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Hudson, Amanda, and William J. Montelpare. "Predictors of Vaccine Hesitancy: Implications for COVID-19 Public Health Messaging." International Journal of Environmental Research and Public Health 18, no. 15 (2021): 8054. http://dx.doi.org/10.3390/ijerph18158054.
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Objectives: Successful immunization programs require strategic communication to increase confidence among individuals who are vaccine-hesitant. This paper reviews research on determinants of vaccine hesitancy with the objective of informing public health responses to COVID-19. Method: A literature review was conducted using a broad search strategy. Articles were included if they were published in English and relevant to the topic of demographic and individual factors associated with vaccine hesitancy. Results and Discussion: Demographic determinants of vaccine hesitancy that emerged in the literature review were age, income, educational attainment, health literacy, rurality, and parental status. Individual difference factors included mistrust in authority, disgust sensitivity, and risk aversion. Conclusion: Meeting target immunization rates will require robust public health campaigns that speak to individuals who are vaccine-hesitant in their attitudes and behaviours. Based on the assortment of demographic and individual difference factors that contribute to vaccine hesitancy, public health communications must pursue a range of strategies to increase public confidence in available COVID-19 vaccines.
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Jenkins, Marina C., Caroline R. Paul, Shobhina Chheda, and Janice L. Hanson. "Qualitative analysis of reflective writing examines medical student learning about vaccine hesitancy." Asia Pacific Scholar 8, no. 2 (2023): 36–46. http://dx.doi.org/10.29060/taps.2023-8-2/oa2855.
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Introduction: Increases in vaccine hesitancy continue to threaten the landscape of public health. Literature provides recommendations for vaccine communication and highlights the importance of patient trust, yet few studies have examined medical student perspectives on vaccine hesitancy in clinical settings. Therefore, we aimed to explore medical student experiences encountering vaccine hesitancy, mistrust, and personal biases, with the goal of informing medical student education. Methods: A health disparities course including simulated clinical scenarios required students to complete a written reflection. We sorted reflections written in 2014-2016 to identify common topics and used inductive thematic analysis to identify themes relevant to vaccine hesitancy by group consensus. Results: Our sample included 84 de-identified essays sorted into three non-exclusive topics: vaccine hesitancy (n=42), mistrust (n=34), and personal bias (n=39). We identified four themes within medical students’ reflections: 1) Building a Relationship, including emphasis on patient-centred approaches; 2) Preparedness and Need to Prepare for Future Encounters, including highlighting gaps in medical education; 3) Reactions to Encountering Hesitant Patients, including frustration; 4) Insights for Providing Information and Developing a Plan with Hesitant Patients, including approaches to presenting knowledge. Conclusion: Reflections in the context of simulated encounters and discussion are useful in students identifying their preparedness for vaccine discussion with patients. Student reflections can assist educators in identifying missing educational frameworks for particular scenarios such as vaccine hesitancy. Without a structured framework regarding addressing vaccine hesitancy, students draw upon other skills that may contradict recommended practices.
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Khan, Aziz, Shougi S. Abosuliman, Saleem Abdullah, and Muhammad Ayaz. "A Decision Support Model for Hotel Recommendation Based on the Online Consumer Reviews Using Logarithmic Spherical Hesitant Fuzzy Information." Entropy 23, no. 4 (2021): 432. http://dx.doi.org/10.3390/e23040432.
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Spherical hesitant fuzzy sets have recently become more popular in various fields. It was proposed as a generalization of picture hesitant fuzzy sets and Pythagorean hesitant fuzzy sets in order to deal with uncertainty and fuzziness information. Technique of Aggregation is one of the beneficial tools to aggregate the information. It has many crucial application areas such as decision-making, data mining, medical diagnosis, and pattern recognition. Keeping in view the importance of logarithmic function and aggregation operators, we proposed a novel algorithm to tackle the multi-attribute decision-making (MADM) problems. First, novel logarithmic operational laws are developed based on the logarithmic, t-norm, and t-conorm functions. Using these operational laws, we developed a list of logarithmic spherical hesitant fuzzy weighted averaging/geometric aggregation operators to aggregate the spherical hesitant fuzzy information. Furthermore, we developed the spherical hesitant fuzzy entropy to determine the unknown attribute weight information. Finally, the design principles for the spherical hesitant fuzzy decision-making have been developed, and a practical case study of hotel recommendation based on the online consumer reviews has been taken to illustrate the validity and superiority of presented approach. Besides this, a validity test is conducted to reveal the advantages and effectiveness of developed approach. Results indicate that the proposed method is suitable and effective for the decision process to evaluate their best alternative.
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Roopa, Chandrika R., Ganesh N.S Gowri, A. Mummoorthy, and M. Gayathri. "Aggregation Operators in Hesitant Fuzzy Set for Decision Making." International Journal of Recent Technology and Engineering (IJRTE) 10, no. 4 (2021): 101–5. https://doi.org/10.35940/ijrte.D6586.1110421.
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Uncertainty is prevalent in a wide range of real-world issues. The fuzzy sets, vague sets or intuitionistic fuzzy sets are widely used in recent years for decision making and various analysis where uncertainty is predominant. An extension of fuzzy sets is Hesitant Fuzzy Sets, which deals with ambiguous situations that arise when determining an element's membership degree in a set. Researchers have defined various ideas, extensions, aggregation operators, and measurements to deal with reluctant information as a result of this new approach. Machine leaning algorithms are also exploiting hesitant fuzzy sets for better decision making.
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Nguyen, Jennifer, Jordi Montserrat-Adell, Núria Agell, Monica Sánchez, and Francisco J. Ruiz. "Fusing hotel ratings and reviews with hesitant terms and consensus measures." Neural Computing and Applications 32, no. 19 (2020): 15301–11. http://dx.doi.org/10.1007/s00521-020-04778-x.
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Wang, Qi, Yuan Zhao, Zi Xu, Wen Zhang, and Mingsi Zhang. "Integrating Symmetry in Attribute-Based Sentiment Modeling with Enhanced Hesitant Fuzzy Scoring for Personalized Online Product Recommendations." Symmetry 16, no. 12 (2024): 1652. https://doi.org/10.3390/sym16121652.
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Online product reviews provide valuable insights on user experiences and product qualities. However, issues such as information overload and the limited utilization of review features persist, particularly in personalized rankings for popular items like movies. To address these challenges—information overload in online reviews, limited review feature utilization, and personalized decision-making for high-demand products like movies—we introduce a personalized online decision-making framework that integrates a sentiment model for product attributes with an enhanced hesitant fuzzy scoring function. This framework incorporates the concept of symmetry in sentiment analysis. It employs feature words, sentiment terms, and modifiers to assess user sentiments within a hesitant fuzzy setting, utilizing symmetrical relationships between positive and negative sentiments. The improved fuzzy score function efficiently quantifies sentiment values for product features by considering the symmetrical balance of user opinions. Additionally, review quality assessment incorporates both content and reviewer characteristics, resulting in final attribute evaluations. An attribute weighting system, tailored to diverse product types, further captures product specifics and user inclinations, leveraging symmetry to balance varying user preferences. Validation through multi-genre movie sorting demonstrates the method’s capacity to handle review data across varied products and user tastes, offering a robust tool for enhancing online decision quality, especially for high-demand items.
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Magi, Camilla Elena, Emanuele Buccione, Stefano Bambi, et al. "Exploring health locus of control among vaccine-hesitant parents: a scoping review." BMJ Open 15, no. 5 (2025): e100202. https://doi.org/10.1136/bmjopen-2025-100202.
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ObjectivesThis scoping review aimed to explore the relationship between health locus of control (HLOC) and vaccine hesitancy among parents of children aged 0–18 years, focusing on the tools and methods used to assess these constructs.DesignThe review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines and adhered to established methodologies for scoping reviews, including systematic searches across four electronic databases.Data sourcesPubMed, PsycINFO, Web of Science and CINAHL were searched using a comprehensive search strategy to identify relevant studies on 24 September 2024.Eligibility criteria for selecting studiesStudies were included if they examined HLOC and vaccine hesitancy in parents, measured these constructs with validated tools and focused on childhood vaccination.Data extraction and synthesisData were extracted into a structured table capturing study characteristics, HLOC and vaccine hesitancy measurements, and key findings. Results were synthesised narratively to highlight associations and patterns.ResultsFive studies involving a total of 11 758 parents and caregivers of children aged 0–18 years met inclusion criteria. Higher internal HLOC was consistently associated with lower vaccine hesitancy and higher compliance, while lower chance HLOC correlated with greater hesitancy. Powerful others HLOC (ie, trust in healthcare professionals) emerged as a key predictor of better vaccine adherence.ConclusionsThe findings suggest that internal HLOC and trust in healthcare providers are predictors of vaccine acceptance among parents. However, standardised tools and longitudinal studies are needed to further elucidate these relationships and inform targeted interventions to reduce vaccine hesitancy.
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Luttrell-Freeman, Jordan, Timothy J. Bungum, and Jennifer R. Pharr. "A Systematic Review of the Rationale for Vaccine Hesitancy among American Parents." Global Journal of Health Science 13, no. 8 (2021): 77. http://dx.doi.org/10.5539/gjhs.v13n8p77.
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INTRODUCTION: Vaccines are one of the most successful interventions in the history of public health. They are largely responsible for the near eradication of several diseases. However, some people are vaccination averse which can lead to vaccine hesitancy. Vaccine hesitant parents are those that refuse or delay getting their children vaccinated despite the availability of vaccination services. This phenomenon often occurs despite parent’s belief that vaccines are effective. The purpose of this review was to exam available literature to identify predictors of vaccine hesitancy among parents and parental rationale for vaccine hesitancy. 
 
 METHODS: This literature review utilized the SCOPUS database to identify articles examining vaccine hesitancy among American parents, published from 1997 to 2020, inclusive. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was utilized to select articles used in the final literature review. 
 
 RESULTS: Fifty-one articles were included in the final review. Predictors of vaccine hesitancy included demographics (income, education, marital status, race/ethnicity), healthcare practices (provider relationship, use of complementary or alternative medicine), and social-cultural factors. Parental rationale for vaccine hesitancy included concerns about the safety of vaccinations, not fearing diseases covered by vaccinations, and the belief that vaccines were not necessary. The most consistent and prevalent theme of vaccination hesitancy was the strength of the influence that the medical provider has on the parents.
