Distrust Of Government Research Articles

Voluntary self-disclosed Indigenous identity of patients in four Canadian health care settings: A multiple-site qualitative case study.

The lack of Indigenous health care data in Canada makes it challenging to plan health care services and inform Indigenous leadership on the health care needs of their respective Nations and communities. Several Canadian health care organizations have implemented a voluntary Indigenous identifier of patients within their electronic medical records. This study examines facilitators and barriers to implementing such a voluntary self-reported Indigenous identifier, from the perspective of key stakeholders who work at four Canadian health providers where an Indigenous identifier has been implemented. The four Canadian sites comprise three hospitals and one health authority. At each site, key stakeholders participated in semi-structured qualitative interviews. Interviews were transcribed and coded. Relevant documents that were publicly available or provided by each site were reviewed. There were four primary findings. First, for the introduction of an Indigenous identifier to be successful there must be pre-existing strong and trusting relationships between Indigenous communities and health care organizations. Second, health care organizations must provide training for those who ask clientele to self-identify as Indigenous, to overcome issues such as any patient backlash. Third, for the relationship between Indigenous people and health organizations to flourish, data governance must be Indigenous-led. Finally, the collection of Indigenous identifier data can enhance Indigenous health care services and health care service planning and delivery. Due to the ongoing distrust of government and health care services among Indigenous peoples and communities, special considerations are required prior to the implementation of an Indigenous identifier. Of primary importance is how health care organizations can contribute to Indigenous data governance and minimize potential harms associated with the collection of such data. The findings of this study can be used to guide other health care sites and Indigenous leaders aspiring for more robust health data by implementing voluntary Indigenous identity data collection.

Discrimination backfires? Minority ethnic disparities in vaccine hesitancy

A number of minority ethnic groups (MEGs) exhibited persistent reluctance to receive the COVID-19 vaccine. This paper attempts to empirically identify some of the contentious behavioral determinants for vaccine hesitancy (VH) that remain unexplained including the role of risk perceptions, trust in government institutions, and prior experiences of racism and trauma. We draw on unique longitudinal data from a minority-boosted sample that was collected in the United Kingdon (UK). We document robust evidence of MEG disparities in VH, which declined between November 2020 and March 2021. While VH is associated to both historical and current distrust in government, risk beliefs, exposure to racism, and an individuals socio-economic background, these factors do not fully explain MEG disparities. Furthermore, similar patterns of inequality are observed when we examine MEG disparities in healthcare use, suggesting that disparities in VH reflect broader unobservable structural barriers to healthcare access.

Understanding the rationales and information environments for early, late, and nonadopters of the COVID-19 vaccine

Anti-vaccine sentiment during the COVID-19 pandemic grew at an alarming rate, leaving much to understand about the relationship between people’s vaccination status and the information they were exposed to. This study investigated the relationship between vaccine behavior, decision rationales, and information exposure on social media over time. Using a cohort study that consisted of a nationally representative survey of American adults, three subpopulations (early adopters, late adopters, and nonadopters) were analyzed through a combination of statistical analysis, network analysis, and semi-supervised topic modeling. The main reasons Americans reported choosing to get vaccinated were safety and health. However, work requirements and travel were more important for late adopters than early adopters (95% CI on OR of [0.121, 0.453]). While late adopters’ and nonadopters’ primary reason for not getting vaccinated was it being too early, late adopters also mentioned safety issues more often and nonadopters mentioned government distrust (95% CI on OR of [0.125, 0.763]). Among those who shared Twitter/X accounts, early adopters and nonadopters followed a larger fraction of highly partisan political accounts compared to late adopters, and late adopters were exposed to more neutral and pro-vaccine messaging than nonadopters. Together, these findings suggest that the decision-making process and the information environments of these subpopulations have notable differences, and any online vaccination campaigns need to consider these differences when attempting to provide accurate vaccine information to all three subpopulations.

Accessing the right to vote among system-impacted people

Recent efforts to dismantle felon disenfranchisement regimes have the potential to substantially expand electoral eligibility among people with criminal records; however, even among those with criminal legal histories who are eligible to vote, voting rates are often extremely low. Analyzing interview, focus group, and text message conversations among a multi-state sample around the November 2022 election, we identify and describe how administrative barriers to voting—including a lack of understanding about the voting process, confusion about legal eligibility, and perceived risks of rearrest of voting while ineligible—pose an access to justice issue among system-impacted people. These barriers are amplified by government mistrust, specifically the perception that barriers are intentionally constructed to suppress voting, and they are potentially mitigated by outreach by community organizations that are viewed as credible. The findings emphasize that legislative reforms repealing disenfranchisement laws must be accompanied by on-the-ground efforts to address administrative burdens to broaden access to the franchise.

