DESIGN: A nationwide longitudinal survey.
SETTING: Thirty-two randomly selected schools from 13 states and 3 federal territories in Malaysia from February to March 2013, and October to November 2013.
PARTICIPANTS: Form One female students (13 years old).
INTERVENTIONS: None.
MAIN OUTCOME MEASURES: Mean knowledge score of HPV infection.
RESULTS: A total of 2644 students responded to the prevaccination survey, of whom 2005 (70%) completed the postvaccination survey. The mean knowledge score was 2.72 (SD ± 2.20) of a maximum score of 10 in the prevaccination survey, which increased significantly to 3.33 (SD ± 1.73) after the 3 doses of HPV vaccine (P = .001). Many answered incorrectly that, "Only girls can get HPV infection" (91.5%, n = 1841 prevaccination vs 96.1%, n = 1927 postvaccination), and only a few were aware that, "Vaccinating boys helps to protect girls against HPV infection" (11.4%, n = 229 for prevaccination vs 10.2%, n = 206 for postvaccination). The mean knowledge score was significantly higher postvaccination among higher-income families and those with parents of a higher occupational status. Regarding beliefs about the HPV vaccine, 89.4% in the prevaccination survey held the view that they would not get a HPV infection, and the percentage remained similar in the postvaccination survey. Perceived severity of HPV infection also remained low in the pre- and postintervention groups. Only 21.5% reported receiving health information about HPV along with the provision of the HPV vaccine; those who received health information showed higher levels of knowledge.
CONCLUSION: Findings revealed a general lack of knowledge and erroneous beliefs about HPV and the HPV vaccine even after receiving vaccination. This suggests that imparting accurate knowledge about HPV along with vaccine administration is essential. Specifically, girls from lower socioeconomic groups should be a target of educational intervention.
METHODS: A nationwide cross-sectional survey among Secondary One male students in Malaysia.
RESULTS: Among 2823 respondents, knowledge about HPV infection and the HPV vaccine was extremely poor. The mean total knowledge score was only 3.17 (SD ± 2.14), out of a possible score of 10. The majority of respondents were unaware that vaccinating boys can help protect girls against HPV infection (81.6%), and HPV is a sexually transmitted infection (70.1%). Many had the misconception that only females get HPV (78.9%). In multivariable analysis, the factors associated with the intention to receive the HPV vaccination were: agreeing boys need to be vaccinated against HPV infection (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.57-2.68), perceiving their parents might allow them to get the HPV vaccine (OR, 1.66; 95% CI, 1.18-2.34), perceived susceptibility to HPV infection (OR, 1.63; 95% CI, 1.06-2.52), and attending a rural school (OR, 1.49; 95% CI, 1.14-1.95).
CONCLUSIONS: Public health educational programs that are focused and tailored on parents consenting to HPV vaccination for boys at a young age can be useful in improving HPV vaccination rates among boys. There is also a pressing need to educate boys about the benefits of HPV vaccination in males and about HPV disease susceptibility to facilitate adoption of the HPV vaccine by young adults in the future.
METHODS: An anonymous cross-sectional survey was conducted between 4 January and 5 March 2021 in 17 countries worldwide. Proportions and the corresponding 95% confidence intervals (CI) of COVID-19 vaccine acceptance and vaccine characteristics influencing vaccination acceptance were generated and compared across countries and regions. Multivariable logistic regression analysis was used to determine the factors associated with COVID-19 vaccine hesitancy.
RESULTS: Of the 19,714 responses received, 90.4% (95% CI 81.8-95.3) reported likely or extremely likely to receive COVID-19 vaccine. A high proportion of likely or extremely likely to receive the COVID-19 vaccine was reported in Australia (96.4%), China (95.3%) and Norway (95.3%), while a high proportion reported being unlikely or extremely unlikely to receive the vaccine in Japan (34.6%), the U.S. (29.4%) and Iran (27.9%). Males, those with a lower educational level and those of older age expressed a higher level of COVID-19 vaccine hesitancy. Less than two-thirds (59.7%; 95% CI 58.4-61.0) reported only being willing to accept a vaccine with an effectiveness of more than 90%, and 74.5% (95% CI 73.4-75.5) said they would accept a COVID-19 vaccine with minor adverse reactions. A total of 21.0% (95% CI 20.0-22.0) reported not accepting an mRNA vaccine and 51.8% (95% CI 50.3-53.1) reported that they would only accept a COVID-19 vaccine from a specific country-of-origin. Countries from the Southeast Asia region reported the highest proportion of not accepting mRNA technology. The highest proportion from Europe and the Americas would only accept a vaccine produced by certain countries. The foremost important vaccine characteristic influencing vaccine choice is adverse reactions (40.6%; 95% CI 39.3-41.9) of a vaccine and effectiveness threshold (35.1%; 95% CI 33.9-36.4).
