The Medical Mistrust Multiformat Scale: Links with vaccine hesitancy, treatment adherence, and patient–physician relationships.

2021 ◽  
Author(s):  
Keith Sanford ◽  
Mona Clifton
Keyword(s):  
Treatment Adherence ◽  
Vaccine Hesitancy ◽  
Medical Mistrust

scholarly journals SARS-CoV-2: Vaccine Hesitancy among Underrepresented Racial and Ethnic Groups with HIV in Miami, Florida

2021 ◽  
Author(s):  
Deborah L Jones ◽  
Ana S Salazar ◽  
Violeta J Rodriguez ◽  
Raymond R Balise ◽  
Claudia Uribe Starita ◽  
...  
Keyword(s):  
Race And Ethnicity ◽  
Cross Sectional Study ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Baseline Survey ◽  
Advisory Group ◽  
Medical Mistrust ◽  
Cross Sectional ◽  
Exact Test ◽  
Novel Coronavirus

Abstract Background SARS-CoV-2 and HIV disproportionally affect underrepresented ethnoracial groups in the US. Medical mistrust and vaccine hesitancy will likely impact acceptability of SARS-CoV-2 vaccines. This study examined SARS-CoV-2 vaccine hesitancy among underrepresented ethnoracial groups with HIV and identified factors that may reduce vaccine uptake. Methods We conducted a cross-sectional study of adults ≥18 years with HIV residing in Miami, FL. Participants were invited to participate in the ACTION (A Comprehensive Translational Initiative on Novel Coronavirus) cohort study. A baseline survey was administered from April-August 2020 and followed by a COVID-19 vaccine hesitancy survey from August-November 2020. The COVID-19 vaccine hesitancy survey was adapted from the Strategic Advisory Group Experts survey. Comparisons by race and ethnicity were performed using the Freedman-Haltmann extension of Fisher’s exact test Results A total of 94 participants were enrolled, mean age 54.4 years, 52% female, 60% Black non-Latinx, and 40% non-Black Latinx. Black non-Latinx participants were less likely to agree that vaccinations are important for health when compared to non-Black Latinx (67.8% vs 92.1%, p=0.009), less likely to agree that vaccines are effective in preventing disease (67.8% vs 84.2%, p=0.029), less likely to believe that vaccine information is reliable and trustworthy (35.7% vs 71.1%, p=0.002), and less likely to believe vaccines were unnecessary because COVID-19 would disappear soon (11% vs 21%, p=0.049). Conclusion Medical mistrust, vaccine hesitancy and negative sentiments about SARS-CoV-2 vaccines are prevalent among underrepresented ethnoracial groups with HIV, particularly Black non-Latinx. Targeted strategies to increase vaccine uptake in this population are warranted.

Hesitancy and malignancy: Vaccine hesitancy among individuals with cancer.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 148-148
Author(s):  
Stacey A. Ingram ◽  
Nicole E. Caston ◽  
Courtney J. Andrews ◽  
Rebecca England ◽  
Courtney Williams ◽  
...  
Keyword(s):  
Vulnerable Populations ◽  
Vaccine Development ◽  
Severe Disease ◽  
Nationwide Survey ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Medical Mistrust ◽  
Cross Sectional ◽  
Vaccine Acceptance ◽  
The Media

