Communication self-efficacy and communication apprehension in a national sample of undergraduate nursing students: A cross-sectional study.

AIM: The aim of this study was to explore communication apprehension and communication self-efficacy in undergraduate nursing students and identify factors that contribute to communication apprehension and communication self-efficacy. BACKGROUND: Communication education and skills training is often incorporated into undergraduate nursing curricula; however, communication competence continues to be a problem for novice nurses. Communication apprehension is a concept that has been only minimally researched in nursing education and can have a negative impact on student communication readiness. DESIGN: This study employed a cross-sectional design and surveyed a national sample of undergraduate nursing students between October 2022 and March 2023. METHODS: An online survey was sent out to undergraduate nursing student members of the National Student Nurses Association as well as nursing education programs in 8 states and the District of Columbia. The survey was comprised of demographic questions, the Personal Report of Communication Apprehension, and the communication subscale of the Nursing Student Self-Efficacy Survey. RESULTS: Approximately 22.1 % of the students had high communication apprehension, with the highest communication apprehension in public speaking and classroom communication. Communication self-efficacy scores ranged from 12 to 40, with a mean of 31.65 (SD = 6.28). Communication apprehension and communication self-efficacy were significantly negatively correlated. Positive and negative affect were significant predictors of communication apprehension. Affect, as well as current healthcare employment were significant predictors of communication self-efficacy. When controlling for all demographic, educational, and psychological variables, communication apprehension was a significant predictor of communication self-efficacy. CONCLUSIONS: This study is one of the few to explore communication apprehension in undergraduate nursing students. Data demonstrated that communication apprehension is a prevalent problem for many nursing students. Communication apprehension was also found to be a significant predictor of communication self-efficacy after controlling for all other variables. Progression through nursing education did not show a correlation with a decrease in the students' communication apprehension or increase in communication self-efficacy. Given these findings, educational efforts aimed at reducing communication apprehension and enhancing students' school-related affect could contribute to an improvement in communication self-efficacy.

Trust in Mass Media as Sources of Cancer Information: Findings from a Nationally Representative Cross-Sectional Survey in Japan.

Trust is a major factor in effective public dissemination and use of relevant health information to guide important health decisions. To examine mass media as a communication channel for delivering cancer information among Japanese adults, we identified the level of trust in various types of mass media as sources of cancer information, and examined factors associated with trust, including exposure to mass media, sociodemographic factors, and cancer history. Data were analyzed for 3,109 Japanese adults who responded to a nationally representative cross-sectional mail survey. Data included trust in cancer information sources, sociodemographic variables, cancer history, and exposure to mass media. Logistic regression analysis was used. The prevalence of high trust in cancer information sources was highest for physicians (94.7%). Among mass media, Internet (47.2%) was the most trusted source of cancer-related information, followed by television (44.3%), newspapers/magazines (42.7%), and radio (32.7%). The high-exposure group for newspapers (AOR = 1.28, 95%CI = 1.07-1.54) was more likely to trust newspapers. Similarly, high-exposure groups for radio (1.22, 1.02-1.45), Internet (1.21, 1.01-1.45), and television (1.30, 1.10-1.53) were positively associated with trust in each media type. Although trust in mass media was lower than trust in physicians, the study found that a large group of respondents had high levels of trust in mass media sources. Trust in cancer information from each mass media type was mainly related to the level of exposure to each mass media type. Developing health communication strategies using mass media may be effective for disseminating relevant cancer information in Japan.

Identifying Mental Health Literacy as a Key Predictor of COVID-19 Vaccination Acceptance among American Indian/Alaska Native/Native American People.