A Survey on Population Perceived Factors Influencing COVID-19 Vaccination in South Indian Districts.

The COVID-19 pandemic has posed unprecedented challenges to global public health, necessitating the rapid development and distribution of vaccines. Despite the availability of effective vaccines, vaccination uptake remains varied across different regions and populations. This study aims to investigate the factors influencing COVID-19 vaccination uptake in South Indian districts, with a focus on understanding public perceptions. Utilizing a cross-sectional survey methodology, data were collected from a representative sample of residents in selected South Indian districts. The survey explored a range of variables including demographic characteristics, knowledge and awareness about COVID-19 vaccines, perceived risks and benefits, trust in healthcare systems, and sources of vaccine-related information. The preliminary analysis indicates that vaccine uptake is significantly influenced by factors such as age, educational level, and socioeconomic status. High levels of vaccine hesitancy were associated with misinformation, concerns about vaccine safety and efficacy, and distrust in government and healthcare authorities. Conversely, individuals with higher education levels and those who received accurate information from trusted sources showed a greater willingness to get vaccinated. Social and cultural beliefs also played a crucial role in influencing vaccination attitudes, stressing the need for the importance of culturally sensitive health communication strategies.The study investigates a range of factors, including demographic characteristics such as age, gender, education level, and socio-economic status, as well as psychological and social determinants like the perceived risk of COVID-19, trust in vaccines, and the influence of misinformation. This study underscores the need for targeted public health interventions to address vaccine hesitancy and improve vaccination rates in South India. By identifying the key factors influencing vaccination decisions, policymakers and healthcare providers can develop more effective communication and outreach programs tailored to the unique needs and concerns of the population. Enhanced efforts in education, transparency, and community engagement are essential to fostering greater public trust and achieving higher vaccination coverage.

Is gravidity associated with COVID-19 vaccination among pregnant women in Jamaica?

In 2021, Jamaica's maternal mortality ratio doubled as a result of COVID-19-related deaths. Yet, COVID-19 vaccination among pregnant Jamaican women remained low. In the United States, COVID-19 vaccination is lower among pregnant women who have had multiple pregnancies (multigravidas) versus women who were pregnant for the first time (primigravidas). We examined whether this pattern exists in Jamaica. A cross-sectional survey of a convenience sample of 79 pregnant Jamaican women recruited from a teaching hospital (May-July 2022) was used to assess self-reported COVID-19 vaccination and medical mistrust beliefs-operationalized as low vaccine confidence, government mistrust, and race-based mistrust-by gravidity. We used modified Poisson regression to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for vaccination by gravidity, adjusting for age, education, and comorbidities. Thirty-nine (49%) of the participants were multigravidas. Socioeconomic status was similar between multigravidas and primigravidas. COVID-19 vaccination was lower in multigravidas (46%) than primigravidas (75%) after adjusting for age, education, and comorbidities (aPR = 0.67, 95% CI = 0.46-0.99; p = 0.044). Vaccine confidence was lower in multigravidas (p = 0.044). Government mistrust and race-based mistrust did not differ between the two groups. In Jamaica, multigravidas may have lower COVID-19 vaccine uptake and lower vaccine confidence compared with primigravidas. Understanding the distinct needs of pregnant subpopulations is essential for crafting effective maternal vaccination campaigns.

Mandatory Warning Signs for Cannabis: Perspectives and Preferences of Pregnant and Recently Pregnant People Who Use Cannabis.

Five U.S. states where recreational cannabis is legal require Mandatory Warning Signs for cannabis use during pregnancy (MWS-cannabis) to be posted in cannabis dispensaries. Previous research has found adverse health consequences associated with MWS-cannabis and that people lack trust in information on signs. This qualitative study explores people's perspectives and preferences regarding MWS-cannabis. We conducted in-depth interviews with 34 pregnant or recently pregnant individuals from multiple states with varying policy climates in the U.S. who used cannabis before and/or during pregnancy. We asked participants about their perspectives on MWS-cannabis and reactions to specific messages. We reviewed transcripts using thematic analysis. Participants reported mostly negative views on MWS-cannabis, suggesting they may have stigmatizing and negative impacts on pregnant people who use cannabis, discouraging them from seeking care. Many said that the scientific evidence is not strong enough to justify MWS-cannabis, and that they are unlikely to deter pregnant people from using cannabis. Participants asserted that vague or fear-based messages, distrust of government, and the location and timing of the signs undermine the goals of MWS-cannabis. When reacting to specific messages, participants preferred messages that are evidence-based, clear, specific, and aligned with autonomous decision-making. Pregnant and recently pregnant people who use cannabis have mostly negative perceptions of MWS-cannabis and believe they have negative consequences. More work is needed to develop health information resources that meet the needs of people who use cannabis in pregnancy without increasing stigma.

