Behavioral Medicine最新文献

Mass vaccination emerged as a key public health strategy during the COVID-19 pandemic. Yet, greater attention is needed to understand the shifting dynamics of vaccine messaging amid rampant uncertainty across the United States, including its impact on vaccine uptake behaviors over time. Our study presented a unique opportunity to longitudinally explore how perceived uncertainties in COVID-19 vaccine messaging shaped vaccine uptake behaviors among participants enrolled in a remote, nationwide COVID-19 trial in the United States. In-depth, semi-structured qualitative interviews were conducted virtually across two timepoints (T1: December 2020 to March 2021, n = 19; T2: January to February 2022, n = 11). Analysis was guided by immersion crystallization; an inductive and deductive approach to identifying themes and the relationships between them. Most participants (aged 32-74) resided in California (T1: 58%, T2: 45%) and self-identified as white (T1: 63%; T2: 73%) and/or cisgender women (T1: 63%; T2: 55%). All participants expressed interest in the COVID-19 vaccine at T1, among which 21% received their first dose as members of priority groups. By T2, all participants obtained the primary COVID-19 vaccine series, and 73% received a booster. Key themes included: (1) self-efficacy in the absence of cohesive information; (2) shifting guidelines heightened perceived barriers and uncertainties; and (3) unresolved messaging fueled skepticism and reduced trust in public health. Findings underscore how logistical and scientific uncertainties can be detrimental to long-term vaccine uptake, albeit acting in different ways. Communicating uncertainties necessitates iterative, public participation to advance health and scientific literacy, mitigate vaccine skepticism, and sustain vaccine uptake behaviors over time.

An HIV vaccine is crucial for African American men who have sex with men (MSM) as they are disproportionately impacted by HIV in the United States. Successful vaccine uptake at levels sufficient to protect individuals and reduce transmission requires more than developing an effective HIV vaccine-it necessitates a strong intention to get vaccinated. Understanding the perceptions, attitudes, and concerns surrounding HIV vaccination among African American MSM is essential for healthcare providers and stakeholders to communicate and promote vaccine adoption effectively. Using the Health Belief Model and Extended Parallel Processing Model, the study sought to identify factors that would encourage vaccination among HIV vaccine procrastinators-individuals likely to delay getting the vaccine for more than a year-to uptake a hypothetical HIV vaccine. A cross-sectional study was conducted with 432 African American MSM, 18-64 years, residing in the United States. Multivariable logistic regression analysis examined factors influencing the intention to enhance vaccination among HIV vaccine procrastinators who are at risk for HIV. Vaccine procrastinators are more likely to be older, have a greater fear of HIV stigma, perceive low discrimination when receiving HIV prevention support due to their African American MSM identity, do not use PrEP, and have more significant concerns about vaccine safety compared to non-vaccine procrastinators. The absence of understanding HIV vaccine perceptions represents a missed opportunity to inform and guide healthcare providers and policymakers once an HIV vaccine becomes available.

Latina women experience cancer disparities exacerbated by multilevel factors. An understanding of how multilevel factors influence Latinas' use of prevention services, can inform culturally tailored interventions. Using cross-sectional surveys guided by the NIMHD Health Disparities Research Framework, we sought to identify individual (HPV vaccine hesitancy, HPV knowledge, HPV vaccine conspiracy beliefs), interpersonal (strength of provider communication, mother-daughter communication), and community (negative HPV vaccine messages, number of times offered the HPV vaccine, clinic wait times) factors associated with HPV vaccine initiation and completion among Mexican American young adult women. At the individual level, HPV vaccine hesitancy and HPV vaccine conspiracy beliefs were associated with HPV vaccine initiation and completion. HPV vaccine knowledge was not associated with initiation or completion. At the individual level, strength of provider communication and HPV mother-daughter communication was associated with HPV vaccine initiation. Only HPV mother-daughter communication was associated with HPV vaccine completion. At the community level, longer clinic wait times and number of times the HPV vaccine has been offered was associated with HPV vaccine initiation. Exposure to negative HPV vaccine messages was not associated with HPV vaccine initiation but was associated with HPV vaccine completion. Longer clinic wait times and number of times the HPV vaccine was offered was not associated with completion. Findings suggest multilevel factors that influence HPV vaccine initiation can differ from factors that influence completion, an important factor to consider when designing interventions tailored to meet the needs of this population or when implementing evidence-based strategies for HPV vaccination.

