bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health literacy, consciousness, and locus of control in relation to vaccine hesitancy and refusal
Authors: Kouvari K , Hadjikou A , Heraclidou I , Heraclides A 
Published: October 2022

Abstract

Background
About 35% of adult Europeans remain not fully vaccinated against COVID-19. Health literacy (HL), health consciousness (HC), and health locus of control (HLC) have been linked to different health behaviors, yet their role in COVID-19 vaccination uptake remains unclear. Here, we report preliminary findings from a cross-sectional survey conducted in Greece and Cyprus, aiming to elucidate the aforementioned associations.

Methods
Participant recruitment for the current analysis took place from January to June 2022, following proportional quota sampling. The current sample comprises 190 participants, with full information on COVID-19 vaccine hesitancy (composite scale outcome) and refusal (binary outcome), as well as HL (European Health Literacy Survey Questionnaire-Q16), HC (Health Consciousness Scale-G), and HLC (Multidimensional Health Locus of Control Form B). Linear and logistic regression analyses were used to determine associations between the aforementioned factors, using the standardized versions of the independent variables.

Results
After adjusting for sociodemographic factors and other predictors of vaccination status, HL (β, 95% CI: -2.56, -3.76; -1.36), ‘internal’ HLC (-2.76, -3.79; -1.73) and ‘health professionals’ HLC (-2.64, -3.66; -1.63) were strongly and negatively associated with vaccine hesitancy, while HC showed a weaker association in the same direction (-1.46, -2.58; -0.35). In contrast, ‘chance’ HLC was strongly and positively associated with vaccine hesitancy (4.40, 3.37; 5.43). Similar results were detected when vaccine refusal was used as a binary outcome.

Conclusions
Health literacy and locus of control and to a lesser extent health consciousness, are independent predictors of COVID-19 vaccine hesitancy and refusal. Increasing vaccination uptake via programs aiming at enhancing health literacy and shifting health locus of control, can have a significant impact on COVID-19 pandemic management internationally.

Key messages
• Health literacy, locus of control and to a lesser extent consciousness, are novel predictors of vaccine hesitancy and refusal in two Eastern Mediterranean European populations.
• Increasing health literacy and shifting health locus of control could render programs aiming to increase COVID-19 vaccine uptake more targeted and effective, internationally.
Infodemic management for public health practitioners: landscape analysis and practical tools
Authors: Ishizumi A , Purnat T , Ludolph R , Cecchini S , Yau B , Bertrand-Ferrandis C , Briand S , Nguyen T 
Published: October 2022

Abstract

Issue
Infodemics (i.e., overflow of information in physical and digital spaces that makes it difficult for people to make good health decisions) can undermine emergency response, but capacity for infodemic management has been limited in countries thus far. Specifically, there is a need to build capacities in the field with practical and scalable tools.

Description of the problem
WHO has developed tools and trainings to quickly build and enhance infodemic management (IM) capacity at the country-level, such as tools for rapid generation of IM insights and a framework for conducting landscape analyses to establish sustainable IM capacities. These were developed in collaboration with multidisciplinary experts who provided feedback. We sought to create tools that can be a basis for introducing evidence-generation in health information systems to inform emergency preparedness and response, and mainstream methods into routine infodemic diagnostics activities.

Results
The tools and trainings provide a comprehensive framework for diagnosing and addressing infodemics, such as a public health taxonomy to guide digital intelligence analysis and integrated analysis methods for generation of actionable insights. Additionally, the landscape analysis framework outlines steps for assessing strategic needs and assets for routinizing IM functions as part of existing public health systems and programs.

Lessons
The tools and trainings will be deployed in the field to evaluate utility. Feedback from users in the global WHO infodemic manager community will be systematically captured.

Key messages
• Field responders need practical tools and trainings that guide quick infodemic response during health emergencies.
• These tools and trainings can be used to diagnose and intervene on infodemics, even in settings where infodemic insights units are not yet established.
Beliefs about vaccines and information about coronavirus, COVID-19 and the pandemic. Findings from Italy
Authors: Lorini C , Velasco V , Zanobini P , Vecchio L , Bonaccorsi G 
Published: October 2022

Abstract

Introduction
In Italy, COVID-19 vaccination campaign for school personnel started in February 2021 and began mandatory from 15th December 2021 to all the people who work within schools. Here we described Italian school principals’ beliefs about vaccines and its association with feelings about information regarding coronavirus, COVID-19 and the pandemic.

Methods
Data collection started in October 2021 and is ongoing. Beliefs about vaccines were investigated both for COVID-19 vaccination and for vaccination in general.

