Influence of political and medical leaders on parental perception of vaccination: a cross-sectional survey in Australia

ObjectivesThe aim of this survey was to investigate parental vaccination attitudes and responses to vaccine-related media messages from political and medical leaders.DesignThis was a cross-sectional study using a semiquantitative questionnaire. Data were analysed using descriptive statistics, X2tests and logistic regression.SettingData were collected from a web-based questionnaire distributed in Australia by a market research company in May of 2017.Participants411 participants with at least one child under 5 were included in this study. The sample was designed to be representative of Australia in terms of gender and state of residence.Primary and secondary outcome measuresThe primary outcome measures were parental attitudes towards childhood immunisation before and after viewing vaccine-related messages from political and medical leaders, including Donald Trump (USA), Pauline Hanson (Australia) and Michael Gannon (Australia). Parents were classified as having ‘susceptible’ (not fixed) or ‘fixed’ (positive or negative) views towards vaccination based on a series of questions.ResultsParents with fixed vaccination views constituted 23.8% (n=98) of the total sample; 21.7% (n=89) were pro-vaccination and 2.2% (n=9) were anti-vaccination. The remaining 76.2% of participants were classified as having susceptible views towards vaccination. Susceptible parents were more likely to report a change in their willingness to vaccinate after watching vaccine-related messages compared with fixed-view parents, regardless of whether the messaging was positive or negative (Trump OR 2.54, 95% CI (1.29 to 5.00); Hanson OR 2.64, 95% CI (1.26 to 5.52); Gannon OR 2.64, 95% CI (1.26 to 5.52)). Susceptible parents were more likely than fixed-view parents to report increased vaccine hesitancy after viewing negative vaccine messages (Trump OR 2.14, 95% CI (1.11 to 4.14), Hanson OR 2.34, 95% CI (1.21 to 4.50)).ConclusionsThe findings suggest that most parents including the vaccinating majorty are susceptible to vaccine messaging from political and medical leaders. Categorising parents as ‘fixed-view’ or ‘susceptible’ can be a useful strategy for designing and implementing future vaccine promotion interventions.

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Government management capacities and the containment of COVID-19: a repeated cross-sectional study across Chinese cities

BMJ Open ◽

10.1136/bmjopen-2020-041516 ◽

2021 ◽

Vol 11 (4) ◽

pp. e041516

Author(s):

Wenchao Li ◽

Jing Li ◽

Junjian Yi

Keyword(s):

Outcome Measures ◽

Cross Sectional Study ◽

Control Measures ◽

Secondary Outcome ◽

Cross Sectional ◽

Travel Restrictions ◽

Government Management ◽

The Government ◽

Laws And Policies ◽

Novel Coronavirus

ObjectivesBetter understanding of the dynamics of the COVID-19 (2019 novel coronavirus disease) pandemic to curb its spread is now a global imperative. While travel restrictions and control measures have been shown to limit the spread of the disease, the effectiveness of the enforcement of those measures should depend on the strength of the government. Whether, and how, the government plays a role in fighting the disease, however, has not been investigated. Here, we show that government management capacities are critical to the containment of the disease.SettingWe conducted a statistical analysis based on cross-city comparisons within China. China has undergone almost the entire cycle of the anticoronavirus campaign, which allows us to trace the full dynamics of the outbreak, with homogeneity in standards for statistics recording.Primary and secondary outcome measuresOutcome measures include city-specific COVID-19 case incidence and recoveries in China.ResultsThe containment of COVID-19 depends on the effectiveness of the enforcement of control measures, which in turn depends on the local government’s management capacities. Specifically, government efficiency, capacity for law enforcement, and the transparency of laws and policies significantly reduce COVID-19 prevalence and increase the likelihood of recoveries. The organisation size of the government, which is not closely related to its capacity for management, has a limited role.

