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1.
BMJ Open ; 12(6): e059673, 2022 06 10.
Article in English | MEDLINE | ID: covidwho-1886765

ABSTRACT

OBJECTIVE: Given the role of sociocultural gender in shaping human behaviours, the main objective of this study was to examine whether sex and gender-related factors were associated with the public's adherence to COVID-19-recommended protective health behaviours. DESIGN: This was a retrospective analysis of the survey that captured data on people's awareness, attitudes and behaviours as they relate to the COVID-19 policies. SETTING: Data from the International COVID-19 Awareness and Responses Evaluation survey collected between March 2020 and February 2021 from 175 countries. PARTICIPANTS: Convenience sample around the world. MAIN OUTCOME MEASURES: We examined the role of sex and gender-related factors in relation to non-adherence of protective health behaviours including: (1) hand washing; (2) mask wearing; and (3) physical distancing. Multivariable logistic regression was conducted to determine the factors associated with non-adherence to behaviours. RESULTS: Among 48 668 respondents (mean age: 43 years; 71% female), 98.3% adopted hand washing, 68.5% mask wearing and 76.9% physical distancing. Compared with males, females were more likely to adopt hand washing (OR=1.97, 95% CI: 1.71 to 2.28) and maintain physical distancing (OR=1.28, 95% CI: 1.22 to 1.34). However, in multivariable sex-stratified models, females in countries with higher Gender Inequality Indexes (GII) were less likely to report hand washing (adjusted OR (aOR)=0.47, 95% CI: 0.21 to 1.05). Females who reported being employed (aOR=0.22, 95% CI: 0.10 to 0.48) and in countries with low/medium GIIs (aOR=0.18, 95% CI 0.06 to 0.51) were less likely to report mask wearing. Females who reported being employed were less likely to report physical distancing (aOR=0.39, 95% CI: 0.32 to 0.49). CONCLUSION: While females showed greater adherence to COVID-19 protective health behaviours, gender-related factors, including employment status and high country-wide gender inequality, were independently associated with non-adherence. These findings may inform public health and vaccination policies in current as well as future pandemics.


Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Female , Health Behavior , Humans , Male , Pandemics/prevention & control , Retrospective Studies , SARS-CoV-2 , Surveys and Questionnaires
2.
Vaccines (Basel) ; 10(2)2022 Jan 19.
Article in English | MEDLINE | ID: covidwho-1711884

ABSTRACT

BACKGROUND: Strategies to support health care professionals on how to address vaccine hesitancy are needed. METHODS: We developed a 4-h Motivational Communication (MC) training program tailored to help physicians address hesitancy related to influenza vaccination among patients living with rheumatoid arthritis. Five MC competencies were evaluated at baseline and post-training with a standardized patient using the Motivational Interviewing Treatment Integrity [MITI] scale. Adherence to MC during clinical consultations and changes in vaccine intentions was measured as secondary outcomes. RESULTS: Seven rheumatology physicians participated in the training. MITI scores increased in all participants, and 71% (n = 5) achieved thresholds of clinical competency (i.e., ≥3.5/5 at MITI global score and ≥3/5 on at least 3 individual competency score) post-training. Autonomy/support and empathy competencies reached competency thresholds (+2.4 ± 1.3 to +4.1 ± 0.7 and +2.1 ± 0.7 to +4.1 ± 0.7, respectively). Evocation and collaboration competencies improved but without reaching competency thresholds (+1.4 ± 0.8 to +3.1 ± 1.1; +1.4 ± 0.8 to +2.9 ± 1.1, respectively). Direction did not improve. Among 21 patient consultations post-training, 15 (71%) were MC-consistent. Of the 15 patients, 67% (10/15) intended to receive the influenza vaccine and 33% (5/15) received it. CONCLUSION: A brief MC training program targeting vaccine hesitancy increased MC competency among rheumatology physicians and promoted behavioral change among patients.