Results
A total of 726 questionnaires were analyzed so far. The majority feels to be well informed about the coronavirus or the pandemic (75%) and not at all nor a little confused about COVID-19 information (89%). Only 2% disagree/strongly disagree with the statement “vaccination is compatible with my attitudes or religious beliefs”. Beliefs regarding vaccines in general are correlated with those regarding COVID-19 vaccines. When different beliefs are described, we observed a trend towards considering COVID-19 vaccines less safe and effective, but more important to protect themselves and their family than other vaccines. Moreover, beliefs about vaccination in general and regarding COVID-19 are associated with how well they feel informed about the coronavirus or the pandemic, and whether they feel confused about COVID-19 information. In particular: the better they feel informed about the coronavirus and the related pandemic, the higher the perception of vaccines in general and COVID-19 vaccine as important, safe, and effective; the less they feel confused about COVID-19 information.

Conclusions
School principals showed a high level of confidence on vaccines. The association between beliefs in vaccinations and the characteristics of information about COVID-19 supported the effectiveness of Italian vaccination policy and information campaigns.
Development of a strategy to control COVID-19 in hard-to-reach migrant communities
Authors: Rosso A , Rinaldi A , Coluzzi D , Perrelli F , Napoli PA , Villari P 
Published: October 2022

Abstract

Issue/Problem
The risk of SARS-Cov-2 infection and its adverse health effects proved to be higher among socially disadvantaged groups, including migants and ethnic minorities. Hard-to-reach (HTR) migrants, such as undocumented people, those living in informal settelments (e.g squats) or roma people have experienced severe barries to access COVID-19 information, testing and vaccination services.

Description of the problem
During 2020 and 2021, the Migrants'Health Unit of Roma 2 Local Health Unit (ASL) developed different strategies to control the COVID-19 epidemics in HTR communities, addressing both the containment of clusters in informal settelments and access to COVID-19 vaccination for these population.

Methods
A multicomponent and multidisciplinary strategy was implemented, based on a strong collaboration of different services across the ASL and with Non Governmental Organizations (NGOs). Starting from a mapping of the settlements and the identification of the main critical issues for the control of the epidemic in the target populations, interventions were carried out that included the involvement of NGOS in active surveillance, reporting of suspected cases of COVID-19 to the ASL and information to the communities, and the reorganization of health interventions (eg, swabs, epidemiological investigations, COVID-19 vaccinations) directly in HTR communities’ life places.

Results
In the period from April 2020 to February 2021, 15 outbreaks were controlled, for a total of over 4500 persons reached, and 265 COVID-19 cases identified. From July to November 2021, vaccinations were offered in outreach or with dedicated vaccination sessions, which reached 1664 people. The intervention model, based on a deep context analysis, strong multisectoral collaboration, community involvement, lays the foundations for the design of public health strategies, not only aimed at HTR populations.

Key messages
• Controlling COVID-19 in Hard- to- reach migrant populations was possible thanks to a strong collaboration between public health services and NGOs.
• Public health interventions addressed complex groups should envisage intersectoral collaborations, reorientation of services in order to meet target groups’ need and community involvement.
Impact of COVID-19 vaccination on risk perception: a cross- sectional study on vaccinated people
Authors: De Nicolò V , Villari P , De Vito C 
Published: October 2022

Abstract

Background
High risk perception and perceived threat of COVID-19 had played an important role on public attitudes toward vaccination and protective countermeasures acting as motivational factors to perform behaviors that facilitated disease prevention. To explore COVID-19 vaccination influence we conducted a cross-sectional study on vaccinated people (18-80 years old).

Methods
Partecipants, randomly selected, were recruited during the vaccination campaign in the Hub of Cosenza, Calabria Region, Italy, at the end of the 2nd wave of pandemic (Jul-Aug 2021). A multivariable logistic regression model was built to calculate odds ratios (OR) and 95% confidence intervals (95% CI) comparing risk perception and preventive measures confidence pre vs. post vaccination.

Results
Globally 625 partecipants fully responded; 51.4% women, mean age 40.5 years (SD +/-15.36). Infection risk perception and protective measures adherence significantly decreased after the vaccination even if a significant gender gap was present; women were always more worried and respectful than men. More prudent partecipants had a significantly higher mean age. 64.2% of participants believed that compliance with social distancing was yet absolutely necessary after the immunization and about half of them believed that also the use of masks was yet necessary. Results of multivariable analysis confirmed that risk perception decreases after vaccination in different contexts: workplace (0.65; 95% CI 0.44-0.94); sport activities (0.60; 95% CI 0.39-0.95); bars and restaurants (0.51; 95% CI 0.33-0.80); means of transport (0.32; 95% CI 0.19-0.50) as well as handwashing practice (2.23 95% CI 1.20-4.12).

Conclusions
The research shows that COVID-19 vaccination significantly decreases self-perceived risk and adherence to preventive measures. Public Health communication strategies could underline that COVID-19 vaccination is indispensabile but not sufficient to protect the World against this devastating catastrophe.