 
 CONCLUSION: Balanced communication with a trusted medical provider that addresses both the benefits and risk of vaccinations, along with parents’ concerns about safety are important factors to reduce vaccine hesitancy among parents.
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Bhardwaj, Priya, Sunita K. Yadav, Sunita Jetly, Daman Saluja, and Jyoti Taneja. "Unveiling parental perspectives: COVID-19 vaccination for children in India." Journal of Family Medicine and Primary Care 13, no. 4 (2024): 1481–87. http://dx.doi.org/10.4103/jfmpc.jfmpc_1485_23.
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ABSTRACT Background: Irrespective of the availability of a safe and effective COVID-19 vaccine and its success rate in adults, administering vaccines to children remains a challenge for healthcare workers. Children’s vaccine hesitancy among parents remains substantial and is exacerbated due to misleading information. In the present study, we aimed to investigate the hesitancy of parents and their concern about the vaccination and clinical characteristics of COVID-19 in their children. Methods: A cross-sectional web-based and offline survey comprised of questions about the demographic of children, the status of COVID-19 infection, its severity, vaccination status, sources of information, willingness, concerns and attitude of parents to vaccinate their children against the COVID-19 virus, was conducted. Overall, 846 responses from parents fulfilling the inclusion criteria were analysed by GraphPad Prism 5. Results: Out of the 846 responses, 51.2% (n = 433) of children were vaccinated against COVID-19. Out of vaccinated children (51.2%), 60.3% (n = 261) had experienced adverse events. Around 21% (n = 98) of children had a history of exposure to the SARS-CoV-2 virus. Among the infected children, 14.3% were asymptomatic and 85.7% had symptoms. Approximately 8% of children had comorbidities, with chronic lung diseases and asthma being the most common. Among the 846 participating parents, 59.5% were mothers and the remaining 40.5% were fathers. A total of 2.7% and 22.2% of parents were found hesitant to administer the COVID-19 vaccine to their children aged 15–18 years and below 15 years, respectively. Among hesitant parents, mothers were found slightly more hesitant as compared to fathers. Also, 35.5% of parents were found hesitant about their own COVID-19 vaccination. Furthermore, the concern for COVID-19 vaccine unwillingness among parents is that a child has already achieved natural immunity after COVID-19 infections (76.8%) followed by vaccine safety and its side effects. The motivating factors to convince parents for their children’s COVID-19 vaccination were if their doctors recommend it, followed by detailed information on vaccine side effects and efficacy in children. The most trusted source of information for the parents was found to be the healthcare workers. Conclusion: These results suggest that data and reviews regarding the safety and efficacy of the COVID-19 vaccine readily available in the public domain could serve as a highly effective strategy for promoting and implementing widespread vaccination among children. By providing easily accessible and comprehensive information, public health authorities can address parental concerns, dispel misconceptions and foster a greater sense of trust in the vaccination process.
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Laura, Jacobs, Kattumana Tarunjose, Konnova Angelina, et al. "How Storytelling Can Combat Vaccine Hesitancy: a Transdisciplinary Approach." Transdisciplinary Insights 2, no. 1 (2018): 92–103. http://dx.doi.org/10.11116/tdi2018.2.4.
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Abstract The recent decline in vaccination rates across Europe has led to outbreaks of vaccine preventable diseases such as measles. Although there have always been persons opposed to vaccination, in recent years an increasing number of parents are losing confidence in or are being complacent about vaccinating their children. Given the accessibility of information on the internet, parents are actively and independently researching vaccines. They are exposed to negative claims about vaccines that appeal to their emotions and emotional stories tend make parents doubt vaccinations. By contrast, most positive vaccine messages focus on providing information through scientific data which has proven to be ineffective for some hesitant parents.Vaccine hesitancy can only be understood by looking at it from different perspectives and by exchanging knowledge between multiple fields of study. A transdisciplinary approach, in which individuals with different backgrounds search for solutions together, is necessary to be able to provide one or more solutions to the problem. Therefore, we spent eight months trying to solve part of this wicked <target target-type="page-num" id="p-93"/>problem from a transdisciplinary perspective. Based on literature reviews of different topics within vaccine hesitancy, interviews with hesitant parents, interactions with various stakeholders within and outside academia, and analyses of popular views on social media concerning vaccines, we question the effectiveness of the current pro-vaccine approaches. We also suggest adopting ‘storytelling’ that incorporates scientific data to inform parents and we argue that narratives are intrinsically persuasive as they are easier to understand and could prove more effective than traditional scientific communication. We expect that this strategy will contribute to the increase in and maintenance of high vaccination coverage rates and stop the circulation and outbreak of vaccine preventable diseases.
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Evans, William Douglas, and Jeff French. "Demand Creation for COVID-19 Vaccination: Overcoming Vaccine Hesitancy through Social Marketing." Vaccines 9, no. 4 (2021): 319. http://dx.doi.org/10.3390/vaccines9040319.
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The COVID-19 pandemic has led to millions of deaths and tested the capabilities of the medical and public health systems worldwide. Over the next two years as more approved vaccines are made available and supply meets or exceeds demand, medical and public health professionals will increasingly be faced with the challenge of vaccine hesitancy. There is an urgent need to create demand in groups that are either uninformed, vaccine hesitant, or actively resistant to COVID-19 vaccination. This study reviews theory, evidence, and practice recommendations to develop a vaccine demand creation strategy that has wide applicability. Specifically, we focus on key elements including supply side confidence, vaccine brand promotion strategy, service marketing as it relates to vaccine distribution, and competition strategy. We present evidence that these strategies can make a significant contribution to overcoming COVID-19 hesitancy in a high supply scenario. The paper also makes recommendations about factors that need to be considered in relation to vaccine delivery services and systems that, if done badly, may reduce uptake or result in the creation of more vaccine hesitancy. In summary, there is a need for well researched and tested demand creation strategies that integrate with brand strategy, supply side, and service delivery.
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Dutta, Palash, and Rupjit Saikia. "A Decision-making Approach for Choosing a Reliable Product under the Hesitant Fuzzy Environment via a Novel Distance Measure." Vikalpa: The Journal for Decision Makers 45, no. 3 (2020): 147–59. http://dx.doi.org/10.1177/0256090920976765.
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Executive Summary In the contemporary time, the reliability of any product has become a big issue from the customer’s perspective due to exponentially mushrooming markets of electronics and digital gadgets. Since the use of digital equipment is tremendously increasing, as a consequence, the production and availability of products are also increasing rampantly. Due to the flooding of digital products, customers often end up in a dilemma regarding the abundant choice and subsequently, become very much dependent upon the reviews of experts and fellow customers as well. In many cases, unfortunately, it is encountered that the products are not reliable enough as suggested by the reviewers. Besides, it is often seen that the manufacturing companies provide almost similar types of features and facilities for products and customers usually end up in a dilemma The confusion gets triggered when varieties of commodities are manufactured and supplied by different manufacturers bearing almost the same features nearly at the same price. In such situations, the reviews of experts and customers already using the product become essential. The reliability of a product relies upon the reviews of the previous customers of the same product. In this article, fuzzy multi-criteria decision-making methodology has been employed to find the reliability of a product considering different features of the product based on the reviews of customers and experts. This paper presents a neo distance measure on hesitant fuzzy set which is found on the notion of score function and mean deviation. Explanatory instances are provided to reveal the distinctiveness and merit of our proposed idea on distance measure over existing distance measures. After that, the proposed distance measure is applied in the decision-making approach for taking up the best electronic products. It is evidenced that the proposed distance measure is beneficial to measure distance degree between two unequal Hesitant Fuzzy Elements (HFEs) without putting extra elements in the shorter HFE. The proposed distance measures can be utilized in the decision-making field in the near future under diverse conditions to display undetermined particulars in a much-clarified manner.
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Zhang, Dong, Chong Wu, and Jiaming Liu. "Ranking products with online reviews: A novel method based on hesitant fuzzy set and sentiment word framework." Journal of the Operational Research Society 71, no. 3 (2019): 528–42. http://dx.doi.org/10.1080/01605682.2018.1557021.
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Karin Aurani and Nana Dyki Dirbawanto. "Pengaruh Online Customer Review Dan Perceived Risk Terhadap Keputusan Pembelian." Jurnal Manajemen Bisnis Era Digital 1, no. 2 (2024): 162–77. http://dx.doi.org/10.61132/jumabedi.v1i2.101.
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Currently, the beauty care industry is experiencing significant sales growth. However, in 2022, the number of monthly web visits to Sociolla decreased. High perceived risk can make consumers hesitant to make purchases. Similarly, online customer reviews can greatly impact consumer confidence. This study aims to determine the effect of online customer reviews and perceived risk on purchasing decisions for Sociolla consumers in Medan city. The research employed a quantitative approach with an associative design. The study focused on Sociolla application users in Medan City, with a sample size of 96 respondents selected through non-probability purposive sampling. Primary data was collected through direct distribution of questionnaires, while secondary data was obtained through literature review. The study results suggest that online customer reviews have a significant positive impact on purchasing decisions. The t-count value of 4.478 (>1.985) and a significance value of 0.000 (<0.05) indicate this. Additionally, perceived risk also has a significant positive effect on purchasing decisions, with a t-count value of 2.049 (>1.985) and a significance value of 0.043 (<0.05), and a regression coefficient value of 0.134. During simultaneous testing, the variable of online customer reviews and perceived risk have a combined effect with a level of influence of 21.3%. The remaining 78.7% is influenced by factors outside the scope of this study.
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Murphy, Timothy. "The Pacifism of Duane Friesen: Engaged Realism, Process Thought, and Critical Assessment." Process Studies 42, no. 1 (2013): 110–31. http://dx.doi.org/10.2307/44798333.