148 Background: The World Health Organization cited vaccine hesitancy as one of 2019’s top ten threats to global health, a threat that has been further exacerbated by COVID-19 pandemic. Existing COVID-19 vaccine hesitancy research focuses on the general population, but less is known about the specific concerns of medically vulnerable populations, including individuals with cancer. Methods: This cross-sectional analysis used data that assessed likelihood of COVID-19 vaccination (likely vs unlikely/unsure) among past or current patients with cancer from a nationwide survey administered in December 2020 by the Patient Advocate Foundation (PAF), a non-profit organization that provides case management and financial aid to patients diagnosed with a chronic illness. Inclusion criteria included previous or current cancer treatment, aged ≥ 19, and a valid e-mail address. Age, sex, race/ethnicity, and urban/rural residence were abstracted from the PAF database. Respondents self-reported education level, employment status, trust in media regarding COVID-19 pandemic, and media viewership on COVID-19 vaccine development. The Group-Based Medical Mistrust Scale assessed respondents’ level of mistrust in medical providers based on ethnicity. Likelihood of COVID-19 vaccine acceptance was evaluated using risk ratios (RR) and 95% confidence intervals (CI) from modified Poisson regression models with robust error variance. All variables were included in our model. Results: Of 429 respondents, 48% were unlikely/unsure about accepting the COVID-19 vaccine, primarily due to concerns about vaccine safety (32%) and worry about health conditions (12%). When compared to those likely to accept COVID-19 vaccine, respondents who were unlikely/unsure were more often Black, Indigenous, or People of Color (40% vs. 23%), aged 36-55 (40% vs. 29%), and female (80% vs. 65%). In adjusted analysis, Black respondents were 55% less likely to accept a COVID-19 vaccine, when compared to White respondents (RR 0.55; 95% CI 0.4-0.8). When compared to those who did not follow the media regarding COVID-19 vaccine development, those who followed the media very closely were 4.5 times more likely to accept a COVID-19 vaccine (RR 4.5; 95% CI 1.6-13.2). Respondents who reported below average trust in the media were 60% less likely to accept a COVID-19 vaccine (RR 0.6; 95% CI 0.5-0.8), compared to those who reported above average trust in the media. Conclusions: Despite being at high risk of COVID-19 morbidity and mortality, a substantial proportion of under-resourced individuals with cancer were unlikely/unsure about vaccination, exposing a significant disconnect between risk of severe disease and vaccine acceptance. Our analysis also reveals a need to assess for and debunk misinformation to increase vaccine enthusiasm among medically vulnerable populations.

scholarly journals COVID-19 Related Medical Mistrust, Health Impacts, and Potential Vaccine Hesitancy Among Black Americans Living with HIV

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Laura M. Bogart ◽  
Bisola O. Ojikutu ◽  
Keshav Tyagi ◽  
David J. Klein ◽  
Matt G. Mutchler ◽  
...  
Keyword(s):  
Black Americans ◽  
Health Impacts ◽  
Vaccine Hesitancy ◽  
Medical Mistrust ◽  
Potential Vaccine ◽  
Living With Hiv

scholarly journals Race-based medical mistrust, medication beliefs and HIV treatment adherence: test of a mediation model in people living with HIV/AIDS

2016 ◽  
Vol 39 (6) ◽  
pp. 1056-1064 ◽  
Author(s):  
Seth C. Kalichman ◽  
Lisa Eaton ◽  
Moira O. Kalichman ◽  
Tama Grebler ◽  
Cynthia Merely ◽  
...  
Keyword(s):  
Treatment Adherence ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Medical Mistrust ◽  
Mediation Model ◽  
Medication Beliefs ◽  
Adherence Test ◽  
Living With Hiv ◽  
Hiv Aids

scholarly journals VACCINE HESITANCY AND MEDICAL MISTRUST IN WOMEN CONSIDERING OR UNDERGOING FERTILITY TREATMENTS

2021 ◽  
Vol 116 (3) ◽  
pp. e363
Author(s):  
Luce A. Kassi ◽  
Shriya Shah ◽  
Angela K. Lawson ◽  
Eve C. Feinberg ◽  
Amelia Swanson ◽  
...  
Keyword(s):  
Vaccine Hesitancy ◽  
Medical Mistrust ◽  
Fertility Treatments

scholarly journals Medical Mistrust and Stigma Associated with COVID-19 Among People Living with HIV in South Africa

2021 ◽  
Author(s):  
Jana Jarolimova ◽  
Joyce Yan ◽  
Sabina Govere ◽  
Nompumelelo Ngobese ◽  
Zinhle M. Shazi ◽  
...  
Keyword(s):  
South Africa ◽  
Female Gender ◽  
Summary Score ◽  
Vaccine Hesitancy ◽  
People Living With Hiv ◽  
Medical Mistrust ◽  
Therapy Program ◽  
Conspiracy Beliefs ◽  
A Prospective Study ◽  
Living With Hiv

