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Objectives: We compared socio-demographic characteristics, health-related variables, vaccination-related beliefs and attitudes, vaccination acceptance, and personality traits of individuals who vaccinated against COVID-19 and who did not vaccinate by December 2021.Methods: This cross-sectional study used data of 10,642 adult participants from the Corona Immunitas eCohort, an age-stratified random sample of the population of several cantons in Switzerland. We used multivariable logistic regression models to explore associations of vaccination status with socio-demographic, health, and behavioral factors.Results: Non-vaccinated individuals represented 12.4% of the sample. Compared to vaccinated individuals, non-vaccinated individuals were more likely to be younger, healthier, employed, have lower income, not worried about their health, have previously tested positive for SARS-CoV-2 infection, express lower vaccination acceptance, and/or report higher conscientiousness. Among non-vaccinated individuals, 19.9% and 21.3% had low confidence in the safety and effectiveness of SARS-CoV-2 vaccine, respectively. However, 29.1% and 26.7% of individuals with concerns about vaccine effectiveness and side effects at baseline, respectively vaccinated during the study period.Conclusion: In addition to known socio-demographic and health-related factors, non-vaccination was associated with concerns regarding vaccine safety and effectiveness., + ID der Publikation: unilu_68453 + Sprache: Englisch + Letzte Aktualisierung: 2023-06-30 12:14:10

This study aimed to understand parental discourse about vaccination, and to provide guidance for communication that addresses the needs of parents. We analyzed parental discourse on child vaccination in general and tick-borne encephalitis (TBE) specifically in a Swiss parental online community. For this purpose, a data set containing 105k posts written by parents between 2007 and 2019 was analyzed using a combination of linguistic discourse analysis and qualitative content analysis. Results show that parents enter into a multidimensional decision-making process, characterized by elaborate practices of negotiation, consideration of vaccination recommendations as well as six distinct influencing thematic factors (vaccination safety, development and control, effectiveness, epidemiology, necessity, alternatives or additional prevention methods). The study shows a clear pattern of seasonality, with parents talking about TBE vaccination mostly triggered by events such as tick bites in spring and summer. From a public health perspective, the study emphasizes the need for sufficient, balanced, and tailored information about TBE vaccination. Online forums provide valuable information about what matters to parents and when, which can help public health authorities and practitioners provide information according to these concerns and enhance health literacy among parents.

Background: The current COVID-19 pandemic poses a huge public health challenge to governments, including the need to communicate preventive measures in a way that a large part of the population understands, accepts, and adheres to. Reaching young people is especially challenging. Previous research indicates that media information sources as well as political ideology might play an important role in the level of acceptance and adherence to such measures. We address the open question if there is a connection between political ideology, COVID-19 information behavior, and adherence with containment measures with data from the COVIDisc project. Methods: The COVIDisc project (SNF grant 196328), investigates how young people, aged 15-34 yrs., perceive the communication during the Coronavirus pandemic and what media they use to inform themselves. A random sample drawn by the Federal Statistical Office (FSO) (N=3597, 1812 from Thurgau and Zürich and 1785 from Ticino) was invited to take part in an online survey in November/December 2020. Political ideology was assessed with an 11-point scale, in which the center corresponded to a neutral position and the numbers left and right of the center corresponded to increasing left or right ideology. Results: 893 participants were included in the analysis. The mean age is 22.8 (sd 5.8), 43% are from Zurich or Thurgau and 57% from Ticino, 56% are female and 82% were born and raised in Switzerland. 27.8% of respondents placed themselves at the center of the 11-point political ideology scale and 10.2% at the poles far left/far right (4-5 points from the center). Participants using news sources and official sources placed themselves more to the left on the ideology scale, while persons not using any sources at all placed themselves more to the right. The majority of young people reported to follow the COVID-19 measures most of the time or always. First regression analyses indicate that the type of media sources used is not significantly associated with adherence to preventive measures, whereas this is the case for positioning far left/far right on the ideology scale when the interaction between far left/far right and trust in government is considered. Conclusions: Political ideology shapes young people's media use and therefore it is important to use diverse channels for COVID-19 communication. First analyses suggest that positioning far left/far right on the ideology scale is associated with less adherence to preventive measures.