BACKGROUND: This study examines how health literacy and mental health literacy associate with the willingness to receive a COVID-19 vaccination among American Indian/Alaska Native/Native American (AI/AN) people. METHODS: The data were collected with an online Qualtrics survey in February 2021 (n = 563). A purposive snowball sampling strategy was used by sending recruitment flyers to colleagues and organizations who work with AI/AN communities to share with appropriate potential respondents. We performed linear regression analyses examining the relationships between the willingness to receive a COVID-19 vaccination and socio-demographic characteristics such as age, gender, education, health literacy, mental health literacy, self-rated physical and mental health status, worry about getting COVID-19, perceived COVID-19 susceptibility, and perceived COVID-19 severity. RESULTS: Mental health literacy and health literacy predicted 30.90% and 4.65% of the variance (R2adjusted) in the willingness to receive a COVID-19 vaccine, respectively. After holding the self-rated physical/mental health status, worry about getting COVID-19, perceived susceptibility, perceived severity, health literacy, and socio-demographics constant, mental health literacy was still a strong predictor (b = 0.03, p < 0.001) for the willingness to receive a COVID-19 vaccine (model R2adjusted = 40.14%). CONCLUSIONS: We identified mental health literacy as a substantial factor associated with the willingness to receive a COVID-19 vaccination among AI/AN respondents.

Chinese Americans' Information Sources on, Preferred Types of, and Satisfaction with COVID-19 Vaccination.

According to the Centers for Disease Control and Prevention (CDC), about 87% of Asian Americans had received at least one dose of the COVID-19 vaccine as of July 2023. The purpose of this study is to identify the sources of information, preferred vaccine types, and levels of satisfaction related to COVID-19 vaccination among Chinese Americans, the largest subgroup of Asian immigrants living in the U.S. Our survey data were collected from 241 Chinese American early adopters of the COVID-19 vaccine, who completed at least one dose of the COVID-19 vaccine in June 2021. Our results indicated that their major information sources regarding COVID-19 vaccination included health officials and authorities, local news, family/friends/co-workers, social media platforms, and healthcare professionals. More than half of the participants expressed a preference for the Pfizer-BioNTech (New York, U.S.) vaccine based on the primary considerations of safety, efficacy, credibility of the developer, and availability. A majority of the participants felt satisfied with their experience of receiving the COVID-19 vaccination. Participants with higher levels of self-efficacy and subjective norms related to receiving the COVID-19 vaccine were more likely to express satisfaction with the vaccination. These findings provide valuable insights into Chinese Americans' information sources, vaccine preferences, and satisfaction levels regarding COVID-19 vaccination. This knowledge can help guide future vaccination interventions and campaigns.

Exploring communication apprehension in nursing and healthcare education: A scoping review.

Communication among healthcare professionals is critical to optimizing patient outcomes, and communication education is incorporated into the educational programs of healthcare professions students. Communication can be a source of stress for new healthcare professionals, however, there is a lack of research on communication apprehension (CA) in healthcare students, especially in nursing education. This scoping review sought to explore CA and factors associated with CA among healthcare professions students. This scoping review report was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (Tricco et al., Annals of Internal Medicine, 2018, 169, 467-473). Twenty studies of healthcare professions students were included for analysis. The percentage of health professions students with high CA ranged from 0.7% to 27%. Five out of seven intervention studies demonstrated a significant decrease in CA after the intervention. This review identified inconsistent associations between CA and various individual and educational factors. More research is needed utilizing rigorous research designs, designs employing qualitative methodology, and studies to investigate the impact of language on CA in health professions students who speak English as a second language.

Age, gender and socioeconomic disparities in human papillomavirus (HPV) awareness and knowledge among Japanese adults after a 7-year suspension of proactive recommendation for the HPV vaccine: A nationally representative cross-sectional survey.

