Potential motivators affecting parental intention in COVID-19 vaccination for children aged 6 months to 4 years: Implications for targeted vaccine interventions in Japan

Although COVID-19 vaccination was approved for younger children in Japan in October 2022, uptake rates remain critically low. This study aimed to investigate Japanese parents' intentions, hesitators' probability of positive intention change, and factors that motivate COVID-19 vaccination. Parents with a 6-month to 4-year-old child living in Japan participated in this internet-based, cross-sectional survey conducted from December 19, 2022, to January 4, 2023. The modified Poisson regression analysis was used to assess the probabilities of changing intention by each motivator when comparing the degree of hesitancy among hesitators, and the Poisson generalized estimating equations were used to compare the probabilities of changing intentions by potential motivators within hesitant individuals. Among 12,502 participants, 10,008 (80.1%) were hesitators. Parents with lower hesitancy levels were more likely to be motivated to vaccinate their children through potential motivators. Vaccine hesitators were motivated to vaccinate their children, particularly by proven vaccine effectiveness (including "protecting children from getting sick" with a probability ratio [PR] of 3.7 [95% confidence interval (CI) 3.5-3.9] and "less likely to infect adults" with a PR of 2.9 [95% CI 2.8-3.1]), as well as vaccine safety (including "safe vaccination of millions of children" with a PR of 3.1 [95% CI 3.0-3.3]) compared to injunctive norm (including "community leader recommendation"). Therefore, initially addressing parents with low hesitancy levels is an effective strategy that motivates COVID-19 vaccination. Also, providing evidence-based information about COVID-19 vaccine efficacy and safety that is consistent with parents' needs is crucial.

Factors Affecting Physical Activity in People with Dementia: A Systematic Review and Narrative Synthesis

Physical activity (PA) has positive effects on the physical and cognitive functioning of people with dementia. Knowledge about what limits and stimulates people with dementia to participate in PA is essential to promote effective PA implementation and enhance PA levels. Previous reviews primarily included opinion-based studies, using data from interviews, focus groups or dyads. By including implementation studies, we aimed to elaborate on previous reviews by identifying new barriers to PA and new facilitators and motivators for PA. We conducted systematic searches in Pubmed, PsychInfo and Web of Science for studies published up to the 21st of September 2021. Search terms were related to the population of people with dementia, PA interventions and implementation outcomes. Studies were included if PA participation was investigated during actual PA implementation. No restrictions were made regarding study design, date of publication, PA type or outcome measures. Studies not implementing PA or not evaluating the implementation were excluded. Based on 13 empirical studies, we identified 35 barriers, 19 facilitators and 12 motivators. Of these, 21 barriers, 11 facilitators and 4 motivators were not identified by previous reviews. New factors are related to the support for people with dementia from informal and formal caregivers, e.g., revealing the importance of a trusting relationship. Furthermore, support for staff from the institution or an external party is needed to overcome doubts about PA, for example, related to safety and effects. New factors also suggested specific recommendations for the content and organization of the PA intervention, for instance, related to how to give instructions. Overall, factors affecting PA identified with opinion-based or implementation studies are complementary. Our extended overview shows the complexity of PA implementation and may help to personalize PA, develop implementation strategies, facilitate actual PA implementation and free up resources needed for effective implementation.

Understanding Older Adults' Experiences With Technologies for Health Self-management: Interview Study

BACKGROUND

Many older adults now use technologies such as wearable devices and telehealth services to support their health and well-being while living independently at home. However, older adults vary in how they use these technologies, and there is a lack of knowledge regarding the motivations that influence their acceptance and use of health-related technologies in home environments.

OBJECTIVE

This study aimed to understand the types of technologies that older adults use to support their health and the factors that motivate them to use their chosen technologies to support their health. In addition, we aimed to understand the factors that enable the effective use of technologies for health self-management and to identify the barriers that can negatively affect the adoption of technologies.