Despite the role that emotions have in influencing health behaviors, limited research has systematically investigated their role in COVID-19 vaccination decisions compared to the role of cognitions in vaccine behavior. This study aimed to (a) identify groups of adults with similar emotional responses to COVID-19 via latent profile analysis and (b) examine differences in vaccine intentions and uptake between emotion groups. Data were drawn from two samples designed to approximate nationally representative samples of US adults. The first survey (N = 3,853) was administered between December 2020 and January 2021, amid emergency authorization for COVID-19 vaccination. The second survey (N = 3,528) was administered in August 2021, alongside FDA COVID-19 vaccination approval. Five emotion profiles were replicated across the samples: "Emotionally Unaffected," "Contempt," "Low Emotional Effect," "Moderate Emotional Effect," and "High Emotional Effect," which were differentially associated with vaccine intentions and behavior. Negative emotions varied in their effects: Participants in the "Contempt" group were most likely to reject the vaccine (Sample 1) and remain unvaccinated (Sample 2), whereas those in the "High Emotional Effect" group were less likely to be vaccine hesitant (Sample 1) and had the highest vaccination rates (Sample 2). Concerns about the COVID-19 vaccine also varied by emotion group among unvaccinated participants (Sample 2). Taken together, these novel findings highlight the need for emotion-responsive public health messaging. We suggest that COVID-19 vaccine communication strategies should be tailored to address people's distinct emotional responses, including those driven by anger and disgust, to improve the effectiveness of vaccination campaigns.

Despite over 15 years of human papillomavirus (HPV) vaccination implementation, uptake remains below national targets. Black/African American adolescents are less likely to complete the HPV vaccine series, due to a myriad of multilevel factors including vaccine hesitancy. The objective of this study was to develop a tailored mHealth intervention to promote vaccine confidence among Black families with adolescents. We generated a message bank from the literature, then prioritized and edited content according to needs identified in previous research with Black parents, community stakeholder input, and expert consensus. We conducted three rounds of prototype feedback sessions with 16 parents of adolescents aged 9-13 years from the Greater Newark Area. We recruited at family-friendly events, through community researchers, and with snow-ball sampling. We employed user-centered design techniques, elicited open-ended feedback, and collected relevance ratings for rapid qualitative analysis. Transcripts were thematically analyzed. Results indicated intervention content and features should be tailored by information source and channel. Fact-based messages with neutral framing balancing cancer prevention benefits and safety were highly rated. Including links to trustworthy sources was perceived as increasing credibility and helpful for family-centered decision-making. Parents also wanted age-appropriate information with graphics to explain the purpose and importance of HPV vaccination to their adolescents. Developing the intervention with families highlighted the need for multi-modalities, including informational short-message-service (SMS) and detailed emails with tailored information. Multi-modal interventions providing accurate information tailored to parents' questions and concerns, have potential to educate and empower parents to protect their children from HPV cancers.

The US has seen a sharp increase in measles cases in recent years. The measles vaccines (MMR and MMRV) are highly effective at preventing measles infections; however, vaccine coverage varies between racial/ethnic categories. Our objective was to use Minnesota Department of Health data to examine the association between a child's birthing parent's race, ethnicity, and other sociodemographic characteristics, and receipt of the first dose of a measles-containing vaccine by age 24 months. Sociodemographic data came from Minnesota birth certificate records (from 2017 to 2022), which are unique among states in how detailed ethnicity is characterized. During this timeframe, only 80% of the study population received the first dose of a measles-containing vaccine by age 24 months. We identified vaccination inequities by ethnicity, which could not be fully explained by these ethnic groups' differing socioeconomic status. Two groups, Somali-Minnesotan and Ethiopian-Minnesotan (which are often aggregated into a "Black" race), had the lowest levels of on-time first dose coverage (Somali = 31%, Ethiopian = 64%). Other factors associated with a lower predicted probability of coverage by 24 months included receiving inadequate prenatal care and lower socioeconomic status. Our main findings demonstrate the importance of racial/ethnic disaggregation when studying vaccine inequities. Collapsing race/ethnicity into broad categories like "Black" or "Hispanic" obscures a great deal of variability in outcomes. Those who are identified as at-risk for missing vaccine doses, the causes for this, and the possible approaches public health agencies might consider in preventing outbreaks should all differ depending on who is most affected.

