD, Nieves-Lugo K, Yamanis T, Taylor H, Martinez O, Yamasaki Y, Limaye R, Davis W, Beyrer C, Zea MC. Enhanced immigration enforcement in the USA and the transnational continuity of HIV care for Latin American immigrants in deportation proceedings. Lancet HIV 2018; 5:e597-e604. [PMID: 29997050 PMCID: PMC6211169 DOI: 10.1016/s2352-3018(18)30074-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 04/09/2018] [Accepted: 04/16/2018] [Indexed: 06/08/2023]
Abstract
In our work as clinicians, researchers, and immigrant rights advocates, we have noted increased anxiety about the possibility of deportation and disruptions in care among immigrants with HIV. Before the 2016 US elections, patients rarely asked about HIV treatment in their home countries. However, since the increase in anti-immigrant rhetoric and arrests by US Immigration and Customs Enforcement, patients have voiced concerns about the availability of HIV treatment in their home countries much more frequently. Although antiretroviral therapy is available throughout Latin America, access depends on economic, social, and political circumstances. Maintaining uninterrupted continuity of care among immigrants held in detention or deported to their home countries is challenging. In this Viewpoint, we identify periods of particular vulnerability for immigrants during deportation proceedings, from initial detention to deposition in their country of origin. We discuss the effect of enhanced immigration enforcement on the health and wellbeing of HIV-infected immigrants, and on public health. Finally, we also discuss recommendations for clinicians, immigration authorities, and public health institutions in the USA and in receiving countries.
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Affiliation(s)
- Kathleen R Page
- Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
| | - Suzanne Dolwick Grieb
- Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Holly Taylor
- Bloomberg Johns Hopkins School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Rupali Limaye
- Bloomberg Johns Hopkins School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Chris Beyrer
- Bloomberg Johns Hopkins School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Tunstall C, Laing P, Limaye R, Walker C, Kendall S, Lavalette D, Mackenney P, Adedapo A, Al-Maiyah M. 1st metatarso-phalangeal joint arthroplasty with ROTO-glide implant. Foot Ankle Surg 2017; 23:153-156. [PMID: 28865582 DOI: 10.1016/j.fas.2017.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/10/2017] [Accepted: 07/12/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Total joint replacement of the 1st metatarso-phalangeal Joint (MTPJ) has been controversial as arthrodesis remains a good option for patients with end stage 1st MTPJ arthritis. We present a multi centre service evaluation of the ROTO-glide device METHODS: 33 ROTO-glide procedures were carried out in 30 patients across 7 sites within the UK. Exclusion criteria - hallux valgus and arthritis, age below 45 years and over 80 years, inflammatory joint disease. Patient assessed pre and post operatively with AOFAS and Oxford forefoot (MOXFQ) scores and plain radiographs. All patients carried out the same post operative protocol RESULTS: Average age at patients was 58.6 years (45-77). Follow up average was 16.9 months (12-29). Pre-op AOFAS scores average 41.4 (17-67) and post op average 76 (29-100) and the MOXFQ summary index decreased from an average of 43 (20-64) pre op to an average of 17 (0-51) post op. Average total range of motion pre operatively was 32° and post operatively was 61°. There were 2 post operative complications but no revisions were necessary. CONCLUSIONS The early results of this multi centre service evaluation of the ROTO-glide 1st MTPJ replacement support its continued use and evaluation of the prosthesis further.
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Affiliation(s)
- C Tunstall
- Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, Shropshire SY10 7AG, United Kingdom.
| | - P Laing
- Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, Shropshire SY10 7AG, United Kingdom; Wrexham Maelor Hospital, Croesnewydd Road, Wrexham LL13 7TD, United Kingdom
| | - R Limaye
- North Tees and Hartlepool NHS Foundation Hospital Trust, Hardwick Road, Stockton-on-Tees, Cleveland TS19 8PE, United Kingdom
| | - C Walker
- Royal Liverpool University Hospital, Prescot Street, Liverpool, Merseyside L7 8XP, United Kingdom
| | - S Kendall
- New Victoria Hospital, 184-188 Coombe Lane West, Kingston-upon-Thames, Surrey KT2 7EG, United Kingdom
| | - D Lavalette
- Harrogate District Hospital, Lancaster Park Road, Harrogate, North Yorkshire HG2 7SX, United Kingdom
| | - P Mackenney
- South Tees University Hospital, Marton Road, Middlesborough TS4 3BW, United Kingdom
| | - A Adedapo
- South Tees University Hospital, Marton Road, Middlesborough TS4 3BW, United Kingdom
| | - M Al-Maiyah
- South Tees University Hospital, Marton Road, Middlesborough TS4 3BW, United Kingdom
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Limaye R, Ballard A, Futrell E, Ahmed N, Ohkubo S. New Narratives in Global Health: Using Stories and Storytelling to
Promote Family Planning. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Ohkubo S, Limaye R, Ahmed N, Ballard A. Blended Learning on Family Planning Policy Requirements: Key Findings and
Implications from a Mixed Methods Study. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kaufman MR, Rimal RN, Carrasco M, Fajobi O, Soko A, Limaye R, Mkandawire G. Using social and behavior change communication to increase HIV testing and condom use: the Malawi BRIDGE Project. AIDS Care 2014; 26 Suppl 1:S46-9. [PMID: 24735337 DOI: 10.1080/09540121.2014.906741] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