METHODS

A total of 22 older adults participated in semistructured interviews regarding their experiences of using technologies for health self-management. Interview transcripts were analyzed through an in-depth thematic analysis.

RESULTS

The interviews revealed that a range of technologies, such as videoconferencing software, fitness trackers, and other devices, were being used by older adults to support their health. Interviews showed that participants were motivated to use technologies to monitor health issues, to stay active and connected, and to record and change their behavior in the light of foreseen risks related to their future health status. Enablers that facilitated the effective use of technologies include social and organizational influence, convenient access to health care and safety provided by the technology, and easy setup and low cost of the technology. Barriers include information overload and a sense of futility about future health decline; telehealth being an inadequate substitute for in-person consultation; concerns about trust related to privacy and accuracy; and technologies being stigmatizing, uncomfortable to use, expensive, and unfamiliar.

CONCLUSIONS

This study suggested that older adults were using a variety of technologies to prevent or prepare for future health decline, evidencing a resilient attitude toward health and aging. In addition, older adults were willing to continue using the technology when there was a perceived need. The enabler mentioned by most participants was the social and organizational influence that included health care staff, family, friends, and organizations. This analysis provides a better understanding of how older adults use technologies to support their health and can guide the provision of appropriate health technologies for them.

Differential Patterns in Motivations for Practicing Sport and Their Effects on Physical Activity Engagement across the Lifespan

This study aims to report what motivates individuals to be physically active, to determine whether motivating factors influence physical activity (PA) levels, and whether this differs across the lifespan. This is a cross-sectional study with 498 individuals: 117 adolescents, 306 adults, and 75 older adults. PA was assessed using Baecke’s questionnaire, and motivating factors for practicing sports were investigated using a scale with twelve questions. The factor analysis identified three motivating factors for sports practice: psychosocial, bodily, and well-being. The scale’s overall reliability and internal consistency indicated a Cronbach’s alpha of 0.885. The analysis of covariance (ANCOVA) adjusted for sex indicated the three factors as having a significant effect on PA (p < 0.050); however, only the well-being factor showed a significant interaction with age groups (p = 0.023, ηp2 = 0.030). Subsequently, the effect of the well-being factor on PA scores in each age group was explored through regression analyses. Only older adults showed a significant association in the unadjusted [OR = 0.378, p = 0.001, R2 = 0.243] and the sex-adjusted analysis [OR = 0.377, p = 0.001, R2 = 0.288]. These results help us to better understand the underlying motivational reasons in different age groups for engaging in sports.

Factors Influencing the Consumption of Seaweed amongst Young Adults

Seaweed has been traditionally consumed in Asian and Pacific cultures, yet aside from sushi, is still not commonly eaten in Western societies. Edible seaweeds offer distinct nutritional benefits to terrestrial crops, particularly with respect to mineral and fibre content. Understanding the motivations that drive young Australians to eat seaweed is necessary for food product development and consumer marketing strategies, as well as informing future sustainable production through seaweed aquaculture and wild-harvest practices. An observational cross-sectional online survey with n = 1403 young (19–30 years) Australian seaweed consumers was conducted. The 19-item survey included closed-ended, open-ended, and Likert scale responses. Most respondents were female (89.0%), with tertiary level education or above (57.7%). Seaweed was eaten mostly as a snack (87.7%) and in home-prepared meals (30.7%). The key advantages to consumption were flavour (89.1%), nutrient content (49.1%), and health benefits (44.6%), whilst the key barriers were poor accessibility (59.5%), unaffordable pricing (46.5%), and undesirable packaging (19.0%). The consumers reported wanting more promotion to improve their knowledge about seaweed, in addition to environmentally sustainable packaging and sourcing. Pathways to overcome barriers and encourage greater seaweed consumption are discussed. Most critically, improving the promotion and environmental sustainability of seaweed products will improve intake amongst current and future consumers.