Background: Co-creation is the process of involving stakeholders in the development of interventions. Although co-creation is becoming more widespread, reports of the process and lessons learned are scarce. Objective: To describe the process and lessons learned from using the COHESION manual, a co-creation methodology to develop interventions aimed at the improvement of diagnosis and/or management of chronic diseases at the primary healthcare level in a low-resource setting in Peru. Methods: Observational study to describe the use of the COHESION manual ‘Moving from Research to Interventions: The COHESION Model’ developed for a multi-country project in low- and middle-income countries for co-creation and the adaptations needed to customize it to the local context of rural communities in northern Peru. Results: The actual process of co-creation in Peru included co-creation-related questions in the formative research; an initial consultation with stakeholders at the micro, meso, and macro levels (e.g. community members, health workers, and policy-makers); the analysis of the collected data; a second consultation with each stakeholder group; the prioritization of intervention options; and finally the design of a theory of change for all activities included in the complex intervention. The complex intervention included: 1) offer training in specific diseases and soft skills to health workers, 2) create radio programs that promote chronic disease prevention and management plus empower patients to ask questions during their visits to primary health care (PHC) facilities, and 3) provide a small grant to the PHC for infrastructure improvement. Small adaptations to the COHESION manual were necessary for this co-creation process. Conclusion: This study provides a practical example of the process of co-creating complex interventions to increase access and quality of health care in a low-resource setting. The process, components, challenges and opportunities identified could be useful for other researchers who want to co-create interventions with beneficiaries in similar settings.

The global burden attributed to Neglected Tropical Diseases (NTDs) is 47.9 million Disability-Adjusted Life Years (DALYs). These diseases predominantly affect disadvantaged populations. Priority for NTDs has grown in recent years, which is observed by their inclusion in the sustainable development goals (SDGs). This study analyzed the process that allowed these diseases to be included on the global health policy agenda. This global policy analysis used the Shiffman and Smith framework to understand the determinants of global health political priority for NTDs. The framework comprises four categories: actor power, ideas, political contexts, and issue characteristics. Global documents and World Health Assembly (WHA) resolutions were examined, key-informant interviews were conducted, and academic publications were reviewed to understand the four categories that comprise the framework. A total of 37 global policy documents, 15 WHA resolutions, and 38 academic publications were examined. Twelve semi-structured interviews were conducted with individuals representing different sectors within the NTD community who have been involved in raising the priority of these diseases. This study found that several factors helped better position NTDs in the global health agenda. These include the leadership of actors that mobilized the global health community, the creation of a label combining these diseases as a group to represent a larger disease burden, the presence of mechanisms aligning the NTD community, and the agreement on ways to present the NTD burden and potential solutions. The process of building the priority of NTDs in the global health agenda shows that several determinants led to positive outcomes, but these diseases continue to have low priority at the global level which requires the implementation of actions to increase their global priority. These include sustaining the commitment of current actors and engaging new ones; increasing the attention given to diseases formerly categorized as “tool-deficient”, including zoonotic NTDs; continue leveraging on policy windows and creating favorable policy moments to sustain commitment, as well as setting realistic targets. Findings from this study can help develop strategies to build the momentum and drive actions to implement the goals of the new Roadmap for NTDs in the pathway to universal health coverage (UHC) and sustainable development., Author summary Neglected tropical diseases (NTDs) affect vulnerable populations living mostly in tropical and subtropical settings, and disproportionately affect women and children. Historically, the priority given to NTDs in global health policies has been lower than that of HIV, malaria and TB, but in recent years it has increased. To understand the processes that helped raise the positioning of NTDs in global policies, this study used a framework by Shiffman and Smith that assembles determinants of political priority under four categories: actor power, ideas, political contexts, and issue characteristics. A total of 37 global policy documents, 15 WHA resolutions, 38 academic publications, and findings from 12 semi-structured interviews with individuals representing different sectors within the NTD community, were analyzed using a policy framework proposed by Shiffman and Smith. This study found that elements that helped increase the priority of NTDs in global policies included the presence of leaders, institutions and guiding documents to mobilize the community, the creation of the NTD label, and the way the burden and solutions were presented. To continue raising the profile of NTDs at the global level, the study presents suggestions that are in line with UHC and SDG targets.