The Japanese government's 2013 suspension of its proactive recommendation for Human papillomavirus (HPV) vaccination resulted in low HPV vaccination coverage and was unique. However, data on awareness and knowledge of HPV vaccines in the general population was limited. Here, to investigate more recent awareness and knowledge of HPV vaccines by age, gender, and socioeconomic status, we used data from the INFORM Study 2020, a nationally representative cross-sectional survey of self-administered questionnaires with 1,998 Japanese individuals aged 20 to 59 years. We found that 47.5% of females and 21.0% of males had heard of HPV, and 33.6% of females and 16.8% of males had knowledge of HPV vaccine efficacy. After adjusting for potential confounders, females aged 50-54 years were more likely to be aware of HPV than females aged 20-24 (AOR, 2.02, 95%CI: 1.12-3.65). Females (AOR, 2.13, 95%CI: 1.48-3.07) and males (AOR, 1.64, 95%CI: 1.03-2.59) with higher education had more awareness than those with less education. Females with higher education had more knowledge about HPV vaccine efficacy than those with less education (AOR, 1.70; 95%CI: 1.16-2.50). We found a generally low level of awareness and knowledge about HPV vaccines in Japan, which might be attributable to the suspension of proactive recommendations. Additionally, we identified disparities in awareness and knowledge by age, gender, socioeconomic status, and health literacy. Enhancing HPV awareness and understanding of HPV vaccines and implementing targeted efforts for specific subpopulations within Japan after the resumption of proactive recommendation for HPV vaccines, are imperative.

The Role of Uncertainty and Negative Emotion in Chinese Parents' Self-Medication of Children with Antibiotics.

Parents self-medicating their children with antibiotics (SMA) without consulting healthcare professionals is a common practice in China. Previous research has focused primarily on examining the socioeconomic factors that contribute to the prevalence of SMA. This study adopts and extends the theory of planned behavior to understand the cognitive and emotional factors that are associated with parental SMA in China. The responses to an online survey were collected from 961 parents of children aged 6-12 years old, primarily from Gansu, Shandong, and Shaanxi provinces. More than half of the participants (66.5%) engaged in parental SMA. Amoxicillin, Cephradine, and Azithromycin were the most frequently selected antibiotics used for children. Structural equation modeling showed that uncertainty was positively associated with negative emotions, which were in turn positively associated with attitude toward SMA. Uncertainty was also negatively associated with perceived behavioral control (PBC), but the association between PBC and SMA behavior was not significant. Attitude and subjective norm were both positively associated with SMA behavior. The relationship between subjective norm and attitude was also positive. Understanding the psychological factors driving parental SMA may inform tailored interventions to promote responsible antibiotic use among parents.

Trust in and Use of COVID-19 Information Sources Differs by Health Literacy among College Students.

People's health information-seeking behaviors differ by their health literacy levels. This study assessed the relationship between health literacy and college students' levels of trust in and use of a range of health information sources of COVID-19. We collected data from August to December 2020 among college students (n = 763) through an online survey. We used a health literacy measure containing three self-reported survey questions, developed by the CDC. We assessed the extent to which participants trusted and used any of the sixteen different sources of information about COVID-19. Respondents reported high levels of trusting and using COVID-19 information from the CDC, health care providers, the WHO, state/county/city health departments, and official government websites when compared to other sources. After controlling for demographic characteristics (i.e., gender, age, race, ethnicity, and income), those who reported having lower health literacy were significantly less likely to trust and use COVID-19 information from these health authorities when compared to participants who reported having higher health literacy. Students with lower self-reported health literacy indicated not trusting or using official health authority sources for COVID-19 information. Relying on low-quality information sources could create and reinforce people's misperceptions regarding the virus, leading to low compliance with COVID-19-related public health measures and poor health outcomes.

Exploring Factors Associated with Chinese-Americans' Willingness to Receive an Additional Hypothetical Annual Dose of the COVID-19 Vaccine.

