Experiences and perspectives of cancer stakeholders regarding COVID-19 vaccination.

AIM: The risk of dying from COVID-19 is higher for those who are older, immune-compromised, or chronically ill. Vaccines are an effective strategy in reducing mortality and morbidity from COVID-19. However, for COVID-19 vaccination programs to reach full potential, vaccines must be taken up by those at greatest risk, such as cancer patients. Understanding the perspectives of all stakeholders involved in cancer patient COVID-19 vaccine uptake will be critical to ensuring appropriate support, and information is provided to facilitate vaccination. The aim of this research was to explore the longitudinal views of cancer stakeholders regarding COVID-19 vaccination. METHODS: Semistructured interviews were conducted with cancer patients (n = 23), family members (n = 10), cancer health professionals (n = 19), and representatives of cancer nongovernment organizations (n = 7) across Australia 6 and 12 months postrecruitment. Transcripts were thematically analyzed, using an inductive approach. RESULTS: All stakeholder groups expressed mostly positive attitudes toward COVID-19 vaccination, with the following key themes identified: (1) high motivation-vaccination perceived as offering health protection and hope; (2) hesitancy-concern about vaccine hesitancy among the general population, with a minority hesitant themselves; (3) confusion and frustration-regarding the vaccine rollout and patient eligibility; (4) uncertainty-about vaccination in the context of cancer; (5) access to vaccination; and (6) desire for expert individualized advice-on vaccine interaction with cancer treatments. CONCLUSION: These findings highlight the COVID-19 vaccine concerns and information needs of cancer stakeholders. Policymakers need to provide clear tailored information regarding vaccine eligibility, accessibility, benefits, and risks to facilitate vaccine uptake.

Roles, experiences and perspectives of the stakeholders of "10,000 Lives" smoking cessation initiative in Central Queensland: Findings from an online survey during COVID-19 situation.

ISSUE ADDRESSED: The "10,000 Lives" initiative was launched in Central Queensland in November 2017 to reduce daily smoking prevalence to 9.5% by 2030 by promoting available smoking cessation interventions. One of the main strategies was to identify and engage possible stakeholders (local champions for the program) from hospitals and community organisations to increase conversations about smoking cessation and referrals to Quitline. We aimed to understand the roles, experiences and perceptions of stakeholders (possible champions for delivering smoking cessation support) of the "10,000 Lives" initiative in Central Queensland, Australia. METHODS: We conducted a mixed-method online survey during the COVID-19 situation (23 June 2020 to 22 August 2020) with a cross-section of possible stakeholders who were targeted for involvement in "10, 000 Lives" using a structured questionnaire with mostly closed-ended questions. Questions were asked regarding their roles, experiences and perceptions about smoking cessation and "10,000 Lives". RESULTS: Among the 110 respondents, 52 (47.3%) reported having provided smoking cessation support, including referral to Quitline, brief intervention and promoting existing interventions. Among them (n = 52), 31 (59.6%) were from hospitals and health services, 14 (26.9%) were from community services and three (5.8%) were from private medical practices while four of them did not report their setting. Twenty-five respondents (22.7%) self-identified as being directly involved with the "10, 000 Lives" initiative, which significantly predicted provision of smoking cessation support (OR 6.0, 95% CI: 2.1-19.8). However, a substantial proportion (63.5%) of those (n = 52) who reported delivering cessation support did not identify as contributing to "10,000 Lives". CONCLUSIONS: Stakeholders from hospitals, health services and community services are the main providers of smoking cessation support in Central Queensland. More could be done to support other stakeholders to feel confident about providing cessation support and to feel included in the initiative. SO WHAT?: Engaging with a range of stakeholders is critical for health promotion program success, to further develop the program and to ensure its sustainability. As such, funding needs to be allocated to the activities that enable this process to occur.

COVID-19 Vaccination in Lower-Middle Income Countries: National Stakeholder Views on Challenges, Barriers, and Potential Solutions.

The development of COVID-19 vaccines does not imply the end of the global pandemic as now countries have to purchase enough COVID-19 vaccine doses and work towards their successful rollout. Vaccination across the world has progressed slowly in all, but a few high-income countries (HICs) as governments learn how to vaccinate their entire populations amidst a pandemic. Most low- and middle-income countries (LMICs) have been relying on the COVID-19 Vaccines Global Access (COVAX) Facility to obtain vaccines. COVAX aims to provide these countries with enough doses to vaccinate 20% of their populations. LMICs will likely encounter additional barriers and challenges rolling out vaccines compared HICs despite their significant experience from the Expanded Programme on Immunisation (EPI). This study explores potential barriers that will arise during the COVID-19 vaccine rollout in lower-middle-income countries and how to overcome them. We conducted sixteen semi-structured interviews with national-level stakeholders from Ghana and Bangladesh (eight in each country). Stakeholders included policymakers and immunisation programme experts. Data were analysed using a Framework Analysis technique. Stakeholders believed their country could use existing EPI structures for the COVID-19 vaccine rollout despite existing challenges with the EPI and despite its focus on childhood immunisation rather than vaccinating the entire population over a short period of time. Stakeholders suggested increasing confidence in the vaccine through community influencers and by utilising local government accredited institutions such as the Drug Authorities for vaccine approval. Additional strategies they discussed included training more health providers and recruiting volunteers to increase vaccination speed, expanding government budgets for COVID-19 vaccine purchase and delivery, and exploring other financing opportunities to address in-country vaccine shortages. Stakeholders also believed that LMICs may encounter challenges complying with priority lists. Our findings suggest that COVID-19 vaccination is different from previous vaccination programs, and therefore, policymakers have to expand the EPI structure and also take a systematic and collaborative approach to plan and effectively rollout the vaccines.

Considerations for Individual-Level Versus Whole-School Physical Activity Interventions: Stakeholder Perspectives.

Strategies to address declining physical activity levels among children and adolescents have focused on 'individual-level' approaches which often fail to demonstrate impact. Recent attention has been on an alternative 'whole-school' approach to increasing physical activity that involves promoting physical activity throughout all aspects of the school environment. There is, however, a lack of evidence on how whole-school physical activity approaches could be implemented in the UK. This qualitative study explored perspectives of key stakeholders on potential reasons for the lack of impact of individual-level school-based interventions on children's physical activity, and key considerations for adopting a whole-school approach. Nineteen semi-structured interviews were conducted with a range of stakeholders involved in the implementation of physical activity programmes in UK schools. Data were analysed using an inductive approach. Respondents suggested that individual-level school-based interventions to increase physical activity often failed to consult end users in the design and were typically implemented in environments unsupportive of long-term change. They subsequently outlined specific barriers and key facilitators for the adoption and implementation of whole-school approaches in UK settings and recommended a shift in research foci towards building an evidence base around educational outcomes and whole-school implementation insights.