Subjective Theories of Chinese Office Workers With Irregular Physical Activity: An Interview-Based Study

Objectives

Individuals with irregular physical activity (PA) participation are defined as fluctuators. This study aimed to comprehend how fluctuators’ perceived barriers and motivators in their subjective theories are exhibited and cognitively represented in relation to their everyday PA practices and lapses.

Methods

The design of “Research Program Subjective Theories” was used to explore and present fluctuators’ cognition concerning PA participation. Thirty fluctuators were invited to a semi-structured interview. By inductive and deductive coding, fluctuators’ verbal data were converted into word categories for extracting commonalities and comparing differences. By retaining the remaining word categories of high frequency and exploring the interrelationships among the remained word categories using statistical analyses, a superstructure (i.e., visualized representation of fluctuators’ overall cognition) including fluctuators’ main PA motivators, barriers, and behavioral outcomes was compiled.

Results

Fluctuators face common motivators as barriers, such as lack of time, lack of willpower, lack of social support, and physical reasons (discomfort, injuries, or diseases). Fluctuators’ subjective theories primarily differed in motivational configurations. The physically motivated fluctuators (i.e., those predominantly motivated by physically related motivators) were more linked with low PA level, while the mixed motivated fluctuators (i.e., motivated by both physically related and emotionally or socially related motivators) were more likely associated with moderate PA level. The exemplars of the three typical fluctuators were also demonstrated to reveal their real experiences and situations in the daily life context.

Conclusion

Due to the fact that fluctuation research is still in its infancy, this study represents a significant opportunity to promote knowledge growth in this area. Future studies are recommended to convert findings of the present study into interventions that benefit fluctuators in overcoming perceived barriers and enhancing motivations to eventually participate in regular PA.

Perspectives of Western Canadian dairy farmers on providing outdoor access for dairy cows

Dairy cows are highly motivated to access pasture, especially at night in summer. When pasture is not available, dairy cows show a partial preference for alternative types of outdoor access, spending half the night outside in summer on an outdoor sand or wood chip pack. However, many dairy farms do not provide cows outside access. To better understand reasons why dairy farmers choose to provide or not provide outdoor access, we studied the perspectives of dairy farmers located in the 4 Western Canadian provinces: British Columbia, Alberta, Saskatchewan, and Manitoba. Data were collected via (1) 11 focus group discussions with a total of 50 Western Canadian dairy farmers, and (2) semi-structured individual interviews with 6 dairy farmers of Hutterite colonies. Transcripts were analyzed using template analysis. Reasons to not provide outdoor access fell into 5 main themes: (1) adverse climate conditions, (2) negative implications of outdoor access for cow welfare including concerns about udder health, (3) concerns regarding decreases in profitability, (4) farm infrastructure not set up for outdoor access, and (5) higher ability to manage animals kept indoors. Reasons to provide outdoor access fell into the 5 main themes: (1) local climate conditions conducive for outdoor access, (2) beneficial effects of outdoor access on cow welfare including lower lameness prevalence, (3) increased profitability due to a premium milk price provided to farmers that allow pasture access to their cows, (4) farm infrastructure that is set up for outdoor access, and (5) easier management of animals outdoors. We conclude that the decision to provide outdoor access depends on how farmers weigh these factors given the constraints on their farm, as well as their personal beliefs and values.

Willingness, perceived barriers and motivators in adopting mobile applications for health-related interventions among older adults: a scoping review protocol

INTRODUCTION

The world's older population continues to grow at an unprecedented rate. An ageing population poses a great challenge to our healthcare system that requires new tool to tackle the complexity of health services as well as the increasing expenses. Mobile health applications (mHealth app) is seen to have the potential to address these challenges, alleviating burdens on the healthcare system and enhance the quality of life for older adults. Despite the numerous benefits of mHealth apps, relatively little is known about whether older adults perceive that these apps confer such benefits. Their perspectives towards the use of mobile applications for health-related purposes have also been little studied. Therefore, in this paper, we outline our scoping review protocol to systematically review literature specific to older adults' willingness, perceived barriers and motivators towards the use of mobile applications to monitor and manage their health.

