The effects of parent's health literacy and health beliefs on vaccine hesitancy.

Parental vaccine hesitancy is a key factor influencing children's vaccination against infectious diseases such as the COVID-19. The current study aims to investigate how parent's health literacy and health belief affect parental hesitancy toward the COVID-19 vaccination, and navigate effective measures to help parents make vaccination decision for children. A mixed-mode web survey was conducted among parents of children aged 3-11 years. Parental vaccine hesitancy, health literacy, and health beliefs were assessed. Parallel mediation model examined whether the association between parent's health literacy and vaccine hesitancy was mediated by health beliefs. In total, 11.3% of the 346 participants reported vaccine hesitancy. Hesitant parents were more likely to be he mother (Father: 4.5%; Mother: 12.9%) and with children having allergic issues (Allergic: 18.3%; Non-allergic: 9.8%). Meanwhile, parents with lower health literacy were more likely to show hesitancy towards vaccinating their children (ß = -6.87, 95% CI = [-10.50, -3.11]). This relationship was partially mediated by more perceived barriers in vaccination (ß = -2.53, 95%CI = [-4.09, -1.02]), but not other health beliefs. In other words, parents with better health literacy may perceive fewer barriers in making vaccination decision for their children, thus being less hesitant. Accordingly, healthcare professionals and policy makers could design education service to promote parents' health literacy, and remove the perceived barriers as well as increase their confidence in following the COVID-19 vaccine guidance for children.

Spatial governance for COVID-19 prevention and control in China's development zones.

Mandatory policy networks are an important collaborative governance model for crisis response. To reveal the operation and effectiveness of public sector-led crisis governance at the development zone level, this study draws on collaborative governance theory to develop a theoretical framework that reveals the external constraints, collaborative dynamics, collaborative actions, and collaborative outcomes of crisis governance in development zones. Based on qualitative research methods, this study analyzes pandemic prevention policy documents issued during the pandemic by China's national economic and technological development zones and their localities to reflect the complete process of governance. The findings indicate that a mandatory policy network, guided by a local governance framework, facilitated the rapid achievement of collaboration in development zones in responding to the crisis. Top-down leadership developed over time in the public sector, and the responsiveness and innovation of enterprises and social organizations played an important role in collaborative governance. Wins at each stage of the governance process are necessary for the continuation of collaborative actions and can drive the adaptation of a collaborative approach in development zones.