Background Social marketing is an approach to behavior change that contributes to disease prevention and control. This study aimed to understand how social marketing interventions have addressed neglected tropical diseases (NTDs). It examined the characteristics, breadth of coverage, and outcomes of social marketing interventions focused on the prevention and control of these diseases. Methodology/Principal findings Studies published in any language between January 1971 and April 2017, targeting at least one of the 17 NTDs prioritized in the World Health Organization (WHO) NTD Roadmap were considered. Included studies had interventions that applied both, at least one core social marketing concept, “social behavioral influence”, and one social marketing technique, “integrated intervention mix”, described in the Hierarchical Model of Social Marketing. This review is registered with PROSPERO CRD42017063858. Twenty interventions, addressing eight NTDs, met the inclusion criteria. They focused on behaviors related to four of the five WHO public health strategies for NTDs. Most interventions incorporated the concepts “relationship building” and “public / people orientation focus”, and the technique “insight-driven segmentation”. All the interventions reported changing behavioral determinants such as knowledge, 19 reported behavior change, and four influenced health outcomes. Conclusion/Significance Evidence from this study shows that social marketing has been successfully used to address behaviors related to most of the five public health strategic interventions for NTDs recommended by the WHO. It is suggested that social marketing interventions for the prevention and control of NTDs be grounded on an understanding of the audience and adapted to the contexts intervened. Building stakeholder relationships as early as possible, and involving the publics could help in reaching NTD outcomes. Elements of the intervention mix should be integrated and mutually supportive. Incorporating health education and capacity building, as well as being culturally appropriate, is also relevant. It is recommended that ongoing discussions to formulate the targets and milestones of the new global Roadmap for NTDs integrate social marketing as an approach to overcome these diseases., Author summary Neglected tropical diseases (NTDs) affect the life of more than a billion people, particularly those living in vulnerable conditions. Five priority strategies exist to prevent and control these diseases that require the adoption of preventive or control behaviors. Social marketing is an approach to behavior change that can help address NTDs. This study aimed to examine social marketing interventions focusing on NTDs using a systematic review of the literature. This qualitative study examined the characteristics, breadth of coverage, and outcomes of interventions for the prevention and control of NTDs. This was done using the Hierarchical Model of Social Marketing framework consisting of one principle, four concepts, and five techniques. The 20 Interventions retrieved were implemented in 13 countries, focused on eight diseases, and addressed four public health strategic interventions for NTDs. Most interventions incorporated the concepts “relationship building” and “public / people orientation focus”, and the technique “insight-driven segmentation”. Findings show that the interventions were successful in generating changes in behavioral determinants, behavior change, and health outcomes and that social marketing can be used to prevent and control NTDs. It is recommended that the new NTD Roadmap integrates this approach to behavior change.

Background: Gender is a determinant of health that intersects with other social stratifiers to shape the health and well-being of populations. Despite the recognition of gender in the global health agenda, limited evidence exists about the integration of gender considerations in interventions, including social marketing interventions, for the prevention and control of neglected tropical diseases. Social marketing is an ethical approach to behavior change aiming to benefit individuals, communities, and society. Since behaviors are gendered and affect disease transmission and healthcare patterns, one would expect social marketing interventions to be gender responsive. Objective: This study aims to understand the extent to which social marketing interventions focusing on neglected tropical diseases are gender responsive. Methods: This study uses data from social marketing interventions collected in a systematic review, this study examined 20 interventions addressing eight neglected tropical diseases in 13 countries. A modified version of the World Health Organization Gender Assessment Tool (GAT) was used to determine the gender responsiveness of the interventions, which was complemented by coding for intersectional sex and gender data. These results are presented in 12 themes. Results: One schistosomiasis intervention implemented in China was assessed as gender responsive. It was not possible to answer many questions from the GAT due to limited data reported in the publications describing the interventions. Despite this, strengths and limitations were found in all the interventions in relation to the use of sex and gender concepts, the disaggregation of data, the consideration of environmental factors, and the involvement of women or men in the different stages of the interventions. Conclusions: Many interventions showed positive actions towards gender responsiveness. However, only one was classified as gender responsive. Others failed to supply enough data for assessment. Recommendations about how sex and gender could be integrated into social marketing interventions are provided.

Comment - No abstract available.