Key messages
• Public Health should promote consciousness and strengthen the importance of health-protective measures in order to further reduce risk of human-to-human transmission after immunization.
• Even after vaccination, extra precautions are still required and necessary to do not nullify vaccination protective effect, mostly in more exposed and less careful groups like young people.
How to deal with COVID-19 vaccine hesitancy in pregnant and breastfeeding women? A meta-analysis
Authors: Bianchi FP , Stefanizzi P , Di Gioia MC , Brescia N , Lattanzio S , Tafuri S 
Published: October 2022

Abstract

Background
Pregnant and breastfeeding women are at an increased risk of severe illness from COVID-19 compared to people who are not pregnant. Therefore, the CDC recommends COVID-19 vaccination for women who are pregnant, breastfeeding, and trying to become pregnant or who may become pregnant in the future. Despite this, low vaccination coverages are reported in this population sub-group. The purpose of this study is to estimate the proportion of pregnant and breastfeeding women expressing hesitation to the COVID-19 vaccine worldwide. Determinants of vaccine compliance and options suggestedto address vaccine hesitancy were also analyzed.

Methods
Forty-six studies were included in the meta-analysis and systematic review, selected from scientific articles available in the MEDLINE/PubMed, Google Scholar, and Scopus databases between January 1, 2020 and February 6, 2022. The following terms were used for the search strategy: (adherence OR hesitancy OR compliance OR attitude) AND (covid* OR SARS*) AND (vaccin* OR immun*) AND (pregnan* OR post-partum OR breastfeeding OR lactating).

Results
The vaccine hesitation rate was 48.4% (95%CI=43.4-53.4%). In a sub analysis by study period, the pooled prevalence of vaccine hesitation was 40.0% (95%CI=31.6-46.6%) considering surveys administered in 2020, 58.0% (95%CI=48.9-66.9%) considering surveys administered in the first semester of 2021, and 38.1% (95%CI=25.9-51.2%) considering surveys administered in the second semester of 2021. The main reasons for vaccine hesitation were lack of information about vaccination, opinion that the vaccine is unsafe, and fear of adverse events for both mother and fetus/child.

Conclusions
In order to achieve high vaccination coverage, a multifactorial approach is needed, requiring major social, scientific, and health efforts. The success of the vaccination campaign in this population depends on the capillarity and consistency of the interventions implemented.

Key messages
• Vaccine hesitancy can be a determining factor in the success (or otherwise) of the anti-COVID-19 immunization campaign.
• Vaccine hesitancy in pregnant and breastfeeding women is a genuine public health concern worldwide.
Smoking during pregnancy and children’s emotional and behavioural trajectories
Authors: Fekom M , Bonello K , Gomajee R , Ibanez G , Martin S , Keyes K , Nakamura A , Lepeule J , Strandberg-Larsen K , Melchior M 
Published: October 2022

Abstract

Background
The nature of the relationship between maternal tobacco smoking during pregnancy and the occurrence of children's behavioural problems is still a matter of controversy. We tested this association using data collected among a sample of children followed from pregnancy to early adolescence (age 11.5 years), accounting for multiple parents’, children's and family characteristics.

Methods
Data come from 1424 mother-child pairs participating in the EDEN mother-child cohort set up in France. Using repeated measures (3, 5.5, 8 and 11.5 years) of the mother-reported Strengths and Difficulties Questionnaire, we estimated trajectories of children's emotional and behavioural difficulties. Two aspects of maternal smoking were studied: the timing and the level of use (cigarettes/day) during the first trimester of pregnancy. Multinomial regression models controlled for confounding factors including maternal mental health and socioeconomic characteristics using propensity scores with the overlap weighting technique.

Results
Contrary to bivariate analyses, in propensity score-controlled regression models, maternal smoking throughout pregnancy was no longer significantly associated with offspring emotional or behavioural difficulties. Maternal heavy smoking (≥10cigarettes/day) remained significantly associated with intermediate levels of overall emotional and behavioural difficulties (OR 1.64, 95%CI 1.04-2.58) and conduct problems (OR 3.05 95%CI 1.22-7.61), as well as with high levels of conduct problems symptoms (OR 2.82 95%CI 0.88-9.06) - although the latter did not reach statistical significance.

Conclusions
The association between maternal smoking in pregnancy and offspring emotional and behavioural difficulties appears to be largely explained by women's other characteristics. However, maternal heavy smoking appears to be related to offspring behavioural difficulties beyond the role of confounding characteristics.

Key messages
• The association between maternal smoking in pregnancy and offspring emotional and behavioural difficulties seem largely explained by the family's socio-demographic and behavioural characteristics.
• Maternal heavy smoking appears to be related to offspring behavioural difficulties beyond the role of confounding characteristics.
Socioeconomic factors affecting psychotherapy use rates
Authors: Selinheimo S , Gluschkoff K , Turunen J , Kausto J , Väänänen A 
Published: October 2022

Abstract

Objectives
Previous studies indicate socioeconomic inequalities in psychotherapy utilization. The aim of this study was to assess the associations of individual annual incomes with the utilization of long-term rehabilitative psychotherapy during nine-year follow-up in men and women. As secondary analyses we assessed the association of main activity with the utilization of psychotherapy.