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Abstract This paper reviews Duane Friesen’s version of pacifism, particularly his realist approach, his demand for political engagement, and his proactive peacemaking stance. Second, it demonstrates his connections with process thought, especially around notions of ordered novelty and contrasts, the nonviolence of God, and eschatological openness. It provides three areas of critique and suggests alternatives, specifically concerning Friesen’s Christology, his notion of revelation, and his commitment to religious pluralism. This paper offers a form of pacifism for radical mainline Christians who would otherwise be hesitant concerning some of Friesen’s theological presuppositions. The paper endeavors to show Friesen’s general compatibility with process philosophical commitments, thus furthering the conversation with process theologians who remain skeptical of pacifist commitments.
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Pa, Wei Jin, Muhammad Izat Emir Zulkifly, and Said Broumi. "Hesitant Fuzzy B-Spline Modeling: A New Approach to Quintic Spatial Curve Approximation Model." Warisan Journal of Mathematical Sciences and Engineering 1, no. 1 (2025): 26–35. https://doi.org/10.37934/wjmse.1.1.2635.
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Fuzzy geometric modeling has been applied in various fields, where the fuzzy set approach allows the representation of uncertainty for better visualization. In fact, numerous types of fuzzy sets, including the traditional fuzzy set, type-2 fuzzy set, and intuitionistic fuzzy set, among others, are successfully applied in geometric modeling, while there is a gap in representing hesitancy, which often occurs during data collection. The hesitant fuzzy set provides a method to represent hesitancy—in other words, all opinions on the data through different membership degrees assigned to each element. This paper aims to introduce a novel model, namely the hesitant fuzzy B-spline curve approximation model. The study starts with a comprehensive literature review on the development of fuzzy geometric modeling. By applying the fundamental concepts of the hesitant fuzzy set and hesitant fuzzy control point relation defined, the hesitant fuzzy B-spline curve approximation model is constructed. A numerical example of hesitant fuzzy quintic B-spline spatial curves is visualized through the model. The study demonstrates an effective and flexible method to represent uncertainty through hesitancy, which will advance the field of fuzzy geometric modeling.
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Durrani, Rukhsana, Arshad Iqbal, and Humaira Akram. "Artificial Intelligence (AI) in Early Childhood Education, Exploring Challenges, Opportunities and Future Directions: A Scoping Review." Qlantic Journal of Social Sciences 5, no. 2 (2024): 411–23. http://dx.doi.org/10.55737/qjss.135537445.
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AI literacy has emerged as a crucial aspect of digital literacy research in the field of education. Currently, there are limited studies about the implications of Artificial Intelligence (AI) in Early Childhood Education (ECE). Owing to the recent development of curricula for young learners in industrialized nations, developing countries are hesitant to adopt AI at the ECE level. A scoping review was undertaken on the content of fourteen research articles published between 2016 and 2023. This scoping review evaluates and reviews the contents of fourteen papers on the knowledge and comprehension of AI in ECE, which covers curriculum design, artificial intelligence tools, instructional methodologies, research designs, evaluation methods, findings, and various types of possibilities and problems linked to AI literacy and content. Several obstacles were identified, including (1) an insufficiently designed curriculum, (2) lacking instructors' understanding, experience, and trust in AI, and (3) the lack of an instruction manual. Engaging in reading can offer educational possibilities and foster the growth of AI literacy in young learners, encompassing AI concepts, actions, and perspectives. This study recommended AI literacy for the educators and learners of ECE to be suitable for their age group and level.
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Doh, Re-mee. "Prosthetic treatment using implants in patients with severe disabilities." Journal of The Korean Dental Association 61, no. 8 (2023): 516–27. http://dx.doi.org/10.22974/jkda.2023.61.8.002.
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Dental implant treatment is no longer a novel and experimental method, instead, it has become one of the primary options for restoring lost teeth. This technique must be carefully considered and applied to patientswith disabilities to improve their oral function and quality of life. Despite its benefits, patients with disabilitiesare often hesitant to undergo oral reconstruction using implants, particularly those with severe disabilities whomay face challenges during treatment due to communication difficulties, lack of cooperation, and involuntarymovements. These challenges may lead to uncertain treatment outcomes and prognoses. This paper reviews the critical factors to consider when performing oral reconstruction using implants in patients with severe disabilities. Considering these factors, the uncertainty associated with treatment can be reduced, and the reconstruction using implant prostheses that can be maintained over the long term can be contemplated.
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Bilszta, Justin, and Edward Nguyen. "Teaching undergraduate medical students how to communicate with vaccine-hesitant patients: A scoping review." Focus on Health Professional Education: A Multi-Professional Journal 24, no. 4 (2023): 1–23. http://dx.doi.org/10.11157/fohpe.v24i4.694.
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Introduction: Vaccine hesitancy poses a challenge to healthcare professionals. Prior to graduation, medical students may not be fully equipped with the knowledge or skills to manage interactions with vaccine-hesitant patients. The aim of this scoping review was to identify and evaluate the characteristics of educational interventions that improve medical students’ skills in communicating with vaccine-hesitant patients. Methods: EMBASE, OVID Medline, CINAHL, and ERIC databases were searched with keywords related to “vaccine hesitancy” and “undergraduate medical education”. One hundred and fourteen primary studies were identified, and seven articles were included for review. Data extraction included the characteristics of educational interventions, such as the modality, duration, frequency and assessment methods. Results: There is limited literature describing educational interventions that help medical students develop skills to effectively with vaccine-hesitant patients. This makes it difficult to draw conclusions on the effectiveness of different pedagogical approaches. Although the included studies generally reported an increase in student self-reported confidence to communicate with vaccine-hesitant patients, none assessed whether the interventions led to changes in student clinical practice or improvements in patient outcomes. Conclusion: Additional research into the identification of educational interventions that establish persistent changes in students’ knowledge, attitudes and skills to communicate with vaccine-hesitant patients is required. An evidence-based medicine component of an education program, which can adapt to evolving contributors to vaccine hesitancy and the variety of concerns across different vaccines, may present a potential solution. Educators would be better directed with further research that aligns health outcomes with teaching, assessment and evaluation of a proposed vaccine-hesitancy curriculum.
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Wallace, Cara, Stephanie Wladkowski, Ruaa Al Juboori, Anna Wingo, and Rebecca Hyde. "A SCOPING REVIEW OF PARTICIPANT MOTIVATIONS, BENEFITS, AND BURDENS IN END-OF-LIFE RESEARCH PARTICIPATION." Innovation in Aging 8, Supplement_1 (2024): 729–30. https://doi.org/10.1093/geroni/igae098.2378.
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Abstract Hospice clinicians are often hesitant to ask patients and their families/caregivers to participate in research, fearing it is too intrusive during a sensitive and vulnerable time. Further, there is a lack of research, highlighting a gap in knowledge of patient and family experience during hospice and palliative care while it also inhibits the understanding of the benefits and burdens of participation in end-of-life research. A scoping review aimed at understanding the motivating factors, benefits, and burdens of participation in research for patients with a terminal illness and their families/caregivers was conducted. Partnering with a librarian scientist, we searched PscyInfo, CINAHL, PubMed, and Scopus for studies published between 2015 and 2024 using the following search terms: “palliative care,” “terminal illness,” or “hospice” AND “subject burden,” research burden,” “benefit,” or “motivation.” 3,431 unique articles were identified and reviewed, with 24 studies meeting inclusion criteria. Results from these 24 studies were mapped out using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Many participants reported greater benefits than burdens, even reporting great value in participation when a burden was experienced. Individuals also reported that participation in a study provided an additional outlet for support, and feeling a socioemotional altruistic benefit even with no direct medical benefit as a study participant. For clinicians working in end-of-life care, connecting patients and caregivers to end-of-life research may not only be beneficial to contribute to literature as well as an additional source of ongoing support for patients and their caregivers.
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Mustian, Karen M., Michelle Janelsins, Luke J. Peppone, and Charles Kamen. "Yoga for the Treatment of Insomnia Among Cancer Patients— Evidence, Mechanisms of Action, and Clinical Recommendations." Oncology & Hematology Review (US) 10, no. 02 (2014): 164. http://dx.doi.org/10.17925/ohr.2014.10.2.164.
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Up to 90 % of cancer patients report symptoms of insomnia during and after treatment. Symptoms of insomnia include excessive daytime sleepiness, difficulty falling asleep, difficulty staying asleep, and waking up too early. Insomnia symptoms are among the most prevalent, distressing, and persistent cancer- and cancer treatment-related toxicities reported by patients and can be severe enough to increase cancer morbidity and mortality. Despite the ubiquity of insomnia symptoms, they are underscreened, underdiagnosed, and undertreated in cancer patients. When insomnia symptoms are identified, providers are hesitant to prescribe pharmaceuticals, and patients are reluctant to take them due to polypharmacy concerns. In addition, sleep medications do not cure insomnia. Yoga is a well-tolerated mode of exercise with promising evidence for its efficacy in improving insomnia symptoms among cancer patients. This article reviews existing clinical research on the effectiveness of yoga for treating insomnia among cancer patients. The article also provides clinical recommendations for prescribing yoga for the treatment of insomnia in this population.
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Schichtel, Markus, Bee Wee, Rafael Perera, Igho Onakpoya, Charlotte Albury, and Sarah Barber. "Clinician-targeted interventions to improve advance care planning in heart failure: a systematic review and meta-analysis." Heart 105, no. 17 (2019): 1316–24. http://dx.doi.org/10.1136/heartjnl-2019-314758.
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ObjectiveAdvance care planning (ACP) is widely advocated to contribute to better outcomes for patients suffering from heart failure. But clinicians appear hesitant to engage with ACP. Our aim was to identify interventions with the greatest potential to engage clinicians with ACP in heart failure.MethodsA systematic review and meta-analysis. We searched CINAHL, Cochrane Central Register of Controlled Trials, Database of Systematic Reviews, Embase, ERIC, Ovid MEDLINE, Science Citation Index and PsycINFO for randomised controlled trials (RCTs) from inception to January 2018. Three reviewers independently extracted data, assessed risk of bias (Cochrane risk of bias tool), the quality of evidence (GRADE) and intervention synergy according to Template for Intervention Description and Replication. ORs were calculated for pooled effects.ResultsOf 14 175 articles screened, we assessed the full text of 131 studies. 13 RCTs including 3709 participants met all of the inclusion criteria. The intervention categories of patient-mediated interventions (OR 5.23; 95% CI 2.36 to 11.61), reminder systems (OR 3.65; 95% CI 1.47 to 9.04) and educational meetings (OR 2.35; 95% CI 1.29 to 4.26) demonstrated a favourable effect to engage clinicians with the completion of ACP.ConclusionThe review provides evidence from 13 published RCTs and suggests that interventions that involve patients to change clinical practice, reminder systems and educational meetings have the greatest effect in improving the implementation of ACP in heart failure.