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Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults

BMJ Open ◽

10.1136/bmjopen-2021-049926 ◽

2021 ◽

Vol 11 (7) ◽

pp. e049926

Author(s):

Sandra Angelika Mümken ◽

Paul Gellert ◽

Malte Stollwerck ◽

Julie Lorraine O'Sullivan ◽

Joern Kiselev

Keyword(s):

Older Adults ◽

Construct Validity ◽

Outcome Measures ◽

Total Sample ◽

Community Dwelling ◽

Secondary Outcome ◽

Life Space ◽

Cross Sectional ◽

The Past ◽

Community Dwelling Older Adults

ObjectivesTo develop a German version of the original University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past 4 weeks and to evaluate its construct validity for urban and rural populations of older adults.DesignCross-sectional validation study.SettingTwo study centres in urban and rural German outpatient hospital settings.ParticipantsIn total, N=83 community-dwelling older adults were recruited (n=40 from urban and n=43 from rural areas; mean age was 78.5 years (SD=5.4); 49.4% men).Primary and secondary outcome measuresThe final version of the translated LSA-D was related to limitations in activities and instrumental activities of daily living (ADL/iADL) as primary outcome measure (primary hypothesis); and with sociodemographic factors, functional mobility, self-rated health, balance confidence and history of falls as secondary outcome measures to obtain construct validity. Further descriptive measurements of health included hand grip strength, screening of cognitive function, comorbidities and use of transportation. To assess construct validity, correlations between LSA-D and the primary and secondary outcome measures were examined for the total sample, and urban and rural subsamples using bivariate regression and multiple adjusted regression models. Descriptive analyses of LSA-D included different scoring methods for each region. All parameters were estimated using non-parametric bootstrapping procedure.ResultsIn the multiple adjusted model for the total sample, number of ADL/iADL limitations (β=−0.26; 95% CI=−0.42 to −0.08), Timed Up and Go Test (β=−0.37; 95% CI=−0.68 to −0.14), shared living arrangements (β=0.22; 95% CI=0.01 to 0.44) and history of falls in the past 6 months (β=−0.22; 95% CI=−0.41 to −0.05) showed significant associations with the LSA-D composite score, while living in urban area (β=−0.19; 95% CI=−0.42 to 0.03) and male gender (β=0.15; 95% CI=−0.04 to 0.35) were not significant.ConclusionThe LSA-D is a valid tool for measuring life-space mobility in German community-dwelling older adults within the past 4 weeks in ambulant urban and rural settings.Trial registration numberDRKS00019023.

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Acceptance Rates and Beliefs toward COVID-19 Vaccination among the General Population of Pakistan: A Cross-Sectional Survey

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.21-0297 ◽

2021 ◽

Author(s):

Farah Yasmin ◽

Waleed Asghar ◽

Maryam Salma Babar ◽

Hiba Khan ◽

Shoaib Ahmad ◽

...

Keyword(s):

General Population ◽

Cross Sectional Study ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Public ◽

Polio Vaccination ◽

Acceptance Rates ◽

To Receive ◽

Do So

Developing countries like Pakistan have previously suffered from barriers to acceptance of vaccination by the public because of financial and belief barriers. This study aims to explore these beliefs and highlight concerns regarding vaccine hesitancy in the general population of Pakistan since they are a hindrance to an effective coronavirus disease-19 (COVID-19) immunization in the country. A cross-sectional study was performed involving 1,778 participants from all four provinces of Pakistan. Results from the study showed more than half of the participants to be unsure of the safety (50%) and efficacy (51%) of the vaccine, whereas 42% were concerned about the side effects of the vaccine. About 72% of the respondents planned to get vaccinated, whereas 28% refused to do so. Internationally made imported vaccines were more trusted by the participants. Forty-four percent of the participants agreed to receive the vaccine upon recommendation from a physician. Lastly, participants who believed in the efficacy of the polio vaccination also considered the COVID-19 vaccine to be safe and effective.