While overall HIV prevalence in Malawi has decreased, it is still high in the southern region of the country. Behavioral prevention activities are crucial to continue the reduction in HIV prevalence. Behavior change is influenced by many factors. Previous work indicates knowledge about HIV transmission, self-efficacy to protect oneself from exposure, and accurate risk perception of one's susceptibility all impact sexual behavior. The current study looks at the effects of a behavior change communication program in Malawi called the BRIDGE II Project on psychosocial and behavioral variables. The program sought to address barriers to individual action and confront societal norms related to sexual risk behavior through a mix of community-based activities and mass media messages delivered through local radio stations. Using cohort data (n = 594), we examined the effect of BRIDGE exposure on three variables that affect HIV behaviors: knowledge, self-efficacy, and risk perception, as well as two behavioral outcomes: HIV testing and condom use at last sex. Data were collected at baseline and for a midterm evaluation. Regression analyses showed exposure to BRIDGE was significantly associated with knowledge level (β = 0.20, p < .001) and self-efficacy (β = 0.35, p < .001) at midterm when controlling for baseline scores, but not risk perception. Psychosocial variables did not show a significant relationship to either behavioral outcome. However, program exposure was a significant predictor of both HIV testing in the past year (odds ratio [OR] = 1.40, p < .001) and condom use at last sex (OR = 1.26, p < .05). This study suggests such a communication intervention may play an important role in not only affecting HIV-related behaviors themselves, but also critical factors that affect HIV behaviors, including knowledge and self-efficacy. It is recommended that communication efforts around HIV risk reduction be increased.
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Affiliation(s)
- Michelle R Kaufman
- a Johns Hopkins University Bloomberg School of Public Health , Center for Communication Programs , Baltimore , MD , USA
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Patel SA, Bangorn S, Aramrattana A, Limaye R, Celentano DD, Lee J, Sherman SG. Elevated alcohol and sexual risk behaviors among young Thai lesbian/bisexual women. Drug Alcohol Depend 2013; 127:53-8. [PMID: 22770462 PMCID: PMC3486947 DOI: 10.1016/j.drugalcdep.2012.06.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 05/21/2012] [Accepted: 06/07/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Little empirical data have been published about drinking or sexual behaviors among Thai lesbians. We examine the association of sexual identity with established indicators of alcohol- and sexual-related health behaviors among female bar patrons. METHODS We conducted a cross-sectional study among women (N=121) aged 18-24 who frequented popular drinking establishments in Chiang Mai, Thailand. We used general linear modeling techniques to estimate associations between sexual identity and positive alcohol expectancy, harmful drinking, age at sexual debut, and number of lifetime sexual partners. RESULTS Nearly one-third of women aged 18-24 recruited from Chiang Mai drinking venues identified as lesbian/bisexual. As compared to their heterosexual counterparts, lesbian/bisexuals reported higher positive alcohol expectancy scores, more harmful drinking, earlier age at sexual debut, and higher number of lifetime sexual partners. In adjusted models, lesbian/bisexual identity was associated with higher positive alcohol expectancy (β=1.94 points; 95% CI: 0.75, 3.13), earlier age at sexual debut (β=-0.85 years; 95% CI: -1.46, -0.23), and higher number of lifetime sexual partners (rate ratio=1.70; 95% CI: 1.22, 2.37). CONCLUSION Lesbian/bisexual women in this study engaged in multiple behaviors that are potentially harmful to health, which may in turn place this group at heightened risk for alcohol abuse and sexually transmitted infections in Thailand. The clustering of alcohol- and sexual-related risk behaviors, and its consequences for health outcomes in this population, should be explored in future research and may be an important point of intervention.
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Affiliation(s)
- Shivani A. Patel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore Maryland, 21205, USA
| | - Sirirojn Bangorn
- Research Institute for Health Sciences, Chiang Mai University, 110 Intavarorose, Muang, Chiang Mai, 50202, Thailand
| | - Apinun Aramrattana
- Research Institute for Health Sciences, Chiang Mai University, 110 Intavarorose, Muang, Chiang Mai, 50202, Thailand
| | - Rupali Limaye
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore Maryland, 21205, USA
| | - David D. Celentano
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore Maryland, 21205, USA
| | - Jennifer Lee
- Wilmer Eye Institute, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287
| | - Susan G. Sherman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore Maryland, 21205, USA
- Corresponding author: Susan G. Sherman, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore Maryland, 21205, USA, Phone: 410-614-3518, Fax: 410-955-1383,
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Limaye R, Sen PK. Stimulated Brillouin scattering in magnetized direct-gap semiconductors. Phys Rev B Condens Matter 1995; 51:1546-1552. [PMID: 9978870 DOI: 10.1103/physrevb.51.1546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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