AbstractWe evaluated COVID-19 stigma and medical mistrust among people living with HIV in South Africa. We conducted telephone interviews with participants in a prospective study of a decentralized antiretroviral therapy program. Scales assessing medical mistrust, conspiracy beliefs, anticipated and internalized stigma, and stereotypes specific to COVID-19 were adapted primarily from the HIV literature, with higher scores indicating more stigma or mistrust. Among 303 participants, the median stigma summary score was 4 [interquartile range (IQR) 0–8; possible range 0–24] and 6 (IQR 2–9) for mistrust (possible range 0–28). A substantial proportion of participants agreed or strongly agreed with at least one item assessing stigma (54%) or mistrust (43%). Higher COVID-19 stigma was associated with female gender and antecedent HIV stigma, and lower stigma with reporting television as a source of information on COVID-19. Further efforts should focus on effects of stigma and mistrust on protective health behaviors and vaccine hesitancy.

scholarly journals The Mediating Roles of Medical Mistrust, Knowledge, Confidence and Complacency of Vaccines in the Pathways from Conspiracy Beliefs to Vaccine Hesitancy

Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1342
Author(s):  
Xiaoning Zhang ◽  
Yuqing Guo ◽  
Qiong Zhou ◽  
Zaixiang Tan ◽  
Junli Cao
Keyword(s):  
Structural Equation ◽  
Model Fit ◽  
Vaccine Hesitancy ◽  
Equation Modeling ◽  
Medical Mistrust ◽  
Measurement Models ◽  
Acceptable Model ◽  
Conspiracy Beliefs ◽  
Vaccine Confidence ◽  
The Impact

Background: Vaccine hesitancy, associated with medical mistrust, confidence, complacency and knowledge of vaccines, presents an obstacle to the campaign against the coronavirus disease 2019 (COVID-19). The relationship between vaccine hesitancy and conspiracy beliefs may be a key determinant of the success of vaccination campaigns. This study provides a conceptual framework to explain the impact of pathways from conspiracy beliefs to COVID-19 vaccine hesitancy with regard to medical mistrust, confidence, complacency and knowledge of vaccines. Methods: A non-probability study was conducted with 1015 respondents between 17 April and 28 May 2021. Conspiracy beliefs were measured using the coronavirus conspiracy scale of Coronavirus Explanations, Attitudes, and Narratives Survey (OCEANS), and vaccine conspiracy beliefs scale. Medical mistrust was measured using the Oxford trust in doctors and developers questionnaire, and attitudes to doctors and medicine scale. Vaccine confidence and complacency were measured using the Oxford COVID-19 vaccine confidence and complacency scale. Knowledge of vaccines was measured using the vaccination knowledge scale. Vaccine hesitancy was measured using the Oxford COVID-19 vaccine hesitancy scale. Confirmatory factor analysis (CFA) was used to evaluate the measurement models for conspiracy beliefs, medical mistrust, confidence, complacency, and knowledge of vaccines and vaccine hesitancy. The structural equation modeling (SEM) approach was used to analyze the direct and indirect pathways from conspiracy beliefs to vaccine hesitancy. Results: Of the 894 (88.1%) respondents who were willing to take the COVID-19 vaccine without any hesitancy, the model fit with the CFA models for conspiracy beliefs, medical mistrust, confidence, complacency and knowledge of vaccines, and vaccine hesitancy was deemed acceptable. Conspiracy beliefs had significant direct (β = 0.294), indirect (β = 0.423) and total (β = 0.717) effects on vaccine hesitancy; 41.0% of the total effect was direct, and 59.0% was indirect. Conspiracy beliefs significantly predicted vaccine hesitancy by medical mistrust (β = 0.210), confidence and complacency (β = 0.095), knowledge (β = 0.079) of vaccines, explaining 29.3, 11.0, and 13.2% of the total effects, respectively. Conspiracy beliefs significantly predicted vaccine hesitancy through the sequential mediation of knowledge of vaccines and medical mistrust (β = 0.016), explaining 2.2% of the total effects. Conspiracy beliefs significantly predicted vaccine hesitancy through the sequential mediation of confidence and complacency, and knowledge of vaccines (β = 0.023), explaining 3.2% of the total effects. The SEM approach indicated an acceptable model fit (χ2/df = 2.464, RMSEA = 0.038, SRMR = 0.050, CFI = 0.930, IFI = 0.930). Conclusions: The sample in this study showed lower vaccine hesitancy, and this study identified pathways from conspiracy beliefs to COVID-19 vaccine hesitancy in China. Conspiracy beliefs had direct and indirect effects on vaccine hesitancy, and the indirect association was determined through medical mistrust, confidence, complacency, and knowledge of vaccines. In addition, both direct and indirect pathways from conspiracy beliefs to vaccine hesitancy were identified as intervention targets to reduce COVID–19 vaccine hesitancy.