4.
BMJ Open ; 12(1): e057127, 2022 01 03.
Article in English | MEDLINE | ID: covidwho-1604731

ABSTRACT

OBJECTIVE: To examine SARS-CoV-2 vaccine confidence, attitudes and intentions in Australian adults as part of the iCARE Study. DESIGN AND SETTING: Cross-sectional online survey conducted when free COVID-19 vaccinations first became available in Australia in February 2021. PARTICIPANTS: Total of 1166 Australians from general population aged 18-90 years (mean 52, SD of 19). MAIN OUTCOME MEASURES: Primary outcome: responses to question 'If a vaccine for COVID-19 were available today, what is the likelihood that you would get vaccinated?'.Secondary outcome: analyses of putative drivers of uptake, including vaccine confidence, socioeconomic status and sources of trust, derived from multiple survey questions. RESULTS: Seventy-eight per cent reported being likely to receive a SARS-CoV-2 vaccine. Higher SARS-CoV-2 vaccine intentions were associated with: increasing age (OR: 2.01 (95% CI 1.77 to 2.77)), being male (1.37 (95% CI 1.08 to 1.72)), residing in least disadvantaged area quintile (2.27 (95% CI 1.53 to 3.37)) and a self-perceived high risk of getting COVID-19 (1.52 (95% CI 1.08 to 2.14)). However, 72% did not believe they were at a high risk of getting COVID-19. Findings regarding vaccines in general were similar except there were no sex differences. For both the SARS-CoV-2 vaccine and vaccines in general, there were no differences in intentions to vaccinate as a function of education level, perceived income level and rurality. Knowing that the vaccine is safe and effective and that getting vaccinated will protect others, trusting the company that made it and vaccination recommended by a doctor were reported to influence a large proportion of the study cohort to uptake the SARS-CoV-2 vaccine. Seventy-eight per cent reported the intent to continue engaging in virus-protecting behaviours (mask wearing, social distancing, etc) postvaccine. CONCLUSIONS: Most Australians are likely to receive a SARS-CoV-2 vaccine. Key influencing factors identified (eg, knowing vaccine is safe and effective, and doctor's recommendation to get vaccinated) can inform public health messaging to enhance vaccination rates.


Subject(s)
COVID-19 , Health Communication , Vaccines , Adult , Attitude , Australia , COVID-19 Vaccines , Cross-Sectional Studies , Humans , Intention , Male , Public Health , SARS-CoV-2 , Vaccination
5.
Eur J Public Health ; 31(6): 1270-1277, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1361773

ABSTRACT

BACKGROUND: Italy was the first European country to be affected by COVID-19. Considering that many countries are currently battling the second wave of the pandemic, understanding people's perceptions and responses to government policies remain critical for informing on-going mitigation strategies. We assessed attitudes towards COVID-19 policies, levels of adherence to preventive behaviours, and the association between COVID-19 related concerns and adherence levels. METHODS: We recruited a convenience sample of Italian individuals from an international cross-sectional survey (www.icarestudy.com) from 27 March to 5 May 2020. Multivariate regression models were used to test the association between concerns and the adoption of preventive measures. RESULTS: The survey included 1332 participants [female (68%), younger than 25 (57%)] that reported high awareness (over 96%) and perceived importance (88%) of policies. We observed varied levels of adherence to: hand-washing (96%), avoiding social gatherings (96%), self-isolation if suspected or COVID-19 positive (77%). Significantly lower adherence to self-isolation was reported by individuals with current employment. High levels of concerns regarding health of other individuals and country economy were reported. Only health concerns for others were significantly associated with higher adherence to hand-washing behaviour. CONCLUSIONS: In order to inform current/future government strategies, we provide insights about population's responses to the initial pandemic phase in Italy. Communication approaches should consider addressing people's concerns regarding the health of other individuals to motivate adherence to prevention measures. Provision of social and economic support is warranted to avoid unequal impacts of governmental policies and allow effective adherence to self-isolating measures.


