Using a theoretical framework of Intervention Mapping to inform public health communication messages designed to increase vaccination uptake; the example of mpox in the Netherlands

Aim Vaccination hesitancy threatens herd immunity and reduces the chances of overcoming pandemics such as the recent Covid-19 pandemic. The present investigation looked at psychological predictors of Covid-19 vaccination intention and vaccination uptake. Subject and methods Two representative Norwegian samples (collected in 2020, N = 1003, and 2022, N = 1000) filled in online questionnaires assessing variables of the theory of planned behavior (attitudes, social norms, and perceived behavioral control) as well as optimistic bias and anticipated regret. Results Results showed that these variables could explain 69% of the variance in vaccination intentions and 41% of the variance in vaccination uptake. Significant predictors in both samples include attitudes, social norms within the family, perceived behavioral capability, and higher anticipated regret for not getting vaccinated. Intentions were also predicted by lower anticipated regret for getting vaccinated, and vaccination uptake was additionally predicted by older age and lower perceived behavioral autonomy. Optimistic bias did not predict intentions to get vaccinated or vaccination uptake. Conclusion Interventions designed to increase vaccination uptake should focus on attitudes, norms, perceived behavioral control, anticipated regret, and possibly altruistic motivations.

People who are homeless are at increased risk of COVID-19 infection, and of poorer associated outcomes. Delivering vaccinations to, and ensuring uptake of multiple doses in, people who are homeless is complex. Financial incentives may improve vaccination uptake, particularly in people who have not received routine vaccinations previously, though evidence about the effect of incentives is limited and variable.This randomized controlled trial (ANZCTR 383156) assessed the effect of a financial incentive (an A$10 grocery voucher) on uptake of the second COVID-19 vaccination in Australian adults who were homeless, and who had received their first dose. Participants were recruited through a vaccination program for people experiencing homelessness between September 2021 and January 2022. They were followed-up for a minimum of 6.5 months. Uptake was measured ‘on-time’ at 6 weeks, and at any time during the trial period. Vaccination status was checked on the Australian Immunisation Register. Demographic and vaccination program characteristics associated with uptake were also investigated.Eighty-six people consented to participate, and 43 were randomly allocated to each of the ‘incentive’ and ‘no incentive’ groups. The incentive slightly increased the likelihood of a participant receiving a second vaccination on-time (risk difference (RD), 11.6 % [95 %CI, −9.0, 32.2 %]; p = 0.27), and at any time during the trial (RD, 14.0 % [95 %CI, –2.2, 30.1 %], p = 0.09). The incentive had a significant positive effect on uptake in people with no previous vaccination history, increasing their likelihood of receiving a second vaccination on-time (RD, 42.3 % [95 %CI, 15.7, 68.8 %]; p = 0.002) and at any time during the trial (RD, 38.7 % [95 %CI, 16.1, 61.3 %], p < 0.001).Financial incentives may increase COVID-19 vaccination uptake in people who are homeless, and particularly those who have no previous vaccination history. Future research should consider alternative incentive values, types, and cost-effectiveness.

Background: African countries experience high rates of infectious diseases that are mostly preventable by vaccination. Despite the risks of infections and other adverse outcomes, vaccination coverage in the African region remains significantly low. Poor vaccination knowledge is a contributory factor, and effective communication is crucial to bridging the vaccination uptake gap. This review summarises vaccination communication strategies adopted across African countries and associated changes in vaccine uptake. Methods: A systematic search was conducted in five bibliographic databases between 2000 and 2023 and supplemented with an additional Google Scholar search. Studies with data on vaccination communication and uptake in the English language were considered. A narrative synthesis was performed, and findings were presented in text and tables. Findings: Forty-one studies from fourteen African countries met the inclusion criteria. Several communication strategies were implemented for 13 different vaccines, mainly childhood vaccines. Mass campaigns and capacity building were the most common strategies for the public and health workers, respectively. Community-based strategies using social mobilisation effectively complemented other communication strategies.Overall, vaccination uptake increased in all countries following vaccination communication interventions. Barriers and facilitators to optimising vaccination communication at systemic and individual levels were also identified. Key barriers included lack of vaccine information, access issues, and high cost, while facilitators included improved vaccine education, reminders, trust-building initiatives, and community involvement. Conclusions: This review highlights effective vaccination communication strategies implemented across Africa as well as systemic and individual barriers and facilitators influencing vaccination uptake. The findings can inform strategies for vaccination communication and campaign planning to improve vaccination coverage in Africa.