Methods
For this study, we selected those from a random sample of the working-age population (18-55 years) with information about income at each time point during the follow-up from 2011 to 2019 (N = 736 613). Psychotherapy usa during the follow-up period served as dependent variable and sosiodemographic variables, annual incomes and main activity (employed, unemployed, studying, other) were used as independent variables. To examine change in the psychotherapy use rates over time, we used sex-stratified generalized estimating equations logistic regression models with predicted marginal probabilities.

Results
Psychotherapy use rate was constantly higher among women than in men (in 2011 0.8% and 0.2%) and increased from 2011 to 2019 among both genders and income quartiles (among women 174% - 231% and among men 213% - 248% increase between quartiles). Among men, psychotherapy use rate was highest among lowest income quartile throughout the study interval. Among women such difference was not observed. Among women, studentś psychotherapy use increased significantly when compared to other groups from 2011 to 2019 (299% increase vs 89% - 210% increase among other groups). A similar pattern was seen among studying men versus other groups.

Conclusions
Between 2011 and 2019 the probability of having psychotherapy increased among both genders. Unexpectedly, pro-rich psychotherapy use rate was not observed. The highest probability to use psychotherapy in lowest income quartile might be linked with differences in health care systems for students and for other.
Occupational class, gender, mental distress and use of psychotherapy
Authors: Kokkinen L , Gluschkoff K , Kausto J , Selinheimo S , Väänänen A 
Published: October 2022

Abstract

Introduction
Previous studies have shown the effects of occupational class and gender on mental distress and use of psychotherapy. However, less is known about the mental distress-based use of psychotherapy in different occupational classes.

Objectives
The aim of our study is to show how the prevalence of mental distress and the use of long-term psychotherapy correlates in different occupational classes by gender.

Methods
Data were drawn from the Rise of Mental Vulnerability Study (psychotherapy) and FinHealth 2017 Study (mental distress). Adjusting for age, we calculated GHQ caseness, psychotherapy use rate, and the ratio between GHQ caseness and psychotherapy use rate in three occupational classes (upper non-manual employees, lower non-manual employees, and manual workers) separately for men and women. Age-adjustment was performed through regression analysis by using model generated predicted values of GHQ caseness and psychotherapy use rate at the average sample age of 40.

Results
In the group of upper non-manual men there were 10 persons with severe mental distress for every single person having used psychotherapy. For lower non-manual men and manual male workers the numbers were 14 and 31, respectively. In the group of upper non-manual women there were six persons with severe mental distress for every person having used psychotherapy. For lower non-manual women and manual female workers these numbers were nine and 18, respectively.

Conclusions
We found differences in the mental distress-based use of state-subsidized long-term psychotherapy between occupational classes. For upper non-manual workers, the use of therapy best meets their mental distress. The opposite is true for manual workers. We also found differences between men and women, but these findings should be confirmed with larger datasets.
Depression, diabetes and change in cognitive functioning: results from the Canadian Longitudinal study on Aging
Authors: Shojaa M , Deschenes S , McLeish J , Schmitz N 
Published: October 2022

Abstract

Background
Individuals who ultimately receive a diagnosis of dementia typically have an observable accelerated cognitive decline (ACD) many years prior to diagnosis. Depression in combination with diabetes is an emerging risk factor that is associated with cognitive problems. Using data from the Canadian Longitudinal Study on Aging, the objective of the present study was to investigate the longitudinal association between depression, diabetes, and cognitive decline in an elderly cohort.

Methods
Baseline and follow-up data from a population-based study in Canada were used. The sample consisted of 18161 adults between 45 and 85 years of age without diabetes. Cognitive functioning was assessed at baseline and after 4 years using six measures: the Rey Auditory Verbal Learning Test (RAVLT), the Mental Alternation Test (MAT), the Animal Fluency Test (AF), the Controlled Oral Word Association Test (COWAT), the Stroop Test, and the Prospective Memory Test. Depression was assessed using the CES-D10. Regression analysis was conducted to evaluate interactions between depression, diabetes and cognitive decline.

Results
The mean age of participants was 61 years. Participants with a comorbidity of depression and diabetes had an accelerated cognitive decline (g-factor) compared to those with depression without diabetes and those with diabetes without depression (regression coefficients ß=-0.145 (0.036), ß=-0.076 (0.011), and ß=-0.053 (0.021), respectively).

Conclusions
This study suggests that depression and diabetes might increase the risk of cognitive decline in a synergistic way.