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Healthcare Workers Preparedness for COVID-19 Pandemic in the Occupied Palestinian Territory: A Cross-sectional Survey

10.21203/rs.3.rs-112643/v1 ◽

2020 ◽

Author(s):

Osaid Alser ◽

Heba Alghoul ◽

Zahra Alkhateeb ◽

Ayah Hamdan ◽

Loai Albarqouni ◽

...

Keyword(s):

Healthcare Workers ◽

Gaza Strip ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Occupied Palestinian Territory ◽

Governmental Institutions ◽

Palestinian Territory

Abstract Background: The coronavirus disease 19 (COVID-19) pandemic threatens to overwhelm the capacity of a vulnerable healthcare system in the occupied Palestinian territory (oPt). Sufficient training of healthcare workers (HCWs) in managing COVID-19 and the provision of personal protective equipment (PPE) are essential in allowing oPt to mount a credible response to the crisis.Methods: A cross-sectional study was conducted using a validated online questionnaire between March 30, 2020 and April 12, 2020. Primary outcomes were availability of PPE and HCWs preparedness in oPt for COVID-19 pandemic. Secondary outcome was regional and hospital differences in oPt in terms of availability of PPE and HCWs preparedness.Results: Of 138 respondents, only 38 HCWs (27.5%) always had access to facemasks and 15 (10.9%) for isolation gowns. Most HCWs did not find eye protection (n=128, 92.8%), N95 respirators (n=132, 95.7%), and face shields (n=127, 92%) always available. Compared to HCWs in West Bank, those in the Gaza Strip were significantly less likely to have access to alcohol sanitizers (p=0.03) and gloves (p <0.001). On average, governmental hospitals were significantly less likely to have all appropriate PPE than non-governmental institutions (p = 0.001). Only 16 (11.6%) surveyed felt confident in dealing with a potential COVID-19 case, 57 (41.3%) having received any COVID-19-related training, and 57 (41.3%) not having a local hospital protocol. Conclusion: HCWs in oPt are underprepared and severely lacking adequate PPE provision. The lack of PPE provision will exacerbate spread of COVID-19 and deepen the crisis, whilst putting HCWs at risk.

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Acceptability of the Coronavirus Disease-2019 Vaccine Among Medical Students in Uganda: a Cross Sectional Study.

10.21203/rs.3.rs-425207/v1 ◽

2021 ◽

Author(s):

Andrew Marvin Kanyike ◽

Ronald Olum ◽

Jonathan Kajjimu ◽

Daniel Ojilong ◽

Grabriel Madut Akech ◽

...

Keyword(s):

Medical Students ◽

Perceived Risk ◽

Cross Sectional Study ◽

Vaccine Hesitancy ◽

Cross Sectional Survey ◽

Future Health ◽

Vaccine Acceptability ◽

Cross Sectional ◽

The Future ◽

Global Threat

Abstract Background COVID-19 is still a major global threat and vaccination remains the long-lasting solution. Unanimous uptake of the COVID-19 vaccine is required to subsequently avert its spread. We therefore, assessed COVID-19 vaccine acceptability, hesitancy, and associated factors among medical students in Uganda. Methods This study employed an online descriptive cross-sectional survey among medical students across 10 medical schools in Uganda. A structured questionnaire as a Google form was sent to participants via WhatsApp. Data was extracted and analyzed using Microsoft Excel 2016 and STATA 16. Descriptive statistics, bivariate and multivariable analyses were performed. Results We surveyed 600 medical students, 377 (62.8%) were male. COVID-19 vaccine hesitancy and acceptability were 30.7% and 37.3%, respectively. Factors associated with vaccine acceptability were being female (aOR = 1.9, 95% CI: 1.3–2.9, p = 0.001), being single (aOR = 2.1, 95% CI 1.1–3.9, p = 0.022). Very high (aOR = 3.5, 95% CI 1.7–6.9, p < 0.001) or moderate (aOR = 2.2, 95% CI 1.2–4.1, p = 0.008) perceived risk of getting COVID-19 in the future, receiving any vaccine in the past 5 years (aOR = 1.6, 95% CI 1.1–2.5, p = 0.017), and COVID-19 vaccine hesitancy (aOR 0.6, 95% CI 0.4–0.9, p = 0.036). Conclusions This study revealed low levels of acceptance towards the COVID-19 vaccine among medical students, low self-perceived risks of COVID-19, and many had relied on social media that provided them with negative information. This poses an evident risk on the battle towards COVID-19 in the future especially when these future health professions are expected to be influencing decisions of the general public towards the same.