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Ali Alotaibi, Najmah, Rawan Abdullah Alhumyani, Bushra Ahmed Ali Alqahtani, Najla Jaber Alkhaldi, and Jaber Alkhaldi. "Factors Influencing Childhood Vaccination Hesitancy Among Parents in Saudi Arabia: A Systematic Review." Journal of Pioneering Medical Sciences 14, Special Issue 1 (2025): 108–18. https://doi.org/10.47310/jpms202514s0115.
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Objective: This systematic review aimed to assess childhood vaccine hesitancy among parents in Saudi Arabia and explore the perceptions of pediatric healthcare professionals regarding vaccine-hesitant parents (VHPs). Methods: Following PRISMA guidelines, a search was conducted in Scopus, PubMed and Web of Science for studies published between January 2015 and December 2024. Studies were selected using the PEO framework. Data were extracted independently by two reviewers and quality was assessed using the AXIS tool. Results: From 823 initial records, 26 studies were included in the final analysis. Vaccine hesitancy rates varied from 7.1% to 72.2%. Factors influencing hesitancy included parental education, fear of side effects, lack of reliable information, social media misinformation and limited trust in healthcare providers. Conclusion: Demographic, social and healthcare-related factors contribute significantly to vaccine hesitancy among Saudi parents. Targeted public health interventions, improved health literacy and effective physician-parent communication are essential to address this growing concern.
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Neog, Debanga Raj, Rhythm Grover, Ramdas Ransing, and Rodrigo Ramalho. "A Conceptual Framework for the Development of Chatbots Addressing COVID-19 Vaccine Hesitancy." I.P. Pavlov Russian Medical Biological Herald 30, no. 4 (2022): 575–80. http://dx.doi.org/10.17816/pavlovj91196.
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Aim of this letter is to review Chatbots that answer questions of vaccine-hesitant people, their utility, and their limitations in addressing psycho-social determinants of COVID-19 vaccine hesitancy. The authors propose a conceptual framework that could guide the development of artificial intelligence-based Chatbots and summarise the salient features of the four Chatbots discussed in the literature today, developed to address COVID-19 vaccine hesitancy.
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Nur Azisa, Nur Amelinda Kharia, Maskun, Nurul Hidayat Ab Rahman, and Arnita Pratiwi Arifin. "Criminal Acts of Physical and Non-Physical Sexual Violence in University." Jurnal IUS Kajian Hukum dan Keadilan 12, no. 3 (2024): 542–57. https://doi.org/10.29303/ius.v12i3.1497.
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Sexual violence in educational environments, especially universities, is a significant social issue that needs urgent attention. This was highlighted in a case study at Hasanuddin University in 2022. There has been an increasing number of victims over the years, largely because many victims of sexual violence, both physical and non-physical, are hesitant to report due to fear of psychological impact, concerns about victim-blaming, ongoing harassment, or discrimination. The study utilized purposive sampling and combined field studies with literature reviews for data collection. Through qualitative descriptive analysis, which included interviews and literature assessments, the research explored the involvement of victims in incidents of sexual violence at the university. It was found that the role of victims at Hasanuddin University was actively involved in both physical and non-physical aspects of sexual violence. The study also discusses what regulations and measures are effective in reducing sexual violence, providing insights into how they affect the overall environment based on the experiences of victims and authorities. Keywords: Sexual Violence, University, Victimology.
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Sansabas-Villalpando, Verónica, Iván Juan Carlos Pérez-Olguín, Luis Asunción Pérez-Domínguez, Luis Alberto Rodríguez-Picón, and Luis Carlos Mendez-González. "CODAS HFLTS Method to Appraise Organizational Culture of Innovation and Complex Technological Changes Environments." Sustainability 11, no. 24 (2019): 7045. http://dx.doi.org/10.3390/su11247045.
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Sustainable development implies establishing principles, objectives and strategies within organizations that impact the organizational culture in innovation. However, a method needs to be defined in order to know the critical factors that allow the strengthening of the organizational culture in innovation with emphasis on Industry 4.0 and sustainable development in a highly changing environment for a specific organization. In this sense, the paper identifies the set of factors that are documented through reviews and analysis of the literature, subsequently proposes a Multi-Criteria Decision Making (MCDM) methodology using hesitant fuzzy linguistic term sets (HFLTS) and combinative distance-based assessment (CODAS), where factors are evaluated to obtain a score and hierarchy value. Weight values were calculated using the ambiguity reduction method, which incorporates the knowledge acquired by researchers in organizational culture of innovation and expert judgment under the Saaty scale used in analytic hierarchy process (AHP). Finally, a model of organizational culture in innovation is proposed that can be used by organizations to focus strategies on the factors of greater hierarchy and thereby optimize their resources considering the sustainable development and the Industry 4.0 approach.
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Veyvoda, Michelle A., and Thomas J. Van Cleave. "Re-Imagining Community-Engaged Learning: Service-Learning in Communication Sciences and Disorders Courses During and After COVID-19." Perspectives of the ASHA Special Interest Groups 5, no. 6 (2020): 1542–51. http://dx.doi.org/10.1044/2020_persp-20-00146.
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Purpose Community-engaged learning, often practiced through service-learning pedagogy, has been shown to have numerous benefits for both students and communities in communication sciences and disorders undergraduate and graduate programs. While service-learning typically involves students applying their knowledge and learned skills to help satisfy an expressed community need, the recent shift to online learning combined with shuttered community partner organizations may make some practitioners hesitant to pursue the pedagogy. This tutorial reviews the literature on service-learning, its use in online learning, and ways in which faculty in higher education can re-imagine and prioritize community engagement during and after the COVID-19 pandemic. Conclusions Continued community-engaged learning, whether through virtual, hybrid, or in-person practice, is still an essential component of a liberal education that can help students practice clinical skills, develop cultural humility and cross-cultural knowledge, gain an understanding of social inequities and health care disparities, and build positive relationships with their community. There are ways for faculty to re-imagine service-learning course delivery in order to maintain the virtues of higher education, sharpen clinical skills, and develop civic engagement among students.
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Burke-Garcia, Amelia, Erin Cutroneo, Dasha Afanaseva, et al. "Findings from a qualitative analysis: Social media influencers of color as trusted messengers of HPV vaccination messages." PLOS ONE 20, no. 4 (2025): e0319160. https://doi.org/10.1371/journal.pone.0319160.
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Background Despite HPV vaccination reducing the prevalence of cervical cancer by 90%, vaccination rates remain lower among communities of color due to vaccine hesitancy and mistrust in traditional public health messengers. The emergence of social media influencers, a newer kind of messenger, presents a unique opportunity to share immunization messages in new ways with a variety of communities. This paper reviews the qualitative findings from a study aimed at assessing influencers’ perceptions of and approaches to sharing messaging about the HPV vaccine. Methods Guided by several theories (Theory of Planned Behavior, Narrative Theory, and Opinion Leader Theory), the study team designed an intervention-based study consisting of qualitative interviews and social media influencer-designed and disseminated messaging. We worked closely with an influencer marketing firm to recruit 10 influencers of color who had children aged 9-14 – to write about the vaccine with their followers. Influencers used a provided factsheet to draft social media posts about vaccinating their children against HPV. Influencers were interviewed about their post and posts and interview transcripts were analyzed for key themes. Results Most influencers were hesitant to talk about vaccinations for fear of backlash. Most committed to writing, however, because they were compelled to support important health topics. All used the power of storytelling to convey the messages and highlighted their personal journeys of vaccine decision making. Influencers also highlighted the struggles of parenting and talked emotionally about how making decisions about this vaccine prompted feelings about their child growing up. Influencers also believed that they could help people make the decision to vaccinate. Conclusions The findings from this study elucidates the emotional context within which parents are being asked to vaccinate their children and thus, how personal the decision to vaccinate is. Most influencers noted that they had received a doctor’s recommendation but were taking the time to do their own research. Insights from this study can help inform current and future public health communication programs aimed at supporting immunization efforts. It also can provide lessons for other health topics.
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Koh, Sky Wei Chee, Liow Yiyang, Victor Loh Weng Keong, Liew Seaw Jia, Chan Yiong-Huak, and Doris Young. "SG-APSIC1026: COVID-19 vaccine acceptance and hesitancy among primary healthcare workers in Singapore." Antimicrobial Stewardship & Healthcare Epidemiology 3, S1 (2023): s3. http://dx.doi.org/10.1017/ash.2023.10.
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Objectives: Factors affecting COVID-19 vaccine acceptance and hesitancy among primary-care healthcare workers (HCWs) remain poorly understood. We sought to identify factors associated with vaccine acceptance and hesitancy among HCWs. Methods: A multicenter online cross-sectional survey was performed across 6 primary-care clinics from May to June 2021, after completion of the vaccination rollout. The following data were collected: demographics, profession, years working in healthcare, residential status, presence of chronic medical conditions, self-perceived risk of acquiring COVID-19, and previous influenza vaccination. HCWs who accepted the vaccine were asked to rank their 5 best reasons for vaccine acceptance. HCWs who were vaccine hesitant completed the 5C scale on psychological antecedents of vaccination. Results: Of 1,182 eligible HCWs, 557 responded (response rate, 47.1%) and 29 were excluded due to contraindications. Among 557 respondents, the vaccine acceptance rate was 94.9% (n = 501) and 5.1% were hesitant (n = 27). COVID-19 vaccine acceptance was not associated with sex, age, ethnicity, profession, number of years in healthcare, living status, presence of chronic diseases, self-perceived risk, or previous influenza vaccination. The 3 most common reasons for COVID-19 vaccine acceptance as ranked by 501 HCWs were (1) to protect their family and friends, (2) protect themselves from COVID-19, and (3) the high risk of acquiring COVID-19 because of their jobs. The 15-item questionnaire from the 5C psychological antecedents of vaccination was completed by 27 vaccine hesitant HCWs. The mean scores for the components of the 5Cs were ‘confidence’ (3.96), ‘complacency’ (3.23), ‘constraint’ (2.85), ‘calculation’ (5.79) and ‘collective responsibility’ (4.12). Conclusions: COVID-19 vaccine hesitancy is a minute issue among primary-care HCWs in Singapore, where the acceptance rate is 95% with a 5% hesitancy rate. Future studies can focus on other settings with higher hesitancy rates and acceptance of booster vaccinations with the emergence of the SARS-CoV-2 δ (delta) variant. Trial Registration: This study was approved by the National Healthcare Group (NHG) Domain Specific Review Board (DSRB), Singapore on April 26, 2021 (Reg No. 2021/00213).