Background: In the UK, African communities are a focus of public health efforts to increase uptake of HIV testing. Mobile phone interventions may be an innovative way of reaching migrant groups who are known to face multiple obstacles in accessing mainstream health services. This paper presents findings from a feasibility study that used participatory approaches to investigate the use of a text messaging intervention to encourage HIV testing among migrant African communities.Methods: Participants were recruited in the city of Nottingham by a team of community researchers. They were sent two text messages per week (one on HIV and one on general health) for 12 weeks. Baseline and follow-up questionnaires were completed to measure HIV testing behaviour, HIV related knowledge and attitudes and general health. Participants’views on the intervention were solicited.Results: One hundred and sixty-nine participants were enrolled in the study. Follow up data on HIV testing was obtained for 76 participants (45%) and complete follow up measures were available from 60 participants (36%). Eight reported seeking an HIV test during the study period. There were statistically significant positive changes in attitudes about HIV, and a trend towards increased knowledge about HIV. One third of participants reported improvements in physical activity levels, diet, and stress management following the intervention. The intervention messages and structure were positively evaluated.Conclusions: Well-designed mobile phone messaging proved to be a feasible and acceptable intervention to promote both HIV testing and lifestyle behaviours among African migrant communities in the UK. When co-constructed with communities, they hold considerable promise for overcoming some of the health-related barriers faced by migrant populations in new countries. Future research and service development should focus on exploiting and evaluating this potential in relation to other key health priorities.

Identifying correlates of sedentary behaviour across all levels of the ecological model and understanding their interrelations is a promising method to plan effective interventions. The present study examined whether the objectively assessed and the perceived neighbourhood are associated with children’s sedentary behaviour time (SBT). A comprehensive set of factors at different levels of influence across the ecological model were taken into account and analysed for mediating and modifying effects. Analyses were based on 1306 children and adolescents (6⁻16 years) participating in the population-based SOPHYA-study. Accelerometers were used to assess SBT, the perceived environment was examined by a validated parental questionnaire, and objective environmental data were allocated using GIS (ArcMap 10.2, Esri, Redlands, CA, USA) for each family’s residential address. A high perceived safety was associated with less SBT. Boys, those whose residential neighbourhood was characterized by dead ends in urban areas, a low main street density in the neighbourhood of children and greenness were less likely to exhibit SBT. The association of the objective environment with the respective parental perceptions was low and no significant mediating effect was found for the perceived environment. We conclude for land-use planning to reduce sedentary behaviour objective environments should be complemented with efforts to increase parental sense of security.

Different methodological approaches for implementation research in global health focusing on how interventions are developed, implemented and evaluated are needed. In this paper, we detail the approach developed and implemented in the COmmunity HEalth System InnovatiON (COHESION) Project, a global health project aimed at strengthening health systems in Mozambique, Nepal and Peru. This project developed innovative formative research at policy, health system and community levels to gain a comprehensive understanding of the barriers, enablers, needs and lessons for the management of chronic disease using non-communicable and neglected tropical diseases as tracer conditions. After formative research, COHESION adopted a co-creation approach in the planning of interventions. The approach included two interactions with each type of stakeholder at policy, health system and community level in each country which aimed to develop interventions to improve the delivery of care of the tracer conditions. Diverse tools and methods were used in order to prioritise interventions based on support, resources and impact. Additionally, a COHESION score that assessed feasibility, sustainability and scaling up was used to select three potential interventions. Next steps for the COHESION Project are to further detail and develop the interventions propositioned through this process. Besides providing some useful tools and methods, this work also highlights the challenges and lessons learned from such an approach.

Purpose – The purpose of this paper is to investigate the reasons for participating and not participating in an e-health workplace physical activity (PA) intervention. Design/methodology/approach – Semi-structured interviews and two focus groups were conducted with a purposive sample of employees who enrolled and participated in the intervention and with those who did not complete enrolment, hence did not participate in it. Data were examined using thematic analysis according to the clusters of “reasons for participation” and for “non-participation”. Findings – Reported reasons for participation included a need to be more active, to increase motivation to engage in PA, and to better manage weight. Employees were attracted by the perceived ease of use of the programme and by the promise of receiving reminders. Many felt encouraged to enrol by managers or peers. Reported reasons for non-participation included lack of time, loss of interest towards the programme, or a lack of reminders to complete enrolment. Practical implications – Future e-health workplace behavioural interventions should consider focusing on employees’ needs and motivators to behaviour change, provide regular reminders for participants to complete enrolment and ensure that procedures are completed successfully. Barriers to participation could be identified through formative research with the target population and feasibility studies. Originality/value – This study combines a qualitative analysis of the reasons why some employees decided to enrol in a workplace PA intervention and why some others did not. This study highlights factors to consider when designing, implementing and promoting similar interventions and that could inform strategies to enhance participation in workplace PA interventions.