METHODS AND ANALYSIS

Arksey and O'Malley's scoping review methodology framework will guide the conduct of this scoping review. The search strategy will involve electronic databases including PubMed, Excerpta Medica Database, Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, Google Scholar and ScienceDirect, in addition to grey literature sources and hand-searching of reference lists. Two reviewers will independently screen all abstracts and full-text studies for inclusion. Data will be charted and sorted through an iterative process by the research team. The extracted data will undergo a descriptive analysis and simple quantitative analysis will be conducted using descriptive statistics. Engagement with relevant stakeholders will be carried out to gain more insights into our data from different perspectives.

ETHICS AND DISSEMINATION

Since the data used are from publicly available sources, this study does not require ethical approval. Results will be disseminated through academic journals, conferences and seminars. We anticipate that our findings will aid technology developers and health professionals working in the area of ageing and rehabilitation.

Quantitative data analysis of perceived barriers and motivators to physical activity in stroke survivors

BACKGROUND

Levels of physical activity after stroke are low, despite multiple health benefits. We explored stroke survivors' perceived barriers, motivators, self-efficacy and intention to physical activity.

METHODS

Fifty independently mobile stroke survivors were recruited prior to hospital discharge. Participants rated nine possible motivators and four possible barriers based on the Mutrie Scale, as having 'no influence', 'some influence' or 'a major influence' on physical activity. Participants also rated their self-efficacy and intention to increasing walking.

RESULTS

The most common motivator was 'physical activity is good for health' [34 (68%)]. The most common barrier was 'feeling too tired' [24 (48%)]. Intention and self-efficacy were high. Self-efficacy was graded as either 4 or 5 (highly confident) on a five-point scale by [34 (68%)] participants, while 42 (84%) 'strongly agreed' or 'agreed' that they intended to increase their walking.

CONCLUSION

Participants felt capable of increasing physical activity but fatigue was often perceived as a barrier to physical activity. This needs to be considered when encouraging stroke survivors to be more active.

An Administrator's Perspective on the Organization of Physical Activity for Older Adults in Long-Term Care Facilities

BACKGROUND

The positive influence of physical activity (PA) on health is well documented. Even at old age, PA remains useful but participation in PA decreases with age. In long-term care facilities (LTCFs), PA appears to be reduced to a bare minimum. Because administrators have a key role in developing the care policy of LTCFs, it is important that they support the organization of PA in LTCFs.

OBJECTIVE

The main objective of this mixed-method study was to identify motivators and barriers for organizing PA in LTCFs according to administrators. A secondary goal was to examine the knowledge of the World Health Organization (WHO) guidelines regarding PA and to reveal potential motivators and barriers for the implementation of the guidelines.

METHODS

First, 24 administrators completed semistructured interviews. Data were analyzed using the deductive approach of qualitative content analysis. The obtained motivators and barriers were categorized on 3 different levels (intrapersonal, interpersonal, and community) according to the socioecological model by 2 independent reviewers; conflicts were resolved with a third researcher. Next, 127 administrators of Flemish (Belgium) LTCFs completed an online questionnaire survey containing open-ended, unique, and multiple choice questions regarding the LTCFs, PA, and the WHO guidelines, as well as statements (scored on a 5-point Likert scale) regarding perceived motivators and barriers for organizing PA sessions in the LTCF.

RESULTS

In the qualitative component, the administrators reported 31 motivators and 24 barriers for organizing PA in the LTCF. In the survey, maintaining or enhancing general health of the residents (98%) and improving the psychological well-being of the residents were marked as key motivators at the intrapersonal level. The administrators (97%) were convinced that PA is a useful way to spend time for LTCF residents. Encouraging social contact (94%) and countering loneliness (86%) are the motivators cited at the interpersonal level. At the community level, the infrastructure of the facility (91%) and adequate and sufficient material (88%) are the main motivators. The barriers that were presented to the participants were scored as less important. The majority of the administrators (83%) are not familiar with the WHO guidelines for PA; 70% of the participants believe that the guidelines are useful, but only 40% is convinced that it is realistic to implement the guidelines in an LTCF.