Subject(s)
COVID-19 , Pandemics , Cross-Sectional Studies , Female , Humans , Italy/epidemiology , Public Opinion , SARS-CoV-2 , Surveys and Questionnaires
7.
Front Public Health ; 9: 630189, 2021.
Article in English | MEDLINE | ID: covidwho-1278465

ABSTRACT

Objective: To assess and share learnings on the motivators and behavioural adherence across sex and age to evolving strategies in public policy to prevent the spread of SARS-CoV-2 at the end of a first COVID-19 wave and the beginning of a second COVID-19 wave in Australia. Design and Setting: A national longitudinal survey using a framework based on evidence-based behaviour change models. The survey was administered to a national sample representative across sex, age and location was undertaken at two time points: May 1st to 5th, 2020, and July 1st to 7th, 2020. Results: Overall 2,056 surveys were completed across the first and second rounds, with 63% (1,296/2,056) completing both. Age range was 18-99 years (median 53, IQR: 34-64). Suboptimal physical distancing and self-quarantining if unwell/diagnosed was reported in one in four respondents and not getting a test at onset of symptoms reported in one in three. Those non-adherent to all three behaviours (19%, 60/323), were mainly male, younger, lived in major cities and reported fewer concerns or motivators to change behaviour. Overall, government lockdown measures were considered very important by 81% (835/1,032) and appropriate by 75% (772/1,029). Conclusions: Prior to the suppression of a second COVID-19 wave, a significant minority of Australians reported suboptimal behavioural adherence to vital policy strategies to limit SARS-CoV-2 spread, mostly young adults and men. Successful wave 2 suppression required consistent communication from political and health leaders and supportive public health and economic strategies. Additional lockdown and punitive strategies were needed in Victoria and were generally well-supported and adhered to. To limit subsequent lockdown, this work reinforces the need for a mix of communication around saving lives of the vulnerable, and other strategies targeting high risk groups, facilitation of easy testing and minimisation of financial impacts.


Subject(s)
COVID-19 , Adolescent , Adult , Aged , Aged, 80 and over , Communicable Disease Control , Health Knowledge, Attitudes, Practice , Humans , Longitudinal Studies , Male , Middle Aged , SARS-CoV-2 , Self Report , Victoria , Young Adult
8.
Vaccines (Basel) ; 9(6)2021 Jun 17.
Article in English | MEDLINE | ID: covidwho-1273524

ABSTRACT

The success of large-scale COVID-19 vaccination campaigns is contingent upon people being willing to receive the vaccine. Our study explored COVID-19 vaccine hesitancy and its correlates in eight different countries around the globe. We analyzed convenience sample data collected between March 2020 and January 2021 as part of the iCARE cross-sectional study. Univariate and multivariate statistical analyses were conducted to explore the correlates of vaccine hesitancy. We included 32,028 participants from eight countries, and observed that 27% of the participants exhibited vaccine hesitancy, with increases over time. France reported the highest level of hesitancy (47.3%) and Brazil reported the lowest (9.6%). Women, younger individuals (≤29 years), people living in rural areas, and those with a lower perceived income were more likely to be hesitant. People who previously received an influenza vaccine were 70% less likely to report COVID-19 vaccine hesitancy. We observed that people reporting greater COVID-19 health concerns were less likely to be hesitant, whereas people with higher personal financial concerns were more likely to be hesitant. Our findings indicate that there is substantial vaccine hesitancy in several countries, with cross-national differences in the magnitude and direction of the trend. Vaccination communication initiatives should target hesitant individuals (women, younger adults, people with lower incomes and those living in rural areas), and should highlight the immediate health, social and economic benefits of vaccination across these settings. Country-level analyses are warranted to understand the complex psychological, socio-environmental, and cultural factors associated with vaccine hesitancy.