scholarly journals “That same stigma...that same hatred and negativity:” a qualitative study to understand stigma and medical mistrust experienced by people living with HIV diagnosed with COVID-19

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andre Hall ◽  
Olivier Joseph ◽  
Samantha Devlin ◽  
Jared Kerman ◽  
Jessica Schmitt ◽  
...  
Keyword(s):  
Qualitative Interviews ◽  
Vulnerable Groups ◽  
Vaccine Hesitancy ◽  
People Living With Hiv ◽  
Medical Mistrust ◽  
Hiv Diagnosis ◽  
Future Health ◽  
Increased Risk ◽  
Related Stigma ◽  
Living With Hiv

Abstract Background The COVID-19 and HIV epidemics have exacerbated existing inequities among vulnerable groups and severely impacted communities of color. People living with HIV (PLWH), who may already face stigma or discrimination, are at risk of experiencing further stigma as a result of COVID-19, which can result in medical mistrust. Methods We performed qualitative interviews between June and August 2020 among 32 PLWH, including 10 individuals diagnosed with COVID-19. A majority of participants perceived themselves as having an increased risk of contracting COVID-19 due to their HIV status. Results Of those who tested positive for COVID-19, the majority regarded their HIV diagnosis as having a more profound impact on their lives but found similarities between COVID-19 stigma and HIV-related stigma. Many participants also expressed mistrust. Conclusions These results can be used to better understand the perspectives of PLWH during the COVID-19 pandemic and have important implications for potential COVID-19 vaccine hesitancy and future health crises.

scholarly journals Validity of the Spanish Version of the Vaccination Attitudes Examination Scale

Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1237
Author(s):  
Borja Paredes ◽  
Miguel Ángel Cárdaba ◽  
Ubaldo Cuesta ◽  
Luz Martinez
Keyword(s):  
Internal Consistency ◽  
Convergent Validity ◽  
Discriminant Validity ◽  
Structure Study ◽  
Spanish Version ◽  
Vaccine Hesitancy ◽  
Medical Mistrust ◽  
Confirmatory Factor ◽  
Good Internal Consistency ◽  
High Internal Consistency

Individuals vary in the extent to which they have unfavorable attitudes towards vaccines. The Vaccination Attitudes Examination (VAX) Scale is a recently developed brief 12-item questionnaire created to better understand general vaccination attitudes. The current research aimed at providing a Spanish adaptation of the VAX Scale. After conducting an initial pilot study, Exploratory and Confirmatory Factor Analysis showed that the Spanish version of the scale had good internal consistency and factor structure (Study 1), discriminant validity from other individual differences measures (such as the Beliefs about Medicine Questionnaire and the Medical Mistrust Index) as well as good predictive validity of relevant vaccination-related outcomes (Study 2). In conclusion, in the present research, the Spanish version of the VAX scale proved to have a high internal consistency, showed convergent validity with other conceptually similar constructs, and successfully predicted vaccination intentions and vaccination decisions. Having this scale available in Spanish will allow researchers to analyze vaccination processes and vaccine hesitancy over a great number of people.

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