CONCLUSIONS: The inter-regional and individual country disparities in COVID-19 vaccine hesitancy highlight the importance of designing an efficient plan for the delivery of interventions dynamically tailored to the local population.
METHODS: A total of 429 respondents diagnosed with urologic cancers (prostate cancer, bladder and renal cancer) from Sarawak General Hospital and Subang Jaya Medical Centre in Malaysia were interviewed using a structured questionnaire. Objective and subjective FT were measured by catastrophic health expenditure (healthcare-cost-to-income ratio greater than 40%) and the Personal Financial Well-being Scale, respectively. HRQoL was measured with the Functional Assessment of Cancer Therapy - General 7 Items scale.
RESULTS: Objective and subjective FT were experienced by 16.1 and 47.3% of the respondents, respectively. Respondents who sought treatment at a private hospital and had out-of-pocket health expenditures were more likely to experience objective FT, after adjustment for covariates. Respondents who were female and had a monthly household income less than MYR 5000 were more likely to experience average to high subjective FT. Greater objective FT (OR = 2.75, 95% CI 1.09-6.95) and subjective FT (OR = 4.68, 95% CI 2.63-8.30) were associated with poor HRQoL.
CONCLUSIONS: The significant association between both objective and subjective FT and HRQoL highlights the importance of reducing FT among urologic cancer patients. Subjective FT was found to have a greater negative impact on HRQoL.
METHODS: A nationwide cross-sectional, self-administered online survey was conducted on 1-19 May 2020. The health belief model (HBM) was used as a theoretical framework for understanding COVID-19 vaccination intent and WTP.
RESULTS: A total of 3,541 complete responses were received. The majority reported a probably yes intent (54.6%), followed by a definite yes intent (28.7%). The perception that vaccination decreases the chances of getting COVID-19 under the perceived benefit construct (OR = 3.14, 95% CI 2.05-4.83) and not being concerned about the efficacy of new COVID-19 vaccines under the perceived barriers construct (OR = 1.65, 95% CI 1.31-2.09) were found to have the highest significant odds of a definite intention to take the COVID-19 vaccine. The median (interquartile range [IQR]) of WTP for COVID-19 vaccine was CNY¥200/US$28 (IQR CNY¥100-500/USD$14-72). The highest marginal WTP for the vaccine was influenced by socio-economic factors. The majority were confident (48.7%) and completely confident (46.1%) in domestically-made COVID-19 vaccine. 64.2% reported a preference for a domestically-made over foreign-made COVID-19 vaccine.
CONCLUSIONS: The findings demonstrate the utility of HBM constructs in understanding COVID-19 vaccination intent and WTP. It is important to improve health promotion and reduce the barriers to COVID-19 vaccination.
METHODS: An online cross-sectional survey assessing female undergraduate students' intention to obtain the HPV vaccine and their acceptability of 2-, 4- and 9-valent HPV vaccines (2vHPV, 4vHPV, and 9vHPV, respectively).
RESULTS: Of a total of 997 complete responses, 55.2% reported intent to obtain the HPV vaccine. Some of the significant factors exerting influence on intent to obtain HPV vaccination were high knowledge score (OR = 1.469, 95% CI:1.087-1.987), perceived high risk of HPV infection (OR = 1.466, 95%CI:1.017-2.114), perception of no serious side effects (OR = 1.562, 95%CI:1.150-2.121), and mass media exposure to HPV vaccination information (OR = 2.196, 95%CI: 1.625-2.966). Socioeconomic status indicators did not significantly influence intent to obtain the HPV vaccine. A higher proportion of respondents were willing to pay for 2vHPV (78.6%) and 4vHPV (68.0%) compared with 9vHPV (49.3%). Socioeconomic status indicators were the strongest correlates of acceptability for all the three vaccines. Exposure to mass media reporting about HPV vaccination is the factor which exerts the most influence on acceptance of 9vHPV after socioeconomic status indicators.