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Frequency of television viewing and association with overweight and obesity among women of the reproductive age group in Myanmar: results from a nationwide cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2018-024680 ◽

2019 ◽

Vol 9 (3) ◽

pp. e024680 ◽

Cited By ~ 7

Author(s):

Rajat Das Gupta ◽

Ibrahim Hossain Sajal ◽

Mehedi Hasan ◽

Ipsita Sutradhar ◽

Mohammad Rifat Haider ◽

...

Keyword(s):

Rural Women ◽

Television Viewing ◽

Wealth Index ◽

Educational Status ◽

Cross Sectional Study ◽

Overweight And Obesity ◽

Reproductive Age ◽

Secondary Outcome ◽

Cross Sectional Survey ◽

Cross Sectional

ObjectivesThis study aimed to discern the association between the frequency of television viewing and overweight and obesity among reproductive age women of Myanmar.DesignThis was a cross-sectional study.SettingThis study used Myanmar Demographic and Health Survey (2015–2016) data.ParticipantsTotal of 12 021 women both aged 15–49 years and also not pregnant or did not deliver a child within the 2 months prior to the survey were included.Primary and secondary outcome measuresThe primary outcome was overweight (23.0 kg/m2to <27.5 kg/m2) and obesity (≥27.5 kg/m2), which was measured using the Asian body mass index cut-off. Ordered logistic regression analysis was conducted to find the association between the explanatory and outcome variables. The potential confounders controlled in the multivariable analyses were age, place of residence, region of residence, highest educational status, current employment status, wealth index, parity and number of household members.ResultsThe prevalence of overweight was 26.5% and obesity was 12.2% among the study participants. The odds of being overweight and obese were 20% higher (adjusted OR (AOR) 1.16, 95% CI 1.02 to 1.32; p=0.023) among those who watched television at least once a week compared with those who did not watch television at all. Rural women who watched television at least once a week were 1.2 times more likely to be obese (AOR 1.16, 95% CI 1.01 to 1.34; p=0.040) compared with those who did not watch television at all.ConclusionsFrequent television watching was associated with obesity among rural women of reproductive age in Myanmar.

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Prevalence and associated risk factors of hypertension among persons aged 15–49 in India: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-029714 ◽

2019 ◽

Vol 9 (12) ◽

pp. e029714 ◽

Cited By ~ 3

Author(s):

Soumitra Ghosh ◽

Manish Kumar

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Family Health ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Effective Interventions ◽

Life Style Changes ◽

Associated Risk Factors

ObjectivesThis is the first attempt to provide estimates on the prevalence of hypertension at the national, state and district level, a prerequisite for designing effective interventions. Besides, the study aims to identify the risk factors of hypertension.DesignWe analysed cross-sectional survey data from the fourth round (2015–2016) of National Family Health Survey (NFHS). NFHS was conducted between January 2015 and December 2016, gathering information on a range of indicators including blood pressure. The age adjusted prevalence of hypertension was calculated for state comparison, while multilevel logistic regression analysis was done to assess the correlates of hypertension.Setting and participantsIndia (2015–2016; n=811 917) aged 15–49.Primary and secondary outcome measuresThe primary outcome is hypertension, which has been defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg.ResultsThe age-adjusted prevalence of hypertension in India was 11.3% (95% CI 11.16% to 11.43%) among persons aged between 15 and 49 and was four percentage points higher among males 13.8% (95% CI 13.46% to 14.19%) than among females 10.9% (95% CI 10.79% to 11.06%). Persons in the urban location (12.5%, 95% CI 12.25% to 12.80%) had a marginally higher prevalence than persons in rural location (10.6%, 95% CI 10.50% to 10.78%). The proportion of population suffering from hypertension varied greatly between states, with a prevalence of 8.2% (95% CI 7.58% to 8.85%) in Kerala to 20.3% (95% CI 18.81% to 21.77%) in Sikkim. Advancing age, obesity/overweight, male sex, socioeconomic status and consumption of alcohol were found to be the major predictors of hypertension.ConclusionsHypertension prevalence is now becoming more concentrated among the poor. Policy measures should be taken to improve the hazardous working conditions and growing social pressures of survival responsible for ‘life-style’ changes such as consumption of high calorie food and alcohol.