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Batteux, Eleonore, Freya Mills, Leah Ffion Jones, Charles Symons, and Dale Weston. "The Effectiveness of Interventions for Increasing COVID-19 Vaccine Uptake: A Systematic Review." Vaccines 10, no. 3 (2022): 386. http://dx.doi.org/10.3390/vaccines10030386.
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Vaccination is vital to protect the public against COVID-19. The aim of this systematic review is to identify and evaluate the effectiveness of interventions to increase COVID-19 vaccine uptake. We searched a range of databases (Embase, Medline, Psychology & Behavioral Science, PsycInfo, Web of Science and NIH Preprints Portfolio) from March 2020 to July 2021 for studies which reported primary quantitative or qualitative research on interventions to increase COVID-19 vaccine uptake. Outcome measures included vaccination uptake and reported intention to vaccinate. Reviews, position papers, conference abstracts, protocol papers and papers not in English were excluded. The NHLBI quality assessment was used to assess risk of bias. In total, 39 studies across 33 papers met the inclusion criteria. A total of 28 were assessed as good quality. They included interventions relating to communication content, communication delivery, communication presentation, policy or vaccination delivery, with 7 measuring vaccination uptake and 32 measuring vaccination intention. A narrative synthesis was conducted, which highlighted that there is reasonable evidence from studies investigating real behaviour suggesting that personalising communications and sending booking reminders via text message increases vaccine uptake. Findings on vaccination intention are mixed but suggest that communicating uncertainty about the vaccine does not decrease intention, whereas making vaccination mandatory could have a negative impact. Although much of the research used experimental designs, very few measured real behavioural outcomes. Understanding which interventions are most effective amongst vaccine-hesitant populations and in the context of booster vaccinations will be important as vaccine roll outs continue across the world.
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James, Stephanie F., LaToya J. Braun, Christine Feltman, and Robert Haight. "Development of an Integrated Immunology and Vaccines Pharmacy Elective." INNOVATIONS in pharmacy 8, no. 3 (2017): 1. http://dx.doi.org/10.24926/iip.v8i3.526.
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Objective: To describe an elective course on immunology and vaccines for pharmacy students that extends beyond basic immunization training.
 Design: A three credit-hour Immunology and Vaccines elective was developed and taught by an immunologist, policy research expert, and pharmacist. The learning objectives of the course included: understanding how the immune system works with vaccines to provide protection against infectious diseases, the history and policies involved in immunization practice, and how to counsel the vaccine hesitant individual. Classes were conducted using a variety of formats; group projects, lectures, films, literature reviews and guest speakers. An end-of-course evaluation was used to gauge student opinion on course value. Students were evaluated by four exams and a final group presentation.
 Conclusion: Students indicated that this course was valuable to their future pharmacy careers and provided insight into why people choose not to vaccinate and how they could use the course insight to properly educate such individuals.
 Conflict of Interest
 We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties
 
 Type: Note
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Ul Hassan, Mehmood, and Dr Hisham Dzakiria. "Pakistani EFL Adult Learners’ Beliefs towards Corrective Feedback in Cooperative Learning Strategy." Journal of Social Sciences Research, Special Issue 5 (December 25, 2018): 749–53. http://dx.doi.org/10.32861/jssr.spi5.749.753.
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The purpose of the study was to investigate beliefs of Pakistani EFL learners towards corrective feedback in cooperative learning environment. The study is qualitative in nature and used narrative approach. This study emphasized on each student’s learning experiences with corrective feedback in cooperative learning strategy. 50 EFL students were divided into five groups. They were engaged in interdependence, group evaluation and face-to-face interaction for cooperative purpose for six week. The researcher observed that during first week some students in each group were hesitant in face-to-face and group evaluation activities. Later, in the third week they tried to play their part and increase their corrective feedback in L2 reading, writing and speaking activities. The interview questions were used to collect data from students. Observation was made, notes were prepared and interviews were recorded from each participant in order to understand their views about corrective feedback in Cooperative learning strategies. The findings of this study provided inspirations and motivation for English teachers to offer L2 learners suitable environment for corrective feedback. The results showed that students quickly realized being able to solve problems as a group that they could not solve as individuals. Students were satisfied by corrective feedback in peer coaching, and peer reviews.
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Koh, Sky Wei Chee, Hwei Ming Tan, Wayne Han Lee, Jancy Mathews, and Doris Young. "SG-APSIC1158: COVID-19 vaccine booster hesitancy among healthcare workers: A retrospective observational study in Singapore." Antimicrobial Stewardship & Healthcare Epidemiology 3, S1 (2023): s3—s4. http://dx.doi.org/10.1017/ash.2023.12.
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Objectives: COVID-19 booster uptake has remained poor among healthcare workers (HCWs) despite evidence of improved immunity against the SARS-COV-2 δ (delta) and ο (omicron) variants. Although most studies have used a questionnaire to assess hesitancy, we aimed to identify factors affecting booster hesitancy by examining actual vaccine uptake across time. Methods: COVID-19 vaccination database records were extracted for HCWs working at 7 Singaporean public primary-care clinics between January and December 2021. Data included sex, profession, place of practice, vaccination type, and dates. Time to booster was calculated from the date of vaccination minus the date of eligibility. The χ2 test was used to compare the relationship between first dose and booster hesitancy. The Kaplan-Meier method and the log-rank test were used to evaluate differences in cumulative booster uptake. Multivariate Cox regression was used to investigate predictors of timely booster vaccination. The vaccination rate was charted across time and was corroborated with media releases pertaining to legislative changes. Results: Of 891 primary-care HCWs, 877 (98.9%) were fully vaccinated and 73.8% of eligible HCWs had taken the booster. HCWs were less booster hesitant (median, 16 days; range, 5–31.3) compared to the first dose (median, 39 days; range, 13–119.3). First-dose–hesitant HCWs were more likely to be booster hesitant (OR, 3.66; 95% CI, 2.61–5.14). Adjusting for sex, workplace, and time to first dose, ancillary HCWs (HR, 1.53; 95% CI, 1.03–2.28), medical HCWs (HR, 1.8; 95% CI, 1.18–2.74), and nursing HCWs (HR, 1.8; 95% CI, 1.18–2.37) received boosters earlier than administrative staff. No temporal relationship was observed for booster uptake, legislative changes, or COVID-19 case numbers. Conclusions: Vaccine hesitancy among HCWs had improved from first dose to booster, with timely booster vaccination among medical and nursing staff. Tailored education, risk messaging, and strategic legislation might help reduce delayed booster vaccination. This study was approved by the National Healthcare Group (NHG) Domain Specific Review Board (DSRB), Singapore on December 28, 2021 (Reg No. 2021/01120).
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Bazel, Mahmood A., Fathey Mohammed, and Mazida Ahmad. "A Systematic Review on the Adoption of Blockchain Technology in the Healthcare Industry." EAI Endorsed Transactions on Pervasive Health and Technology 9 (April 20, 2023): e4. http://dx.doi.org/10.4108/eetpht.v9i.2844.
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INTRODUCTION: Blockchain technology is a distributed ledger, decentralized, and cryptographically secure technology which has garnered considerable interest in different sectors including healthcare. It can enable better trust, security, management, and transparency of healthcare data, processes, and transactions resulting improving quality of care. Despite the fact of the increasing number of research investigating the applications/potentials of blockchain in healthcare, there is a scarcity of comprehensive reviews that focuses on the factors that influence its adoption in the healthcare industry. OBJECTIVES: This review aims to summarise existing studies regarding the adoption of blockchain technology in the healthcare industry. This review presents a detailed review of existing empirical studies investigating the factors influencing blockchain adoption in healthcare by highlighting the research methodologies, targeted stakeholders, adoption theories/models used, and the influential factors explored in each of these studies. Careful syntheses of these studies would enable researchers and partitioners to acquire a wide knowledge and understand various opportunities and challenges of blockchain implementation in healthcare. METHODS: Inspired on “Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)” guidelines, the study's scope and research questions are established, Scopus database is selected as an information resource, search strategy, and inclusion and exclusion criteria for document selection is developed. This review was conducted in August 2022. From 223 articles found in the search, 12 met the eligibility criteria and were selected to be extensively analyzed in this review. RESULTS: This review reveals that very few empirical studies exist that sought to explore the significant factors influencing blockchain adoption in healthcare. The qualitative method was the most method employed, healthcare providers were the most targeted stakeholders, and most of the studies were not based on adoption theories/models. Privacy, government regulation, and trust were the most influential factors investigated in the studies. CONCLUSION: The utilization of blockchain can help handle many issues in healthcare systems and bring improved healthcare delivery. Little attention has been paid to highlight internal and external factors that would impact successful blockchain adoption in healthcare. Additionally, the evaluated research placed little attention on understanding how underlying factors interact, social structures and institutional mechanisms affect the adoption of blockchain in healthcare. The reasons why healthcare organizations are hesitant to implement blockchain are still not clear. There is a need to conduct more research to examine the factors influencing the decision of healthcare stakeholders to adopt blockchain by using adoption theories/models. The proposed framework of the factors in this study may contribute as a starting point for future blockchain adoption studies in the healthcare industry.
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Kashyap, Angshuman, Sangeeta Shrivastava, and Pradeep Krishnatray. "Vaccine Hesitancy: The Growing Parent–Provider Divide." Asia Pacific Media Educator 29, no. 2 (2019): 259–78. http://dx.doi.org/10.1177/1326365x19895826.
