Testing persuasive messages about booster doses of COVID-19 vaccines on intention to vaccinate in Australian adults: A randomised controlled trial.

INTRODUCTION: Achieving high COVID-19 vaccine booster coverage is an ongoing global challenge. Health authorities need evidence about effective communication interventions to improve acceptance and uptake. This study aimed to test effects of persuasive messages about COVID-19 vaccine booster doses on intention to vaccinate amongst eligible adults in Australia. METHODS: In this online randomised controlled trial, adult participants received one of four intervention messages or a control message. The control message provided information about booster dose eligibility. Intervention messages added to the control message, each using a different persuasive strategy, including: emphasising personal health benefits of booster doses, community health benefits, non-health benefits, and personal agency in choosing vaccination. After the intervention, participants answered items about COVID-19 booster vaccine intention and beliefs. Intervention groups were compared to the control using tests of two proportions; differences of ≥5 percentage points were deemed clinically significant. A sub-group analysis was conducted among hesitant participants. RESULTS: Of the 487 consenting and randomised participants, 442 (90.8%) completed the experiment and were included in the analysis. Participants viewing messages emphasising non-health benefits had the highest intention compared to those who viewed the control message (percentage point diff: 9.0, 95% CI -0.8, 18.8, p = 0.071). Intention was even higher among hesitant individuals in this intervention group compared to the control group (percentage point diff: 15.6, 95% CI -6.0, 37.3, p = 0.150). Conversely, intention was lower among hesitant individuals who viewed messages emphasising personal agency compared to the control group (percentage point diff: -10.8, 95% CI -33.0, 11.4, p = 0.330), although evidence in support of these findings is weak. CONCLUSION: Health authorities should highlight non-health benefits to encourage COVID-19 vaccine booster uptake but use messages emphasising personal agency with caution. These findings can inform communication message development and strategies to improve COVID-19 vaccine booster uptake. Clinical trial registration: Registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622001404718); trial webpage: https://www.anzctr.org.au/ACTRN12622001404718.aspx.

Understanding the factors that influence communication about COVID-19 vaccines with patients: Perspectives of Australian immunisation providers.

Background: COVID-19 immunisation providers have been at the forefront of the pandemic, and their ability to communicate effectively with patients is key to encouraging COVID-19 vaccine acceptance and uptake. This study explored providers' perspectives on the factors influencing communication with patients about COVID-19 vaccines. Methods: We used an explanatory-sequential mixed-methods approach to conduct the study between December 2021 and March 2022. Phase I involved a cross-sectional survey with immunisation providers in New South Wales (n = 341; 189 general practitioners, 118 nurses and 34 pharmacists), followed by Phase II: semi-structured, in-depth qualitative interviews (n = 19; 10 nurses, 9 pharmacists). We generated descriptive results for the survey. We analysed the qualitative data thematically using an inductive approach. Results: Almost half of survey participants reported communicating often with people who were hesitant about COVID-19 vaccines (49 %; 166/341), however, 21 % (71/341) reported inadequate time to address concerns during consultations. Interview participants reported communication challenges, including time constraints, difficulties addressing and eliciting patient concerns, and keeping up to date with changing information. Conversely, interview participants reported that easy access to government information resources, time to learn about COVID-19 vaccines proactively, knowing about and being able to use tailored strategies to support Aboriginal and Torres Strait Islander and CALD patients were helpful when communicating with patients. Conclusions: Immunisation providers play an important role in patient vaccine acceptance and uptake. Our findings indicate that whilst providers were largely confident in their interactions with patients, further communication support would strengthen providers' skills in communicating with patients who have questions and concerns about COVID-19 vaccines.

Effect of persuasive messaging about COVID-19 vaccines for 5- to 11-year-old children on parent intention to vaccinate.