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Cross-sectional study on the awareness, susceptibility and use of heated tobacco products among adolescents in Guatemala City, Guatemala

BMJ Open ◽

10.1136/bmjopen-2020-039792 ◽

2020 ◽

Vol 10 (12) ◽

pp. e039792

Author(s):

Anna Gottschlich ◽

Sophia Mus ◽

Jose Carlos Monzon ◽

James F Thrasher ◽

Joaquin Barnoya

Keyword(s):

Sociodemographic Factors ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Tobacco Prevention ◽

Guatemala City ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Tobacco Products ◽

Middle Income ◽

The Past

ObjectivesHeated tobacco products (HTPs) are increasingly marketed worldwide, yet limited research on HTPs has been conducted in low and middle-income countries (LMICs) or among adolescents. Guatemala is one of the few LMICs where HTPs are available. This study examined prevalence and correlates of HTP awareness, susceptibility and use among adolescents in Guatemala.Design, setting and participantsA cross-sectional survey on HTP awareness, susceptibility and use was conducted among 2870 students between the ages of 13 and 17 in private schools in Guatemala City, Guatemala.Primary and secondary outcome measuresThe primary outcome was susceptibility to future use of HTP among school-aged current and never smokers in Guatemala. We also explored awareness and use of HTPs. Multivariate binomial regression models were used to explore associations between these outcomes and both sociodemographic factors and established smoking correlates.ResultsOf all students (n=2870), about half were aware of HTPs (52.4%) and susceptible to future or continued use (52.4%). Whereas 8.4% of students had tried HTPs in the lifetime (but not in the last month), only 2.9% used HTPs in the past month. Independent correlates of HTP susceptibility and ever-use included: use of other tobacco products (current smoking: adjusted OR (AOR)=10.53 and 6.63, respectively; current e-cigarette use: AOR=21.87 and 10.40, respectively), moderate alcohol consumption (AOR=1.49 and 1.19, respectively), marijuana use in the past 30 days (AOR=3.49 and 2.29, respectively) and having friends who use HTPs (AOR=1.83 and 7.28, respectively).ConclusionsAmong this sample of adolescents in Guatemala City, where tobacco control is weak, the prevalence of HTP use was low but susceptibility to future use was high. Tobacco prevention and intervention strategies for cigarettes and e-cigarettes should now also include HTPs, which tend to be used by similar adolescent populations (ie, those who use other substances or are exposed to tobacco through family and friends).

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Willingness of patients to use unused medication returned to the pharmacy by another patient: a cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2018-024767 ◽

2019 ◽

Vol 9 (5) ◽

pp. e024767 ◽

Cited By ~ 5

Author(s):

Charlotte Bekker ◽

Bart van den Bemt ◽

Toine CG Egberts ◽

Marcel Bouvy ◽

Helga Gardarsdottir

Keyword(s):

Outcome Measures ◽

Patient Characteristics ◽

Secondary Outcome ◽

High Educational Level ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Included Patient ◽