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Vast majority of parents continue to immunize their children against deadly infectious diseases. However, of late, growing number of them in both developed and developing nations have refused vaccination forcing the World Health Organization to declare vaccine hesitancy as one of the top ten major threats to global health. This research reviews literature published in the last few years to understand and explain the phenomenon. It identifies 10 reasons for people’s reluctance for vaccination: parental concerns, perceived disease susceptibility, parent–provider relationship, government policies, role of school authorities, weak interpersonal communication (IPC) skills of health workers, religious beliefs, role of media, social media and information on vaccines, and lack of trust. The review categorizes parents who hesitate or refuse vaccination into four categories: obedients, ditherers, doubters and defiants. Finally, it summarizes recommendations and steps that researchers and policy makers have made to stem the growing concerns regarding vaccine hesitancy.
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Christodoulakis, Antonios, Izolde Bouloukaki, Antonia Aravantinou-Karlatou, Michail Zografakis-Sfakianakis, and Ioanna Tsiligianni. "Vaccine Hesitancy and Associated Factors Amongst Health Professionals: A Scoping Review of the Published Literature." Vaccines 12, no. 12 (2024): 1411. https://doi.org/10.3390/vaccines12121411.
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Background/Objectives: Healthcare professionals (HCPs) hold significant influence over public attitudes toward vaccinations. Studies suggest that HCPs are hesitant towards the coronavirus disease 2019 (COVID-19) vaccines. This hesitancy could lead to lower vaccination rates in the community. Therefore, this scoping review aimed to assess the extent of hesitancy towards COVID-19 booster doses among HCPs and identify the associated factors. Methods: A comprehensive search was conducted in the PubMed and Scopus databases from April to August 2024, using keywords related to COVID-19, vaccine hesitancy, HCPs, and booster vaccination. Studies that had been peer-reviewed, published in English after 2022, and focused on the hesitancy of the COVID-19 booster dose hesitancy among HCPs were included. Out of the 6703 studies screened, 24 studies were included. Results: Most of the HCPs have received their initial series of COVID-19 vaccinations. However, there is a lower rate of uptake for booster doses, with hesitancy rates ranging from 12% to 66.5%. Hesitancy rates varied significantly across continents, with Asia, Africa, and Europe ranging from 19.7% to 66.5%, 27% to 46.1%, 14% to 60.2%, respectively. Hesitancy was reported to be influenced by various factors, including concerns about vaccine safety, necessity, and effectiveness of these vaccines. In addition, the hesitancy regarding booster doses was also found to be influenced by factors like age, gender, profession, and previous COVID-19. Physicians, nurses, and pharmacists exhibited vaccine hesitancy rates ranging from 12.8% to 43.7%, 26% to 37%, and 26% to 34.6%, respectively. Conclusions: Our review underscores the hesitancy among HCPs towards receiving booster doses across countries around the world and explores the underlying factors. These findings provide valuable insights for the design of future pandemic vaccination programs.
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Ayyalasomayajula, Shruti, Aditi Dhawan, Mohammed Salim Karattuthodi, et al. "A Systematic Review on Sociodemographic, Financial and Psychological Factors Associated with COVID-19 Vaccine Booster Hesitancy among Adult Population." Vaccines 11, no. 3 (2023): 623. http://dx.doi.org/10.3390/vaccines11030623.
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Background: While considerable evidence supports the safety and efficacy of COVID-19 vaccines, a sizable population expresses vaccine hesitancy. As per the World Health Organization, vaccine hesitancy is one of the top 10 hazards to global health. Vaccine hesitancy varies across countries, with India reporting the least vaccine hesitancy. Vaccine hesitancy was higher toward COVID-19 booster doses than previous shots. Therefore, identifying factors determining COVID-19 vaccine booster hesitance (VBH) is the sine qua non of a successful vaccination campaign. Methodology: This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 standards. A total of 982 articles were pooled from Scopus, PubMed and Embase, while 42 articles that addressed the factors of COVID-19 VBH were finally included for further analysis. Result: We identified factors responsible for VBH and divided them into three major groups: sociodemographic, financial, and psychological. Hence, 17 articles stated age to be a major factor for vaccine hesitancy, with most reports suggesting a negative correlation between age and fear of poor vaccination outcomes. Nine studies found females expressing greater vaccine hesitancy than males. Trust deficit in science (n = 14), concerns about safety and efficacy (n = 12), lower levels of fear regarding infection (n = 11), and worry about side effects (n = 8) were also reasons for vaccine hesitancy. Blacks, Democrats, and pregnant women showed high vaccine hesitancy. Few studies have stated income, obesity, social media, and the population living with vulnerable members as factors influencing vaccine hesitancy. A study in India showed that 44.1% of vaccine hesitancy towards booster doses could be attributed dominantly to low income, rural origin, previously unvaccinated status, or living with vulnerable individuals. However, two other Indian studies reported a lack of availability of vaccination slots, a lack of trust in the government, and concerns regarding safety as factors for vaccine hesitancy toward booster doses. Conclusion: Many studies have confirmed the multifactorial nature of VBH, which necessitates multifaceted, individually tailored interventions that address all potentially modifiable factors. This systematic review chiefly recommends strategizing the campaign for booster doses by identifying and evaluating the reasons for vaccine hesitancy, followed by appropriate communication (at both individual and community levels) about the benefits of booster doses and the risk of losing immunity without them.
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Cénat, Jude Mary, Pari-Gole Noorishad, Schwab Mulopo Bakombo, et al. "A Systematic Review on Vaccine hesitancy in Black Communities in Canada: Critical Issues and Research Failures." Vaccines 10, no. 11 (2022): 1937. http://dx.doi.org/10.3390/vaccines10111937.
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Black communities have been disproportionately impacted by Coronavirus Disease 2019 (COVID-19) in Canada, in terms of both number of infections and mortality rates. Yet, according to early studies, vaccine hesitancy appears to be higher in Black communities. The purpose of this systematic review is to examine the prevalence and factors associated with vaccine hesitancy in Black communities in Canada. Peer-reviewed studies published from 11 March 2020 to 26 July 2022, were searched through eleven databases: APA PsycInfo (Ovid), Cairn.info, Canadian Business & Current Affairs (ProQuest), CPI.Q (Gale OneFile), Cochrane CENTRAL (Ovid), Embase (Ovid), Érudit, Global Health (EBSCOhost), MEDLINE (Ovid), and Web of Science (Clarivate). Eligible studies were published in French or English and had empirical data on the prevalence or factors associated with vaccine hesitancy in samples or subsamples of Black people. Only five studies contained empirical data on vaccine hesitancy in Black individuals and were eligible for inclusion in this systematic review. Black individuals represented 1.18% (n = 247) of all included study samples (n = 20,919). Two of the five studies found that Black individuals were more hesitant to be vaccinated against COVID-19 compared to White individuals, whereas the other three found no significant differences. The studies failed to provide any evidence of factors associated with vaccine hesitancy in Black communities. Despite national concerns about vaccine hesitancy in Black communities, a color-blind approach is still predominant in Canadian health research. Of about 40 studies containing empirical data on vaccine hesitancy in Canada, only five contained data on Black communities. None analyzed factors associated with vaccine hesitancy in Black communities. Policies and strategies to strengthen health research in Black communities and eliminate the color-blind approach are discussed.
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Wahyu Joko Saputro, Supriadi Panggabean, and Ahmad Rifqi. "Android-Based Studio Fitness Application Design on Lifespa Fitness." Inspiration: Jurnal Teknologi Informasi dan Komunikasi 14, no. 2 (2024): 52–65. https://doi.org/10.35585/inspir.v14i2.94.
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The rapid advancement of smartphone technology, particularly with operating systems like Android, has facilitated the development of diverse mobile applications that deliver accessible and functional information. As a widely used platform, Android supports innovative solutions to address user needs in various domains. Fitness, as a structured form of exercise utilizing specialized equipment and techniques, aims to help individuals achieve a proportional and healthy body. Despite its popularity, many people lack knowledge about proper training methods and remain unaware of fitness centers in their vicinity. This challenge is particularly pronounced among beginners, who may feel hesitant to exercise alone. Furthermore, fitness enthusiasts often seek opportunities to exercise with friends or partners to enhance their experience. This study employs a combination of observation, interviews with relevant stakeholders, and literature reviews to gather data and insights for developing the Lifespa Fitness Android-based application. The application serves as a comprehensive fitness information hub, providing users with essential details such as membership procedures, pricing, class schedules, and the location of Lifespa Fitness. Designed with efficiency and user accessibility in mind, the application enables users to access fitness-related information conveniently anytime and anywhere via their smartphones. The development of this application not only addresses the knowledge gap in proper training methods but also fosters greater engagement in fitness activities by making information readily available and promoting social interaction among fitness enthusiasts. This research contributes to the digital transformation of the fitness industry, offering a scalable and user-friendly solution that enhances public health awareness and encourages a more active lifestyle.
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Cuzic, Cristiana, Mihai Rominu, Alisia Pricop, et al. "Clinician’s Guide to Material Selection for All-Ceramics in Modern Digital Dentistry." Materials 18, no. 10 (2025): 2235. https://doi.org/10.3390/ma18102235.
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All-ceramic restorations are the foundation of modern restorative aesthetic dentistry. The industry for dental materials now provides a large selection of biomaterials with a range of constantly improving qualities. Although this is undoubtedly advantageous, the vast array of materials may confuse even experienced dentists. Even if recently the demand of digital dentistry in daily dental practice has significantly increased, due to a lack of understanding concerning cementation techniques, which are different for each type of ceramic used, dentists are continuing to be hesitant to utilise these various CAD/CAM materials. This study analysed 58 articles from 2008 to 2025, focusing on narrative, comprehensive, and systematic reviews and in vitro studies on dental dentistry materials. English articles were included, but non-English articles and case reports were excluded. The analysis included articles from all journal categories, ensuring adherence to inclusion and exclusion criteria. The aim of the research is to assess material classifications and properties that guide practices concerning the adhesive cementation of all-ceramic restorations. In order to provide a clear overview of the composition, characteristics, clinical considerations, and current trends of contemporary dental materials, as well as some recommendations for future research in this area that would be relevant to dentists and the scientific community, the authors of the paper were guided by this structure when writing the article content. The key is to ensure the aesthetics, resistance, and long-term clinical success of the treatment plan by providing dental professionals with clear, accurate information and instructions about resin-luting materials and indirect restoration materials.