AIM: Uptake of COVID-19 vaccines for children aged 5-11 years old in Australia has plateaued. Persuasive messaging is an efficient and adaptable potential intervention to promote vaccine uptake, but evidence for its effectiveness is varied and dependent on context and cultural values. This study aimed to test persuasive messages to promote COVID-19 vaccines for children in Australia. METHODS: A parallel, online, randomised control experiment was conducted between 14 and 21 January 2022. Participants were Australian parents of a child aged 5-11 years who had not vaccinated their child with a COVID-19 vaccine. After providing demographic details and level of vaccine hesitancy, parents viewed either the control message or one of four intervention texts emphasising (i) personal health benefits; (ii) community health benefits; (iii) non-health benefits; or (iv) personal agency. The primary outcome was parents' intention to vaccinate their child. RESULTS: The analysis included 463 participants, of whom 58.7% (272/463) were hesitant about COVID-19 vaccines for children. Intention to vaccinate was higher in the community health (7.8%, 95% confidence interval (CI) -5.3% to 21.0%) and non-health (6.9%, 95% CI -6.4% to 20.3%) groups, and lower in the personal agency group (-3.9, 95% CI -17.7 to 9.9) compared to control, but these differences did not reach statistical significance. The effects of the messages among hesitant parents were similar to the overall study population. CONCLUSION: Short, text-based messages alone are unlikely to influence parental intention to vaccinate their child with the COVID-19 vaccine. Multiple strategies tailored for the target audience should also be utilised.

Increased belief in vaccination conspiracy theories predicts increases in vaccination hesitancy and powerlessness: Results from a longitudinal study.

RATIONALE: Vaccinations are an important part of a public health strategy against preventable diseases, and uptake is influenced by factors including hesitancy. The belief of vaccine related misinformation including anti-vaccination conspiracy theories has been found to be associated with increased vaccine hesitancy. OBJECTIVE: While research suggests that these conspiracy theory beliefs may arise to satisfy unmet needs such as restoring loss of personal control, somewhat ironically these anti-vaccination conspiracy theories may frustrate these needs. This study examined the causal relationships between vaccination hesitancy, vaccination conspiracy theories, and vaccination related powerlessness. METHODS: Using a stationary random intercepts cross lagged panel model, we investigated the temporal ordering of vaccination hesitancy, powerlessness, and vaccination conspiracy theory beliefs in a sample of Australian adults (N = 500) in a longitudinal study with 5-timepoints over 4-months between June and October 2021. RESULTS: Results from a random intercept cross-lagged model, that separates between-person stability from within-person change, suggested that increased belief in vaccination conspiracy theories was associated with future increases in vaccination hesitancy and powerlessness (but not vice versa). Findings also showed that increases in vaccination hesitancy and conspiracy theory beliefs predicted respective increases from a person's trait-level mean at subsequent timepoints. CONCLUSIONS: Vaccination conspiracy theories appear to increase vaccination powerlessness and hesitancy, rather than satisfying an unmet need for personal control.

Democracy and belief in conspiracy theories in New Zealand

The COVID-19 pandemic supercharged the spread of fake news, misinformation, and conspiracy theories worldwide. Using a national probability sample of adults from the New Zealand Attitudes and Values Study during 2020 (17–99 years old;M = 48.59, SD = 13.86;63% women, 37% men;N = 41,487), we examined the associations between agreement with general conspiracy beliefs and political indicators of intention to vote and satisfaction with government, alongside political factors including trust in politicians, political efficacy, identity centrality, and political ideology. Left-wing political ideology, trust in politicians, and political efficacy accounted for most of the explained variance in satisfaction with the government. General conspiracy belief was also a unique contributor to lower satisfaction with the government. We also found a curvilinear relationship between political ideology with heightened belief in conspiracies at both ideological extremes and the centre. Findings are discussed in terms of the consequences of conspiracy belief on democratic engagement. [ FROM AUTHOR] Copyright of Australian Journal of Political Science is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Shining a spotlight on the dangerous consequences of conspiracy theories.

The COVID-19 pandemic has illuminated how conspiracy beliefs-that explain important events as the secret actions of the powerful-can severely impact health choices (such as reduced infection-prevention behaviours). However, the consequences of conspiracy beliefs span far beyond the topic of COVID-19. This review shines a spotlight on how conspiracy beliefs could impact public and personal health (e.g., vaccine uptake), democratic citizenship (e.g., political engagement), intergroup relations (e.g., prejudice and discrimination), and may inspire violence and extremism. We argue that conspiracy beliefs are likely to have the power to mobilise citizens in ways detrimental to a smooth-running society. We conclude the review by offering a range of fruitful avenues for future investigation.