9.
Front Public Health ; 9: 628479, 2021.
Article in English | MEDLINE | ID: covidwho-1154263

ABSTRACT

Background: COVID-19 has caused a global public health emergency. Government mitigation strategies included a series of behavior-based prevention policies that had a likely impact on the spread of other contagious respiratory illnesses, such as seasonal influenza. Our aim was to explore how 2019-2020 influenza tracked onto COVID-19 pandemic and its mitigation methods. Materials and Methods: We linked the WHO FluNet database and COVID-19 confirmed cases (Johns Hopkins University) for four countries across the northern (Canada, the United States) and southern hemispheres (Australia, Brazil) for the period 2016-2020. Graphical presentations of longitudinal data were provided. Results: There was a notable reduction in influenza cases for the 2019-2020 season. Northern hemisphere countries experienced a quicker ending to the 2019-2020 seasonal influenza cases (shortened by 4-7 weeks) and virtually no 2020 fall influenza season. Countries from the southern hemisphere experienced drastically low levels of seasonal influenza, with consistent trends that were approaching zero cases after the introduction of COVID-19 measures. Conclusions: It is likely that the COVID-19 mitigation measures played a notable role in the marked decrease in influenza, with little to no influenza activity in both the northern and southern hemispheres. In spite of this reduction in influenza cases, there was still community spread of COVID-19, highlighting the contagiousness of SARS-CoV-2 compared to influenza. These results, together with the higher mortality rate from SARS-CoV-2 compared to influenza, highlight that COVID-19 is a far greater health threat than influenza.


Subject(s)
COVID-19/epidemiology , COVID-19/physiopathology , Influenza, Human/epidemiology , Influenza, Human/physiopathology , Internationality , Pandemics/statistics & numerical data , Symptom Assessment/statistics & numerical data , Australia/epidemiology , Brazil/epidemiology , Canada/epidemiology , Female , Humans , Male , Public Health/statistics & numerical data , SARS-CoV-2 , United States/epidemiology
10.
BMJ Open ; 11(3): e046127, 2021 03 11.
Article in English | MEDLINE | ID: covidwho-1133215

ABSTRACT

INTRODUCTION: In the context of a highly contagious virus with only recently approved vaccines and no cure, the key to slowing the spread of the COVID-19 disease and successfully transitioning through the phases of the pandemic, including vaccine uptake, is public adherence to rapidly evolving behaviour-based public health policies. The overall objective of the iCARE Study is to assess public awareness, attitudes, concerns and behavioural responses to COVID-19 public health policies, and their impacts, on people around the world and to link behavioural survey data with policy, mobility and case data to provide behavioural science, data-driven recommendations to governments on how to optimise current policy strategies to reduce the impact of the COVID-19 pandemic. METHODS AND ANALYSES: The iCARE study (www.icarestudy.com) uses a multiple cross-sectional survey design to capture self-reported information on a variety of COVID-19 related variables from individuals around the globe. Survey data are captured using two data capture methods: convenience and representative sampling. These data are then linked to open access data for policies, cases and population movement. ETHICS AND DISSEMINATION: The primary ethical approval was obtained from the coordinating site, the Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (REB#: 2020-2099/03-25-2020). This study will provide high-quality, accelerated and real-time evidence to help us understand the effectiveness of evolving country-level policies and communication strategies to reduce the spread of the COVID-19. Due to the urgency of the pandemic, results will be disseminated in a variety of ways, including policy briefs, social media posts, press releases and through regular scientific methods.


Subject(s)
Attitude , COVID-19/psychology , Health Policy , Quality of Life , Cross-Sectional Studies , Humans , Pandemics , Public Health , Surveys and Questionnaires
11.
Prog Cardiovasc Dis ; 67: 2-10, 2021.
Article in English | MEDLINE | ID: covidwho-1062545

ABSTRACT

COVID-19 is one of the biggest health crises that the world has seen. Whilst measures to abate transmission and infection are ongoing, there continues to be growing numbers of patients requiring chronic support, which is already putting a strain on health care systems around the world and which may do so for years to come. A legacy of COVID-19 will be a long-term requirement to support patients with dedicated rehabilitation and support services. With many clinical settings characterized by a lack of funding and resources, the need to provide these additional services could overwhelm clinical capacity. This position statement from the Healthy Living for Pandemic Event Protection (HL-PIVOT) Network provides a collaborative blueprint focused on leading research and developing clinical guidelines, bringing together professionals with expertise in clinical services and the exercise sciences to develop the evidence base needed to improve outcomes for patients infected by COVID-19.


Subject(s)
COVID-19/rehabilitation , Cardiorespiratory Fitness , Exercise , Cardiac Rehabilitation , Exercise Tolerance , Health Policy , Humans , Organizational Policy , Rehabilitation/methods , Respiratory Tract Diseases/rehabilitation , Telemedicine
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