CONCLUSIONS

This study described different motivators and barriers for administrators to organize PA in LTCFs. Contrary to other studies, lack of staff, lack of adequate equipment, and lack of financial resources were rejected as potential barriers for organizing PA. Despite the fact that administrators were not familiar with the WHO guidelines for PA, they believed that the guidelines are useful. The participants reported several barriers for implementation of the guidelines. Administrators of LTCFs are motivated to implement the guidelines if PA can be integrated in daily activities and education of LTCF staff regarding PA is provided.

A Critical Review of Horse-Related Risk: A Research Agenda for Safer Mounts, Riders and Equestrian Cultures

While the importance of improving horse-related safety seems self-evident, no comprehensive study into understanding or reducing horse-related risk has been undertaken. In this paper, we discuss four dimensions of horse-related risk: the risk itself, the horse, the rider and the culture in which equestrian activities takes place. We identify how the ways in which risk is constructed in each dimension affects the applicability of four basic risk management options of avoidance, transference, mitigation and acceptance. We find the acceptance and avoidance of horse-related risk is generally high, most likely due to a common construction of horses as irrevocably unpredictable, fearful and dangerous. The transference of risk management is also high, especially in the use of protective technologies such as helmets. Of concern, the strategy least utilised is risk mitigation. We highlight the potential benefit in developing mitigation strategies directed at: (a) improving the predictability of horses (to and by humans), and (b) improving riders' competence in the physical skills that make them more resilient to injury and falls. We conclude with the presentation of a multidisciplinary agenda for research that could reduce accident, injury and death to horse-riders around the world.

Reasons for smoking cessation attempts among Japanese male smokers vary by nicotine dependence level: a cross-sectional study after the 2010 tobacco tax increase

OBJECTIVES

To examine the association between smoking cessation attempts during the previous 12 months, motivators to quit smoking and nicotine dependence levels among current male smokers after Japan's massive 2010 tobacco tax increase.

DESIGN

Cross-sectional study.

SETTING

A self-reported questionnaire about smoking habits, nicotine dependence levels and factors identified as motivators to quit smoking was administered to 9378 employees working at a company located in Fukuoka Prefecture in Japan (as of 1 October 2011).

PARTICIPANTS

A total of 2251 male current smokers 20-69 years old.

PRIMARY AND SECONDARY OUTCOME MEASURES

Nicotine dependence level assessed by Fagerström Test for Cigarette Dependence (FTCD), smoking cessation attempts during the previous 12 months and motivators for smoking cessation.

RESULTS

The proportion of current smokers who had attempted to quit smoking within the previous 12 months was 40.6%. Nicotine dependence level of current smokers was negatively associated with cessation attempts during the previous 12 months. Motivators for smoking cessation differed by nicotine dependence levels. 'The rise in cigarette prices since October 2010' as a smoking cessation motivator increased significantly at the medium nicotine dependence level (OR 1.44, 95% CI 1.09 to 1.90); however, this association was not statistically significant for individuals with high nicotine dependence (OR 1.24, 95% CI 0.80 to 1.92). 'Feeling unhealthy' was significantly negatively associated for medium (OR 0.42, 95% CI 0.27 to 0.65) and high (OR 0.31, 95% CI 0.14 to 0.71) nicotine dependence levels. Trend associations assessed by assigning ordinal numbers to total FTCD score for those two motivators were statistically significant.

CONCLUSIONS

The efficacy of smoking cessation strategies can be improved by considering the target group's nicotine dependence level. For smokers with medium and high nicotine dependence levels, more effective strategies aimed at encouraging smoking cessation, such as policy interventions including increasing tobacco taxes, are needed.