Chinese-Americans are one of the largest groups of Asian-Americans in the US with distinctive behavioral and cultural characteristics that influence health service use. Although Chinese-Americans have significantly higher COVID-19-related mortality rates, relative to other racial and ethnic groups, limited literature is available examining their willingness to accept the COVID-19 vaccine. With recent development of the combination influenza-COVID-19 vaccine by biotechnology companies to mitigate COVID-19 infection, we examined factors associated with Chinese-Americans' acceptance of hypothetical annual doses of COVID-19 vaccination before the vaccine rollout. A total of 241 Chinese-Americans who received at least one dose of the COVID-19 vaccine completed an online questionnaire developed and based on health behavior theories. Our results indicated that Chinese-American participants who were satisfied with their prior COVID-19 vaccination experience, who had more accurate knowledge and perceived higher susceptibility of getting COVID-19, were more willing to receive the annual COVID-19 vaccine in the future. The findings of our current study may be used to guide the development of strategic messages to promote uptake of the annual COVID-19 vaccine by Chinese-Americans in the U.S.

Trends and differences in perceptions of patient-centered communication among adults in the US.

OBJECTIVE: Patient-centered communication (PCC) is a key indicator of healthcare quality and is critical to patient-centered care. The purpose of this study is to examine the trends in PCC over the past decade and determine if differences in PCC by subpopulation remain METHODS: We used nationally representative survey data from the Health Information National Trends Study (HINTS) to examine PCC. We conducted trend and multivariate regression analyses to understand the changes of PCC scores and differences in PCC by key sociodemographic groups. RESULTS: PCC reported among adults minimally increased with the largest increases in participants involved in making decisions regarding their healthcare. Participants who were non-Hispanic Black, older, had less than a high school education, or rural residents reported more positive perceptions of PCC CONCLUSION: Our findings indicate improvements to PCC over time. These findings also indicate that differences in patients' perceptions of PCC continue to persist and it's possible that personal expectations may influence a person's perception of the quality of PCC experienced PRACTICE IMPLICATIONS: This study highlights the continued need for provider education in patient emotional support and providing patients with the skills and resources to engage in high quality PCC.

Expanding the Health Information National Trends Survey Research Program Internationally to Examine Global Health Communication Trends: Comparing Health Information Seeking Behaviors in the U.S. and Germany.

The Health Information National Trends Survey (HINTS) is a well-established U.S.-based research program administered by the National Cancer Institute to track the public access to and use of health information. This paper introduces a German research initiative, part of the International Studies to Investigate Global Health Information Trends (INSIGHTS) research consortium. This adaptation of the HINTS is important for initiating analyses of global health communication practices and comparing health information seeking behaviors (HISB) across nations to pinpoint potentials and challenges of health information provision and contribute to a deeper understanding of socio-contextual determinants of HISB. First cross-country comparisons revealed that the share of residents seeking for health information is high in the U.S. (80%) and Germany (74%), but different primary sources are used. Whereas a clear majority of U.S. residents chose the Internet to gather health information (74.9%), Germans most often turn to health professionals (48.0%). Socio-structural and health(care)-related predictors were found to contribute to the explanation of HISB in both countries, whereas information-related predictors were only relevant in Germany. The results indicate the need to engage in patient-provider communication to initiate HISB and to improve the access to information for residents with lower socio-economic backgrounds.

Double burden of COVID-19 knowledge deficit: low health literacy and high information avoidance.

OBJECTIVE: People with lower levels of health literacy are likely to report engaging in information avoidance. However, health information avoidance has been overlooked in previous research on responses to viral outbreaks. The purpose of this cross-sectional survey study was to assess the relationship between health literacy and COVID-19 information avoidance. Students (n = 561) at a university in the south central region of the U.S. completed our online survey conducted from April to June 2020 using simple random sampling. We measured information avoidance and the degree to which people opt not to learn about COVID-19 when given the choice. We assessed participants' health literacy level using the Newest Vital Sign (NVS), eHealth Literacy Scale (eHEALS), and All Aspect of Health Literacy Scale (AAHLS). RESULTS: Those with lower health literacy were more likely to avoid information about COVID-19. This negative association between health literacy and information avoidance was consistent across all types of health literacy measures: NVS scores (b = - 0.47, p = 0.033), eHEALS scores (b = - 0.12, p = 0.003), functional health literacy (b = - 0.66, p = 0.001), communicative health literacy (b = - 0.94, p < 0.001), information appraisal (b = - 0.36, p = 0.004), and empowerment (b = - 0.62, p = 0.027). The double burden of low health literacy and high information avoidance is likely to lead to a lack of knowledge about COVID-19.