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AlShurman, Bara’ Abdallah, and Zahid Ahmad Butt. "Proposing a New Conceptual Syndemic Framework for COVID-19 Vaccine Hesitancy: A Narrative Review." International Journal of Environmental Research and Public Health 20, no. 2 (2023): 1561. http://dx.doi.org/10.3390/ijerph20021561.
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Background: Discussions regarding syndemics have dominated research in recent years. Vaccine hesitancy has also been propelled to the forefront. In this narrative review, we aim to frame a novel syndemic framework to understand the interaction between vaccine hesitancy, COVID-19, and negative health outcomes. Methods: A non-systematic electronic search was conducted in PubMed and Google Scholar. Search criteria were limited to articles published between November 2019 and June 2022. Articles related to the COVID-19 syndemic and vaccine hesitancy were included. Results: Our review revealed that the adherence to COVID-19 regulations—although they were effective in preventing COVID-19 transmission, cases, and deaths—created a dynamically unstable ‘vicious cycle’ between undesirable health, economic, and social outcomes. The “accumulation” of complex stressors decreased individuals’ cognitive flexibility and hindered them from making decisions and getting vaccinated. Furthermore, it increased individuals’ risk of acquiring COVID-19, losing their employment, increasing poverty, and decreasing healthcare utilization. We illustrated how the amalgamation of sociodemographic and contextual factors associated with COVID-19 might impact people’s vaccine decisions, making them more hesitant toward COVID-19 vaccination. Failing to receive vaccinations increases the chances of COVID-19 transmission, hospitalization, and other negative health outcomes. Conclusions: Understanding the interaction between these factors is essential to provide policymakers with inspiration to set appropriate interventions for promoting COVID-19 vaccination acceptance to decrease the overall burden of pandemics.
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Hajissa, Khalid, Hammed-Akanmu Mutiat, Nawal Al Kaabi, et al. "COVID-19 Vaccine Acceptance and Hesitancy among Migrants, Refugees, and Foreign Workers: A Systematic Review and Meta-Analysis." Vaccines 11, no. 6 (2023): 1070. http://dx.doi.org/10.3390/vaccines11061070.
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Despite the effectiveness of current vaccines in reducing the spread and severity of SARS-CoV-2 infections, many people, including migrants, refugees, and foreign workers, are hesitant to be vaccinated. This systematic review and meta-analysis (SRMA) was conducted to determine the pooled prevalence estimate of the acceptance and hesitancy rates of the COVID-19 vaccine among these populations. A comprehensive search of the peer-reviewed literature indexed in PubMed, Scopus, Science Direct, and Web of Science databases was conducted. Initially, 797 potential records were identified, of which 19 articles met the inclusion criteria. A meta-analysis of proportions using data from 14 studies revealed that the overall acceptance rate of COVID vaccination among 29,152 subjects was 56.7% (95% CI: 44.9–68.5%), while the prevalence of vaccine hesitancy among 26,154 migrants reported in 12 studies was estimated to be 31.7% (95% CI: 44.9–68.5%). The acceptance rate for the COVID-19 vaccination first declined from 77.3% in 2020 to 52.9% in 2021 and then slightly increased to 56.1% in 2022. The most frequent factors influencing vaccine hesitancy were worries about vaccine efficacy and safety. Intensive vaccination campaigns should be implemented to raise vaccination awareness among migrants, which will increase the acceptance rate for the COVID-19 vaccine and result in herd immunity.
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Omayo, L. N., O. O. Malande, A. M. Musyoki, P. X. Hoffman, and V. E. Adamu. "Determinants of human papillomavirus (HPV) vaccine hesitancy in sub-Saharan Africa: A systematic review." Journal of the African Society for Paediatric Infectious Diseases 2 (December 30, 2023): 1–29. https://doi.org/10.15641/jafspidvol2pp1-29/1666.
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Background: Vaccine hesitancy is a major public health issue that has negatively impacted vaccine uptake in sub-Saharan Africa (SSA). The reasons why individuals hesitate or refuse to vaccinate are variable and factors contributing to vaccine hesitancy are not well outlined. This review, therefore, aims to identify and describe the determinants of HPV vaccine hesitancy in SSA.Methods: A systematic search was conducted across four electronic databases (PubMed, Scopus, CINAHL and Web of Science) from 2007 until October 2021 and updated in January 2022. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, 13 studies were eligible and were included in the analysis. Data extraction and synthesis were guided by the Health Belief Model. Quality assessment was performed using the NIH and CASP quality assessment tools.Results: The most frequently reported factors influencing HPV vaccine hesitancy included concerns about side effects and infertility; limited knowledge of HPV vaccine, HPV infection, and cervical cancer; lack of awareness of vaccination opportunities; mistrust of health workers, health authorities, and new vaccines; influence by caregivers, peers, community members or respected members of the society and religious and cultural factors. Other factors included accessibility issues (roads in poor condition, transport costs), adolescent absenteeism on vaccination day and dropping out of school.Conclusion: To reduce hesitancy and improve HPV vaccination coverage, vaccination programs need to develop and implement inclusive and context-specific strategies to enhance vaccine confidence, alleviate concerns, engage, and provide appropriate information to stakeholders involved in HPV vaccination, and dispel rumours and misinformation. The capacity of teachers and healthcare providers must be reinforced to equip them with knowledge about HPV vaccines, improve their interpersonal communication skills so that they can be better advocates for the vaccine within their communities.
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Vrhovac, Vijoleta, Marko Orošnjak, Kristina Ristić, et al. "Unsupervised Modelling of E-Customers’ Profiles: Multiple Correspondence Analysis with Hierarchical Clustering of Principal Components and Machine Learning Classifiers." Mathematics 12, no. 23 (2024): 3794. https://doi.org/10.3390/math12233794.
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The rapid growth of e-commerce has transformed customer behaviors, demanding deeper insights into how demographic factors shape online user preferences. This study performed a threefold analysis to understand the impact of these changes. Firstly, this study investigated how demographic factors (e.g., age, gender, education) influence e-customer preferences in Serbia. From a sample of n = 906 respondents, conditional dependencies between demographics and user preferences were tested. From a hypothetical framework of 24 tested hypotheses, this study successfully rejected 8/24 (with p < 0.05), suggesting a high association between demographics with purchase frequency and reasons for quitting the purchase. However, although the reported test statistics suggested an association, understanding how interactions between categories shape e-customer profiles was still required. Therefore, the second part of this study considers an MCA-HCPC (Multiple Correspondence Analysis with Hierarchical Clustering on Principal Components) to identify user profiles. The analysis revealed three main clusters: (1) young, female, unemployed e-customers driven mainly by customer reviews; (2) retirees and older adults with infrequent purchases, hesitant to buy without experiencing the product in person; and (3) employed, highly educated, male, middle-aged adults who prioritize fast and accurate delivery over price. In the third stage, the clusters are used as labels for Machine Learning (ML) classification tasks. Particularly, Gradient Boosting Machine (GBM), Decision Tree (DT), k-Nearest Neighbors (kNN), Gaussian Naïve Bayes (GNB), Random Forest (RF), and Support Vector Machine (SVM) were used. The results suggested that GBM, RF, and SVM had high classification performance in identifying user profiles. Lastly, after performing Permutation Feature Importance (PFI), the findings suggested that age, work status, education, and income are the main determinants of shaping e-customer profiles and developing marketing strategies.
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Ananto, Yashin Hilmy, and Ina Ratnasari. "THE INFLUENCE OF VIRAL MARKETING AND ELECTRONIC-WORD OF MOUTH ON THE DECISION TO SUBSCRIBE TO THE NETFLIX APP (Survey on Instagram Followers @netflixid)." Jurnal Ecoment Global 10, no. 1 (2025): 24–35. https://doi.org/10.36982/jeg.v10i1.5153.
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Objectives: This research aims to test and analyze the effect of viral marketing and electronic word of mouth on the Netflix application purchasing decision. This study uses primary data obtained from the results of distributing questionnaires to Netflix Indonesia Instagram followers (@netflixid) Design/Methods/Approach: The method used is descriptive and verification with a quantitative approach. The sample in this study were 384 samples from 1,400,000 population taken using nonprobability sampling method with purposive sampling technique. The analysis technique used in this research is scale range analysis and multiple linear regression analysis and SPSS 26 Software. Findings: The results showed that viral marketing, electronic word of mouth, and subscription decisions in the Netflix application are in the excellent category, meaning that the viral marketing run by Netflix is considered capable of satisfying its users so that these users share their experiences online and influence other users to decide to subscribe. Partially, viral marketing has a positive and significant effect on subscription decisions, electronic word of mouth has a positive and significant effect on subscription decisions. Originality/Value: No previous studies on viral marketing and electronic word of mouth have been conducted on Netflix application subscribe decision. Practical/Policy Implication: Improving the quality of the reviews displayed and their relation to user preferences, Netflix can generate more positive responses and increase the overall positive perception of the app and content. Netflix can improve the quality and variety of its content by ensuring that the content presented has consistency in terms of story, cinematography, and genre diversity. Strategies such as providing original content relevant to local preferences can be implemented to attract subscribers so that users will feel more confident and satisfied with their decision to subscribe. In addition, free trials or subscription discounts can be offered to encourage hesitant subscribers. Keywords: Viral Marketing, Electronic Word of Mouth, Decision
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Erves, Jennifer, Consuelo H. Wilkins, Amanda F. Dempsey, et al. "Development of a Tailored Mobile Phone–Based Intervention to Facilitate Parent-Child Communication and Build Human Papillomavirus Vaccine Confidence: Formative Qualitative Study." JMIR Formative Research 7 (April 4, 2023): e43041. http://dx.doi.org/10.2196/43041.