The COVID-19 pandemic posed a unique set of risks to pregnant women and pregnant people. SARS-CoV-2 infection in pregnancy is associated with increased risk of severe illness and adverse perinatal outcomes. However, evidence regarding the use of COVID-19 vaccines in pregnancy shows safety and efficacy. Despite eligibility and recommendations for COVID-19 vaccination among pregnant women and pregnant people in Canada, uptake remains lower compared to the general population, warranting exploration of influencing factors. The COVERED study, a national prospective cohort, utilized web-based surveys to collect data from pregnant women and pregnant people across Canada on COVID-19 vaccine attitudes, uptake, and hesitancy factors from July 2021 to December 2023. Survey questions were informed by validated tools including the WHO Vaccine Hesitancy Scale (VHS) and the Theory of Planned Behavior (TPB). Of 1093 respondents who were pregnant at the time of the survey, 87.7% received or intended to receive a COVID-19 vaccine during pregnancy. TPB variables such as positive attitudes toward COVID-19 vaccines (OR = 1.11, 95% CI = 1.08–1.14), direct social norms, and indirect social norms were significantly associated with vaccine acceptance. Perceived vaccine risks, assessed by the WHO VHS, were greater in those not accepting of the vaccine. Our study identified several key factors that play a role in vaccine uptake: perceived vaccine risks and safety and social norms. These findings may guide public health recommendations and prenatal vaccine counseling strategies.

Factors associated with pneumococcal vaccination in 2040 people with type 2 diabetes: A cross-sectional study

Digital health interventions (DHIs) are increasingly becoming integrated into diabetes self-management to improve behavior. Despite DHIs becoming available to people with chronic conditions, the development strategies and processes undertaken are often not well described. With theoretical frameworks available in current literature, it is vital that DHIs follow a shared language and communicate a robust development process in a comprehensive way. This paper aims to bring a unique perspective to digital development, as it describes the systematic process of developing a digital self-management program for people with type 2 diabetes, MyDESMOND. We provide a step-by-step guide, based on the intervention mapping (IM) framework to illustrate the process of adapting an existing face-to-face self-management program (diabetes education and self- management for ongoing and newly diagnosed, DESMOND) and translating it to a digital platform (MyDESMOND). Overall, this paper describes the 4 IM steps that were followed to develop MyDESMOND—step 1 to establish a planning group and a patient and public involvement group to describe the context of the intervention and program goals, step 2 to identify objectives and determinants at early design stages to maintain a focus on the strategies adopted, step 3 to generate the program components underpinned by appropriate psychological theories and models, and step 4 to develop the program content and describe the iterative process of refining the content and format of the digital program for implementation. This paper concludes with a number of key learnings collated throughout our development process, which we hope other researchers may find useful when developing DHIs for chronic conditions.

ABSTRACTBackground: Cervical cancer vaccination is efficacious and widely available, yet uptake is less than optimal, even in countries such as Australia that provide government-funded vaccination programmes. Effective communication strategies are needed for presenting Human Papillomavirus (HPV) vaccine-related information in a format that enhances understanding about the vaccine, and ultimately, uptake of the vaccine. Using the Common Sense Model framework, we aimed to assess the role of illness coherence in women’s decisions to undergo the vaccine. As a secondary aim, we piloted a communication strategy entailing the provision of Disease Risk-Action Link information about the links between HPV, cervical cancer, and vaccination on women’s cervical cancer illness coherence.Methods: In total, 132 young Australian women (18–26 years old) completed online surveys measuring illness coherence, vaccine status, intentions to undergo vaccination, and medical/demographic variables. Women who had not undergone vaccination were then randomised to receive either a brief or detailed information message about cervical cancer. Messages varied by the extent of detail (brief vs. detailed) providing Disease Risk-Action Link information about the link between the action of the vaccine, the HPV, and cervical cancer. Next, illness coherence was re-assessed.Results: ANOVA results suggested that women who were vaccinated reported higher levels of illness coherence. Linear regression analyses indicated that, in non-vaccinated women, illness coherence was significantly associated with intentions to vaccinate. ANCOVA analysis indicated that non-vaccinated women assigned to the detailed message condition reported greater increases in illness coherence compared to those assigned to the brief message condition.Conclusion: Illness coherence appears to be an important factor in actual vaccination uptake and intentions to vaccinate. The experimental informational message manipulation further demonstrated that the provision of detailed messages highlighting the Disease-Risk-Action Links in the cervical cancer context can promote illness coherence.