There is a lack of research on the impact of trauma-informed care for survivors of sex trafficking. This article examines service providers' perspectives on trauma-informed best practices for engaging survivors in service provision. Twenty-one service providers in the southwestern US participated in a virtual semi-structured interview that was approximately 1-h in length. Interviews were audio-recorded, transcribed, and data analysis consisted of Braun & Clark's six-stage process for thematic analysis. Five themes were generated from the data, including (1) judgment and stigma, (2) building trust through consistency, (3) compassionate communication, (4) providing opportunities for survivor autonomy and choice, and (5) creating a warm and welcoming environment. Survivors experience stigma and distrust healthcare providers, which can impede their access to and engagement with care. This study highlights the vital role of trauma-informed care in fostering survivor-centered support systems that promote dignity and healing for survivors of sex trafficking.

Immunization of pregnant women against respiratory syncytial virus (RSV) has been recently licensed for use worldwide. In this study, we aimed to assess knowledge, perceptions and potential RSV vaccine acceptance in future pregnancy in mothers of children under 2 years old attending a Tertiary hospital. Α questionnaire-based cross-sectional study was conducted between January and May 2024 (including period of RSV peak circulation in Greek climate), at a university hospital in Greece. A total of 255 participants were enrolled during the 4-month study period. Participants were divided in three categories equally, according to their child's status as follows Admission to the ward with Respiratory tract infection (AR); casualty attendance and Discharge due to Respiratory tract infection that does not need hospitalization (DR) and Admission to the ward for Other reasons (AO), no respiratory tract infection. The majority have not received antenatal vaccination in previous pregnancies with the recommended vaccines, were not aware of RSV, and were not informed about the new RSV vaccine. Most women expressed willingness to receive antenatal vaccination against RSV in future pregnancy, following a healthcare professional's recommendation. Prior antenatal vaccination and knowledge of RSV were found to be positively associated with future vaccine acceptance. Healthcare professional recommendations could play an important role in influencing maternal attitudes toward potential vaccination. These insights underscore the importance of targeted education and communication strategies for women of reproductive age, aiming to enhance uptake of newly introduced antenatal RSV vaccine.

Young adults attending vocational education and training schools often engage in various health risk factors, including poor dietary habits. School canteens are key settings that can promote students' healthy food choices. This study aims to enhance the skills of vocational school canteen staff in preparing healthy food, student-centered communication, and meal presentation. A mixed-methods approach incorporated participatory action research and grounded theory (GT) analysis. The participants included 17 staff members, aged 21 to 60 years, working at three canteens that serve 557 students. Over eight months, four workshops were conducted, with staff engaging in exploratory actions between sessions to enhance student interaction and create healthy meals accommodating student preferences. Data collected from observations, field notes, and interviews were analyzed using GT, while survey data on student meal preferences were described statistically. A one-week choice architecture intervention was implemented in one canteen, and receipt data were collected to assess the impact of the new meal presentations and assessed using binomial logistic regression. The GT analysis identified the core category: "A dialogical hospitality approach facilitates reassurance." The workshops enhanced the staff's skills in healthy food preparation, incorporating student preferences and boosting their confidence in employing a hospitality-based dialogical approach, reassuring students to make healthy food choices. The choice architecture intervention led to a significant increase in the sales of healthy meals. This study highlights the importance of involving staff in targeted training through participatory methods to promote students' healthier food options in vocational school settings.