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Background Human papillomavirus (HPV) vaccine hesitancy is on the rise, and provider communication is a first-line strategy to address parental concerns. The use of the presumptive approach and motivational interviewing by providers may not be enough to influence parental decision-making owing to the providers’ limited time, self-efficacy, and skills to implement these strategies. Interventions to enhance provider communication and build parental HPV vaccine confidence have been undertested. Delivering tailored patient education to parents via mobile phones before they visit the health care provider may address time constraints during clinic visits and positively affect vaccine uptake. Objective This study aimed to describe the development and evaluate the acceptability of a mobile phone–based, family-focused intervention guided by theory to address concerns of HPV vaccine–hesitant parents before the clinic visit, as well as explore intervention use to facilitate parent-child communication. Methods The health belief model and theory of reasoned action guided intervention content development. A multilevel stakeholder engagement process was used to iteratively develop the HPVVaxFacts intervention, including a community advisory board review, a review by an advisory panel comprising HPV vaccine–hesitant parents, a health communications expert review, semistructured qualitative interviews with HPV vaccine–hesitant parents (n=31) and providers (n=15), and a content expert review. Inductive thematic analysis was used to identify themes in the interview data. Results The qualitative interviews yielded 4 themes: overall views toward mobile device use for health information, acceptability of HPVVaxFacts, facilitators of HPVVaxFacts use, and barriers to HPVVaxFacts use. In parent interviews after reviewing HPVVaxFacts prototypes, almost all parents (29/31, 94%) stated they intended to have their child vaccinated. Most of the parents stated that they liked the added adolescents’ corner to engage in optional parent-child communication (ie, choice to share and discuss information with their child; 27/31, 87%) and shared decision-making in some cases (8/31, 26%). After incorporating all input, the final intervention consisted of a 10-item survey to identify the top 3 concerns of parents, followed by tailored education that was mapped to each of the following concerns: evidential messages, images or graphics to enhance comprehension and address low literacy, links to credible websites, a provider video, suggested questions to ask their child’s physician, and an optional adolescents’ corner to educate the patient and support parent-child communication. Conclusions The multilevel stakeholder-engaged process used to iteratively develop this novel intervention for HPV vaccine–hesitant families can be used as a model to develop future mobile health interventions. This intervention is currently being pilot-tested in preparation for a randomized controlled trial aiming to increase HPV vaccination among adolescent children of vaccine-hesitant parents in a clinic setting. Future research can adapt HPVVaxFacts for other vaccines and use in other settings (eg, health departments and pharmacies).
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Höfer, Klemens, Felix Plescher, Sarah Schlierenkamp, et al. "mHealth Apps in German Outpatient Mental Health Care: Protocol for a Mixed Methods Approach." JMIR Research Protocols 13 (December 10, 2024): e56205. https://doi.org/10.2196/56205.
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Background Mental disorders are complex diseases that affect 28% (about 17.8 million people) of the adult population in Germany annually. Since 2020, certain mobile health (mHealth) apps, so-called digital health applications (DiGA), are reimbursable in the German statutory health insurance system. A total of 27 of the 56 currently available DiGA are approved for the treatment of mental and behavioral diseases. An indicator of existing problems hindering the use of DiGA is the rather hesitant prescribing behavior. Objective This project aims to develop health policy recommendations for the optimal integration of DiGA into outpatient psychotherapeutic care. The project is funded by the Innovation Fund of the Joint Federal Committee (grant 01VSF22029). The current status quo of the use of DiGA will be analyzed. Furthermore, concepts for the integration of mHealth apps, as well as their transfer into the care process will be investigated. In addition, barriers will be identified, and existing expectations of different perspectives captured. Methods The project will be based on a mixed methods approach. A scoping review and a qualitative analysis of focus groups and expert interviews will be carried out. Additionally, an analysis of claims data of the statutory health insurance will be conducted. This will be followed by a written survey of insured persons and health care providers. Finally, health policy recommendations will be derived in cooperation with stakeholders. Results The scoping reviews and qualitative analyses have been completed, and the quantitative surveys are currently being carried out. The target number of responses in the survey of insured persons has already been achieved. Furthermore, the analysis claims data of the statutory health insurance is currently being conducted. Conclusions There is a need for research on how DiGA can be optimally integrated into the care process of patients with mental disorders as evidence regarding the topic is limited and prescribing behavior low. Although the potential of DiGA in mental health care has not yet fully unfolded, Germany serves as a model for other countries regarding reimbursable mHealth apps. This project aims to explore the potentials of DiGA and to describe the organizational, institutional, and procedural steps necessary for them to best support mental health care. International Registered Report Identifier (IRRID) DERR1-10.2196/56205
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McCready, Jemma Louise, Bethany Nichol, Mary Steen, John Unsworth, Dania Comparcini, and Marco Tomietto. "Understanding the barriers and facilitators of vaccine hesitancy towards the COVID-19 vaccine in healthcare workers and healthcare students worldwide: An Umbrella Review." PLOS ONE 18, no. 4 (2023): e0280439. http://dx.doi.org/10.1371/journal.pone.0280439.
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Background Healthcare workers (HCWs) and healthcare students display high levels of vaccine hesitancy with impact on healthcare provision, patient safety, and health promotion. The factors related to vaccine hesitancy have been reported in several systematic reviews. However, this evidence needs to be synthesised, as interventions to reduce vaccination hesitancy in this population are needed. Methods This Umbrella Review aimed to explore the barriers and facilitators of vaccine hesitancy toward the COVID-19 vaccine for HCWs and healthcare students. The review was performed and reported in accordance with Joanna Briggs Institutes guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A protocol was preregistered on PROSPERO (CRD42022327354). Eight databases were searched from November 2019 to 23rd May 2022 to identify any systematic reviews that explored factors associated with hesitancy towards the COVID-19 vaccine for HCWs or healthcare students. Results A total of 31 studies were included in the review. The majority of studies (71%) were appraised as strong or moderate quality and there was a slight degree of overlap (<5%) of primary studies between the reviews. Vaccine hesitancy was more common among HCWs and healthcare students in specific occupational roles (e.g. nurses) than others (e.g. physicians). Frequent reasons for hesitancy were related to sociodemographic factors (gender, age, ethnicity), occupational factors (COVID-19 exposure, perceived risk, mandatory vaccination), health factors (vaccination history), vaccine-related factors (concerns about safety, efficacy, side-effects, rapid development, testing, approval and distribution of the vaccine), social factors (social pressure, altruism and collective responsibility), distrust factors (key social actors, pandemic management), information factors (inadequate information and sources, exposure to misinformation). Conclusion The results from this Umbrella Review have wide-reaching implications for the research area, healthcare systems and institutions and governments worldwide. Designing tailored strategies for specific occupational groups is pivotal to increasing vaccine uptake and securing a safe healthcare provision worldwide.
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Su, Xianzhi, Hua Lu, Xinyun Li, Mingli Luo, Fangyuan Li, and Qi Zhang. "COVID-19 vaccine hesitancy in periconceptional and lactating women: a systematic review and meta-analysis protocol." BMJ Open 12, no. 11 (2022): e059514. http://dx.doi.org/10.1136/bmjopen-2021-059514.
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IntroductionThe pandemic of COVID-19 disease has caused severe impact globally. Governments consider vaccination as an effective measure to control pandemic. However, many people have been hesitant to receive COVID-19 vaccine, particularly periconceptional and lactating women. Although research has indicated that pregnant women with COVID-19 are at a higher risk of adverse pregnancy and birth outcomes, as well as severe illness. There appears to be a lack of systematic and comprehensive evidence of the prevalence and determinants of COVID-19 vaccine hesitancy among periconceptional and lactating women. As a result, it has been essential to investigate periconceptional and lactating women’s vaccination views and behaviours. This study will review articles on vaccine hesitancy among periconceptional and lactating women to assess the impact of the COVID-19 vaccine hesitancy during the pandemic.Methods and analysisWe will systematically search observational studies from 1 November 2019 to 30 October 2021 in the following databases: Web of Science, PubMed, EMBASE, MEDLINE, Cochrane Library, EBSCO, WHO COVID-19 Database, CNKI and WanFang Database. The following medical subject headings and free-text terms will be used: “COVID-19 vaccines” AND “female” AND “vaccine hesitancy”. Eligibility criteria are as follows: population (women of reproductive age); exposure (currently pregnant, lactational or trying to get pregnant); comparison (general women who are not in preconception, gestation or lactation) and outcome (the rate of COVID-19 vaccine hesitancy). Article screening and data extraction will be undertaken independently by two reviewers, and any discrepancy will be resolved through discussion. We will use I2statistics to assess heterogeneity and perform a meta-analysis when sufficiently homogeneous studies are provided. We will explore the potential sources of heterogeneity using subgroup and meta-regression analysis.Ethics and disseminationThis study will use published data, so ethical approval is not required. The findings will be disseminated by publication in peer-reviewed journal(s).PROSPERO registration numberCRD42021257511.
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Hosoda, Miwako. "Vaccine Hesitancy in Japan: From a Perspective on Medical Uncertainty and Trans-Scientific Theory." F1000Research 11 (September 27, 2022): 1103. http://dx.doi.org/10.12688/f1000research.125159.1.
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The development and dissemination of vaccines has made immunization possible and has led to the successful control and eradication of various infectious diseases in many parts of the world. However, even when vaccines that are said to be "effective" are offered, a certain number of people do not receive them, and this has become a problem known as "vaccine hesitancy”. Why is vaccine hesitancy a problem? It has been pointed out that the reason is not only because of the risk of contracting infectious diseases if they are not vaccinated, but also because of the lack of a collective immunity system. Vaccines are an effective means of acquiring immunity, but no matter how highly effective vaccines are developed, if the vaccination rate does not exceed a certain number, herd immunity cannot be acquired. Therefore, it is said that how to increase the vaccination rate of the population is a major public health challenge. Hence, the large number of people who do not receive vaccinations due to "vaccine hesitancy" is problematic. This paper reviews previous studies on "vaccine hesitancy" in Japan and analyzes people's hesitancy in terms of negative "rumors" about vaccines, risk perception of vaccine side effects, and sense of burden when receiving vaccinations. Then, I will examine that the background of "vaccine hesitancy" is not only distrust of vaccines and risk perception of side effects, but also distrust of those who provide and promote vaccinations, such as medical professionals, government, and public administration. By using medical uncertainty and trans-scientific theory, this paper argues that the problem of "vaccine hesitancy" can be reduced if medical professionals and governments show sincere empathy and attitude toward victims of adverse vaccine reactions and those who hesitate to vaccinate.