How to improve adherence with quarantine: rapid review of the evidence

Cyber--Physical Systems (CPSs) are a generation of engineered systems in which computing, communication, and control components are tightly integrated. Some important application domains of CPS are transportation, energy, and medical systems. The dynamics of CPSs are complex, involving the stochastic nature of communication systems, discrete dynamics of computing systems, and continuous dynamics of control systems. The existence of communication between and among controllers of physical processes is one of the basic characteristics of CPSs. Under this situation, some fundamental questions are: 1) How does the network behavior (communication delay, packet loss, etc.) affect the stability of the system? 2) Under what conditions is a complex system stabilizable?;In cases where communication is a component of a control system, scalability of the system becomes a concern. Therefore, one of the first issues to consider is how information about a physical process should be communicated. For example, the timing for sampling and communication is one issue. The traditional approach is to sample the physical process periodically or at predetermined times. An alternative is to sample it when specific events occur. Event-based sampling requires continuous monitoring of the system to decide a sample needs to be communicated. The main contributions of this dissertation in energy cyber-physical system domain are designing and modeling of event-based (on-demand) communication mechanisms. We show that in the problem of tracking a dynamical system over a network, if message generation and communication have correlation with estimation error, the same performance as the periodic sampling and communication method can be reached using a significantly lower rate of data.;For more complex CPSs such as vehicle safety systems, additional considerations for the communication component are needed. Communication strategies that enable robust situational awareness are critical for the design of CPSs, in particular for transportation systems. In this dissertation, we utilize the recently introduced concept of model-based communication and propose a new communication strategy to address this need. Our approach to model behavior of remote vehicles mathematically is to describe the small-scale structure of the remote vehicle movement (e.g. braking, accelerating) by a set of dynamic models and represent the large-scale structure (e.g. free following, turning) by coupling these dynamic models together into a Markov chain. Assuming model-based communication approach, a novel stochastic model predictive method is proposed to achieve cruise control goals and investigate the effect of new methodology.;To evaluate the accuracy and robustness of a situational awareness methodology, it is essential to

BackgroundApart from direct protection and reduced productivity loss during epidemics, the main reason to immunize healthcare workers (HCWs) against influenza is to provide indirect protection of frail patients through reduced transmission in healthcare settings. Because the vaccine uptake among HCWs remains far below the health objectives, systematic programs are needed to take full advantage of such vaccination. In an earlier report, we showed a mean 9% increase of vaccine uptake among HCWs in nursing homes that implemented a systematic program compared with control homes, with higher rates in those homes that implemented more program elements. Here, we report in detail the process of the development of the implementation program to enable researchers and practitioners to develop intervention programs tailored to their setting.MethodsWe applied the intervention mapping (IM) method to develop a theory- and evidence-based intervention program to change vaccination behaviour among HCWs in nursing homes.ResultsAfter a comprehensive needs assessment, we were able to specify proximal program objectives and selected methods and strategies for inducing behavioural change. By consensus, we decided on planning of three main program components, i.e., an outreach visit to all nursing homes, plenary information meetings, and the appointment of a program coordinator -- preferably a physician -- in each home. Finally, we planned program adoption, implementation, and evaluation.ConclusionThe IM methodology resulted in a systematic, comprehensive, and transparent procedure of program development. A potentially effective intervention program to change influenza vaccination behaviour among HCWs was developed, and its impact was assessed in a clustered randomised controlled trial.

Fear arousal—vividly showing people the negative health consequences of life-endangering behaviors—is popular as a method to raise awareness of risk behaviors and to change them into health-promoting behaviors. However, most data suggest that, under conditions of low efficacy, the resulting reaction will be defensive. Instead of applying fear appeals, health promoters should identify effective alternatives to fear arousal by carefully developing theory- and evidence-based programs. The Intervention Mapping (IM) protocol helps program planners to optimize chances for effectiveness. IM describes the intervention development process in six steps: (1) assessing the problem and community capacities, (2) specifying program objectives, (3) selecting theory-based intervention methods and practical applications, (4) designing and organizing the program, (5) planning, adoption, and implementation, and (6) developing an evaluation plan. Authors who used IM indicated that it helped in bringing the development of interventions to a higher level.