Acculturation and Health Literacy Among Chinese Speakers in the USA with Limited English Proficiency.

BACKGROUND: Acculturation is an important factor that is uniquely associated with health literacy among racial/ethnic minorities. We examined the relationship between acculturation and health literacy among Chinese speakers in the USA who have limited English proficiency. Since language proficiency is an important subcomponent of acculturation, we also explored the relationship between English language proficiency and health literacy. METHODS: Our sample included 405 participants. To evaluate the appropriateness of the acculturation instrument to elicit valid data, we performed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). We performed linear regressions to investigate the relationship between acculturation and health literacy. RESULTS: Our acculturation instrument can be divided into three factors: English language proficiency, interactions with family and friends, and interactions with neighbors. The acculturation measurement model exhibited good fit. Higher US acculturation was associated with lower Chinese information appraisal, higher English functional health literacy, and higher English information appraisal. Higher English language proficiency was positively associated with English functional health literacy and English information appraisal. There was no relationship between English language proficiency and Chinese health literacy. Neither acculturation nor English language proficiency was associated with empowerment. DISCUSSION: English language proficiency might play an important role in English functional health literacy and information appraisal. Developing and implementing English as a second language (ESL) curriculum in health promotion intervention programs can effectively improve English functional health literacy and information appraisal among populations with LEP.

School Health Service Provider Perceptions on Facilitated Interactive Role-Play Around HPV Vaccine Recommendation.

The purpose of this study was to evaluate a facilitated interactive role-playing activity on increasing human papillomavirus (HPV) vaccine recommendation skills for school nurses and school-based health center staff. A 1-day workshop was implemented for school-based clinicians focused on improving HPV vaccination rates in schools. The workshop included a facilitated interactive role-playing activity involving five scenarios related to recommending the HPV vaccine to parents. Participants completed a usability survey with open-ended questions assessing their experience. A general inductive approach was used to examine responses. Sixteen participants completed the usability survey. The major strength identified specific to the activity included opportunity to practice evidence-based recommendation skills (n = 10). Weaknesses of the activity identified included lack of diversity (n = 4) and complexity within the scenarios (n = 2). Results could shift current educational and clinical paradigms through the implementation of hands-on education strategies to effectively train school-based clinicians to strongly recommend the HPV vaccine.

Does perceived susceptibility and severity of health problems serve as drivers for household enrolment in health insurance? A case study from Nepal.

This study was conducted from a behaviour change perspective to assess the association between the constructs of Health Belief Model and enrolment in health insurance (HI). A cross-sectional study was conducted among 810 households in Kailali and Baglung districts. The study used personal interviews to collect data. Perceived susceptibility, severity of diseases, benefits of enrolment, causes of non-enrolment, interaction with peers/neighbours, and family member's approval to enrol were independent variables and enrolment in HI served as dependent variable. More than half (52%) of the respondents evaluated themselves as not susceptible to health problems. The severity of the health problem was perceived as an economic burden. General treatment and reduction of financial load were perceived as the main benefits of enrolment. Economic status was described as the main barrier to enrol. A vast majority of the respondents had been invited to enrol, and 73% agreed to enrol. Perceived susceptibility and severity of health problems were significantly associated with HI enrolment but were not significant predictors. However, peers' requests to register in HI, discussion with relatives, and family members' approval to enrol were the most significant predictors enrolment. These factors could be incorporated into future intervention plans for increasing enrolment in HI.

Does exposure of mass media associate with utilisation of ANC services? A trend analysis from Nepal demographic and health surveys.