Willingness To Use ◽

High Educational ◽

Patient Willingness

ObjectivesRedispensing by pharmacies of medication unused by another patient could contribute to optimal use of healthcare resources. This study aimed to assess patient willingness to use medication returned by another patient and patient characteristics associated with this willingness.DesignCross-sectional survey.SettingA total of 41 community and 5 outpatient pharmacies in the Netherlands.ParticipantsTotal of 2215 pharmacy visitors.Primary and secondary outcome measuresPatients completed a questionnaire regarding their willingness to use medication returned unused to the pharmacy by another patient, assuming quality was guaranteed. Secondary outcome measures included patient sociodemographic characteristics that were associated with patient willingness, analysed using logistic regression analysis and reported as ORs with 95% CIs.ResultsOf the 2215 patients (mean (SD) age 50.6(18.0) years; 61.4% female), 61.2% were willing to use medication returned unused to the pharmacy by another patient. Patients who were unwilling mostly found it risky. Men were more willing to use returned medication (OR 1.3 95% CI 1.1 to 1.6), as did patients with a high educational level (OR 1.8 95% CI 1.3 to 2.5), those who regularly use 1–3 medications (OR 1.3 95% CI 1.1 to 1.7), those who returned medication to the pharmacy for disposal (OR 1.5 95% CI 1.0 to 2.3) and those who ever had unused medication themselves (OR 1.3 95% CI 1.1 to 1.6)). Patients with non-Dutch cultural background were less willing to use returned medication (OR 0.395% CI 0.3 to 0.4)).ConclusionsWhen quality is guaranteed, a substantial proportion of patients are willing to use medication returned unused to the pharmacy by another patient. This suggests that implementation of redispensing may be supported by patients.

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Association between socioeconomic status and prevalence of non-communicable diseases risk factors and comorbidities in Bangladesh: findings from a nationwide cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2018-025538 ◽

2019 ◽

Vol 9 (3) ◽

pp. e025538 ◽

Cited By ~ 8

Author(s):

Tuhin Biswas ◽

Nick Townsend ◽

Md Saimul Islam ◽

Md Rajibul Islam ◽

Rajat Das Gupta ◽

...

Keyword(s):

Risk Factors ◽

Socioeconomic Status ◽

Outcome Measures ◽

Adult Population ◽

Multivariable Analysis ◽

Communicable Diseases ◽

Secondary Outcome ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Non Communicable Diseases

ObjectivesThis study aimed to examine the prevalence and distribution in the comorbidity of non-communicable diseases (NCDs) among the adult population in Bangladesh by measures of socioeconomic status (SES).DesignThis was a cross-sectional study.SettingThis study used Bangladesh Demographic and Health Survey 2011 data.ParticipantsTotal 8763 individuals aged ≥35 years were included.Primary and secondary outcome measuresThe primary outcome measures were diabetes mellitus (DM), hypertension (HTN) and overweight/obesity. The study further assesses factors (in particular SES) associated with these comorbidities (DM, HTN and overweight/obesity).ResultsOf 8763 adults,12% had DM, 27% HTN and 22% were overweight/obese (body mass index ≥23 kg/m2). Just over 1% of the sample had all three conditions, 3% had both DM and HTN, 3% DM and overweight/obesity and 7% HTN and overweight/obesity. DM, HTN and overweight/obesity were more prevalent those who had higher education, were non-manual workers, were in the richer to richest SES and lived in urban settings. Individuals in higher SES groups were also more likely to suffer from comorbidities. In the multivariable analysis, it was found that individual belonging to the richest wealth quintile had the highest odds of having HTN (adjusted OR (AOR) 1.49, 95% CI 1.29 to 1.72), DM (AOR 1.63, 95% CI 1.25 to 2.14) and overweight/obesity (AOR 4.3, 95% CI 3.32 to 5.57).ConclusionsIn contrast to more affluent countries, individuals with NCDs risk factors and comorbidities are more common in higher SES individuals. Public health approaches must consider this social patterning in tackling NCDs in the country.

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