Suboptimal influenza vaccine uptake among healthcare workers in a regional reference hospital in Spain, 2017–2018. Need for new approaches

Uptake of influenza vaccination by healthcare workers (HCWs) may be related to how influenza campaigns are implemented. This study explores differences in annual influenza campaign implementation between NHS trusts (healthcare organisations) with higher and lower vaccine uptake. A cross-sectional survey with influenza campaign staff in 2016/2017 in 87 NHS trusts in England. The survey measured vaccination policy and uptake target, staff involvement, accessibility, use of peer vaccinators, communication strategies, strategies to address HCW concerns, use of incentives, and management support. The analysis considered implementation differences between higher (n Z 50) and lower (n Z 37) uptake trusts. Higher uptake trusts were more likely to set higher uptake targets, involve a broader range of staff groups in the campaign, and make the vaccine easy to access by core or hard-toreach HCWs. Higher uptake trusts were also more likely to use a greater range of communication strategies, provide real-time feedback on uptake, provide a greater range of incentives to be vaccinated, and have vaccine uptake considered important by managers. Successful influenza vaccination programmes are multifaceted and involve implementation factors at a strategic, organisational, logistical, and personnel level. Lower uptake trusts could improve uptake by identifying and implementing examples of best practice from higher uptake trusts.

BackgroundThe present study aimed to evaluate the results of a theory-based and systematic intervention on Hookah Tobacco Smoking (HTS) cessation in women local to Bandar Abbas, Iran.MethodsIn the present quasi-experimental research, we used an intervention mapping approach to develop, implement, and evaluate an education and training course as our intervention. Applying the results of a systematic review and two prior local qualitative studies, we identified six HTS determinants and set goals for the intervention. We selected 212 eligible women through systematic stratified random sampling and enrolled them in control and intervention groups. The course was presented to the intervention group in 17 sessions for four months. The educational material was developed to address the goals of the intervention, improve HTS determinants, and change the HTS behavior. We used a questionnaire to collect data on participants’ characteristics, HTS behavior, and detailed determinants of HTS in the control and intervention groups at the beginning of the study, at the end of the intervention, and at three- and six- months follow-up. All work done in the study was guided by ethical considerations.ResultsThe results showed no significant difference between women enrolled in control and intervention groups regarding participants’ characteristics and HTS behavior. At baseline, there were no differences between groups for six determinants of HTS (knowledge, attitude, social norms, self-efficacy, habit, and intention). At the end of the intervention and at three and six months follow-up, the women in the intervention group had significantly better results in all six domains, compared with those in the control group. The rate of HTS abstinence at the end of the intervention and at the three- and six-month follow-ups was 61.3%, 48.5%, and 45.5% for the intervention and 16%, 14.4%, and 10% for the control groups, respectively.ConclusionsHTS is a complicated behavior, and its cessation is hard. However, Intervention Mapping (IM) can be a powerful integrative, purposeful, theory-based, and participation-based method to reduce or cease HTS. This method should be tested in other settings.Trial registration: IRCT20190126042494N1, Registered 3.3.2019. https://en.irct.ir/trial/37129

This article examines the Batang Pungkut river ban hole in Mandailing Natal district, an ethnic Mandailing tradition that contains local wisdom in managing the environment. The urgency of this phenomenon is researched because environmental problems are a common (global) problem and are seen as a threat to collective survival. The research question consists of four questions: how is the communication strategy of preservation, opening of the Lubuk Larangan, and communication barriers in preservation and opening, and what impact do residents feel due to the Lubuk Larangan? The research approach used is qualitative with a qualitative descriptive method. The theory used is Robert Cox's environmental communication strategy, with relevant supporting theories, and reviewed through the perspective of Islamic communication. The results concluded that the communication strategies used were persuasive, educative, and coercive. The communication strategy used refers to the value of local wisdom poda na lima (five wise advice), dalihan na tolu (kinship system), and the value of Islamic communication values, namely communicating clearly (qaulan matsuran) and in delivering messages in communication and being gentle (qaulan balighan). Lubuk larangan is managed in stages, starting from identification, planning, production, and evaluation, and is relevant to Robert Cox's environmental communication strategy. The obstacles faced are unlicensed mining, fish theft, environmentally unfriendly fishing gear, internal organizational dynamics, and community awareness. The novelty of the research lies in the presence of transcedental (divine) aspects in the communication strategy applied, and serves as a guideline to maintain their hope. The impacts residents feel are ecological, socio-cultural, economic, and religious. In addition to providing local impacts, this tradition simultaneously impacts the global community.