The study analysed antenatal care (ANC) services usage trends related to exposure to mass media based upon data from three Nepal Demographic and Health Surveys [NDHS] conducted in 2006, 2011, and 2016. Total 12,212 women aged 15-49 having live births within five years preceding each survey included in the study. Most independent variables were found to be associated with utilisation of ANC services. For example, exposure to TV illustrated an increasing services trend. Seventy-three percent of the women had exposure to Radio followed by TV (65%), and newspaper (25%). All three media were significantly associated with ANC services in all surveys (p < 0.05). High exposure to Newspapers were (2.5 times, 95%CI: 1.93-3.19), Radio (1.3 times, 95%CI: 1.13-1.46), and TV (1.6 times, 95%CI: 1.36-1.76) more likely to result in adequate (≥4) ANC visits. Age and age at marriage; caste and educational status of women; place of residence; wealth status; and women's decision-making autonomy were significant predictors for adequate ANC visits. ANC services utilisation trends increased gradually, but not satisfactory. Most socio-demographic variables were also significant predictors for utilizing ANC services. All these predictors should be used to guide ANC services promotion policies and interventions.

Evaluation of HPV Vaccine: Same Way, Same DayTM: A Pilot Study.

Missed clinical opportunities and the lack of strong and consistent vaccine recommendations are key reasons for low HPV vaccination rates. The purpose of this study was to conduct a pilot evaluation of a web-based training's impact on knowledge, attitudes, and self-efficacy related to providing evidence-based HPV vaccine recommendations. Participants completed three online interactive learning modules and the HPV Vaccine: Same Way, Same Day™ smartphone application (app). Participants completed a pre-training survey, immediate post-training survey, and two-month post-survey. Participants demonstrated a statistically significant increase in knowledge scores from T1 to T2 and T1 to T3. Mean attitudes for recommending HPV vaccination for female patients increased from T1 to T2 and T1 to T3. Mean attitudes for recommending HPV vaccination for male patients increased from T1 to T2 and T1 to T3. Mean self-efficacy scores increased from T1 to T2 and T1 to T3. The HPV Vaccine: Same Way, Same Day™ app is a promising strategy for improving HPV vaccine recommendations among physicians. Future research should explore long-term effects and enroll attending and community physicians to examine its efficacy in other physician populations.

Usability Evaluation of the Novel Smartphone Application, HPV Vaccine: Same Way, Same Day, Among Pediatric Residents.

OBJECTIVE: Scalable, deliberate practice training strategies to administer evidence-based recommendations are necessary to improve human papillomavirus (HPV) vaccination rates. We sought to characterize resident clinicians' perceptions regarding the usability of the HPV Vaccine: Same Way, Same Day smartphone application (app). Usability, a critical aspect of digital programs to promote behavior change, was evaluated. METHODS: Fifteen third-year pediatric residents were recruited to complete a usability evaluation of the HPV Vaccine: Same Way, Same Day app, which includes simulated role-play scenarios in which users interact, as a pediatrician avatar, with an animated parent hesitant to accept the vaccine for her child. The app provides information about the vaccine and utilizes deliberate practice, a purposeful and systematic approach to improve performance, to teach evidence-based vaccine recommendation practices, including motivational interviewing skills. Data were derived from in-depth, semistructured interviews with pediatric residents. We used a constructivist general inductive approach to illuminate perspectives via inductive coding and pattern identification. Garrison's theoretical construct on self-directed learning was used to cluster themes into conceptual categories. RESULTS: We classified interview data in 3 conceptual categories: self-management, internal monitoring and motivational principles. Residents described the app as interactive, easy to use, succinct, informative, engaging, and practical. All residents would recommend the HPV Vaccine: Same Way, Same Day app to a colleague. Residents suggested adding more complex cases for future iterations. CONCLUSIONS: From their perspective, pediatric residents reported that an app using deliberate practice principles has the potential to inform and advance providers' counseling skills regarding the HPV vaccine.