CONCLUSIONS: It is important to improve knowledge and health beliefs, and to establish a mass media marketing strategy to promote HPV vaccination in order to enhance HPV vaccine uptake. Undergraduate female students should be provided with detailed information about the different valency vaccine choices to help them make informed decisions about immunization.
Methods: A cross-sectional, self-administered online survey was carried out between 3 September and 15 October 2020.
Results: A total of 8393 complete responses were received from a nationwide sample. Poor sustainability in the practice of "new norm" was reported. Noteworthy disparities were observed in willingness to carry out "new normal" practices by gender, urban-rural locality, non-Han and Han Chinese and educational attainment. There was evidence of economic and social disruption associated with COVID-19 or "new normal" practices. The current mean (±standard deviation [SD]) happiness score (110.45 ± 17.55) was slightly lower than the mean happiness score before (111.12 ± 17.83) the COVID-19 pandemic (t= -9.01, p<0.001). Lower socioeconomic status and greater economic and social disruptions were associated with lower current happiness scores. Moreover, greater willingness to adapt to "new normal" practices was associated with higher levels of happiness.
Conclusion: There is a need to encourage sustainable practice of new norm post-pandemic. Segments of the public continue to experience significant economic and social effects and the post-pandemic 'new norms' remain at risk of leading to psychological consequences.
METHODS: This was a prospective, cross-sectional study. A total of 429 respondents diagnosed with urologic cancers (prostate, bladder and renal cancer) from Sarawak General Hospital and Subang Jaya Medical Centre in Malaysia were interviewed by using a structured questionnaire. SPB and HRQoL were measured by the Self-perceived Burden Scale and the Functional Assessment of Cancer Therapy-General 7 Item Scale respectively.
RESULTS AND CONCLUSION: Self-perceived burden was experienced by 73.2% of the respondents. Respondents who had a lower education level, a monthly household income
METHODS: A online cross-sectional survey was conducted with the people living in Wuhan between March 12th and 23rd, 2020.
RESULTS: Of a total of 2411 complete responses, the mean and standard deviation for the total physical prevention barriers score was 19.73 (standard deviation ± 5.3; range 12-45) out of a possible score of 48. Using a cut-off score of 44 for the State-Trait Inventory score, 79.9% (95% confidence interval [CI]: 78.2-81.5) of the participants reported moderate to severe anxiety during the early phase of the outbreak, and 51.3% (95% CI 49.2-53.3) reported moderate to severe anxiety after the peak of coronavirus disease 2019 was over (during the study period). Comparing anxiety levels in the early phase of the outbreak and after the peak of the outbreak, 58.5% (95% CI 56.5-60.5) recorded a decreased anxiety. Females reported a higher likelihood of having decreased levels of anxiety than males (odds ratio = 1.78, 95% CI 1.48-2.14). Low negative attitudes score were associated with a higher decrease in anxiety (odds ratio = 1.59, 95% CI 1.33-1.89).
CONCLUSIONS: The attitudinal barriers to prevention of transmission of coronavirus disease 2019 are more prominent than physical prevention barriers after the peak of coronavirus disease 2019. High anxiety levels even after the peak warrant serious attention.
Methods: An online survey was sent to all registered undergraduate nursing students at Fujian Medical University, China. The partial least squares structural equation model (PLS-SEM) was used to investigate key factors influencing turnover intention.
Results: A total of 1020 complete responses were received (response rate: 86.2%). Nearly half (49.1%) reported that they would choose not to be on a nursing course if given a choice, 45.4% often think of not going into the nursing profession in the future, and 23.7% would consider entering a healthcare industry that has zero contact with patients. The total turnover intention score range was 3 to 15, and the mean ± standard deviation (SD) was 9.2 (SD ± 2.5). PLS-SEM path analysis revealed that fear of COVID-19 (β = 0.226, p < 0.001) had a positive effect on turnover intention. Satisfaction with life (β = -0.212, p < 0.001) had a negative effect on turnover intention. Analysis of open-ended survey data on students' perspectives on how to encourage nursing students to enter the nursing workforce revealed five central themes: 1) professional role, respect, and recognition; 2) higher wages; 3) reduce workload; 4) enhance occupational health and safety; and 5) career advancement opportunities.
Conclusion: Factors influencing turnover intention and suggestions to reduce students' apprehension towards joining the nursing profession found in this study should be seriously taken into consideration in initiatives to address the nurse shortages.