“It’s another gay disease”: an intersectional qualitative approach contextualizing the lived experiences of young gay, bisexual, and other sexual minoritized men in the United States during the mpox outbreak

BackgroundThe U.S. mpox outbreak in 2022 introduced new and exacerbated existing challenges that disproportionately stigmatize gay, bisexual, and other sexual minoritized men (GBSMM). This study contextualizes the perceptions, susceptibility, and lived experiences of the mpox outbreak among GBSMM in the U.S. using an intersectional framework.MethodsBetween September 2022 to February 2023, we conducted 33 semi-structured qualitative interviews with purposively sampled GBSMM in the Northeast and the South region of the United States on various aspects related to their experience during the mpox outbreak.ResultsWe identified four themes: (1) understanding and conceptualizations of mpox, (2) mpox vaccine availability and accessibility, (3) mpox vaccine hesitancy and mistrust, and (4) call to action and recommendations. GBSMM collectively discussed the elevated mpox stigmatization and homophobic discourse from mainstream social media and news outlets. GBSMM also discussed the lack of availability of mpox vaccines, unclear procedures to receive the vaccine, and continued mistrust in government, non-government, and other institutions of health that were complicit in anti-LGBTQ + narratives related to mpox. However, they expressed that these challenges may be addressed through more LGTBQ + representation and leveraging ways to empower these communities.ConclusionGBSMM have mpox experiences that are distinct and multifaceted. Effectively addressing mpox and mitigating public health emergencies for GBSMM requires prioritizing destigmatizing communication channels and vaccine distribution strategies by centering their stories and lived experiences to advance health equity.

Analysis of Public Comments on Experimental Regulations for Protecting Black Bass during The Spawning Period in Eastern Ontario Reveals Both Stakeholder Acceptance and Skepticism.

Recreational angling of nesting largemouth bass (Micropterus nigricans) and smallmouth bass (M. dolomieu) can greatly increase nest abandonment, and in the northern clines of their range, decrease recruitment. This is the case in eastern Ontario, where high levels of non-compliance and difficult to enforce regulations have impacted black bass (Micropterus spp.) conservation and management. Effective January 1, 2024 until December 31st, 2025, novel and experimental fishing sanctuaries were imposed on portions of Charleston Lake and Opinicon Lake that prohibit recreational fishing of all types from April 15th to the Friday before the first Saturday in July (encompassing the full bass reproductive season). As part of the formal process to institute these experimental regulations, public comments were collected on the Environmental Registry of Ontario. We examined those comments and identified supportive and non-supportive themes related to these experimental regulations. While a majority of stakeholders were in support of the new regulations, we also noted sub-themes that may hinder regulation acceptance. Those sub-themes include: a perceived lack of enforcement negating the potential benefits of the sanctuaries, under-estimation of the extent of non-compliance with existing regulations such that new regulations are unnecessary, misunderstanding and misinformation, as well as distrust of government and the academic research community. Understanding and addressing these stakeholder perspectives will help researchers studying the new sanctuary areas and managers understand any lack of compliance while informing future decisions about bass management in eastern Ontario and beyond.

Hesitant or Confident: A Qualitative Study Examining Latinos' Perceptions of COVID-19 Vaccines in Arizona.

This study aimed to understand vaccine hesitancy and confidence toward the COVID-19 vaccines among Latino adults in Arizona. Latinos (n = 71) aged 18 years or older who resided in Arizona participated in 14 focus groups between February and June 2021. Theoretical thematic analysis was used to examine drivers of these two behaviors, namely, vaccine hesitancy and confidence toward the COVID-19 vaccines, using the COM-B model, comprising capability, opportunity, and motivation factors that generate a behavior. Vaccine hesitancy stemmed from the need for vaccine information (capability factor) and fear of the vaccines, religious beliefs, and perceived barriers stemming from government mistrust (motivation factors). Vaccine confidence arose from trust in science and doctors (capability factor), and a fear of getting sick, protection against COVID-19, getting vaccinated as a civic duty, and a desire to return to normal life (motivation factors). The influence of opportunity factors, such as having access to vaccinations, were not discussed as contributing to vaccine confidence or hesitancy. As predicted by the COM-B model, factors reflecting capabilities and motivations contributed to vaccine hesitancy and confidence, all of which need to be considered in public health messaging. These factors can be targeted to facilitate efforts to promote vaccine uptake and reduce the spread of COVID-19.

Interrogating Covid-19 Protocols and Policing in Nigeria: Implications of Government Distrust and Service Failure (2019 – 2022)

The study examined covid-19 protocols and policing in Nigeria, with implications of government distrust and service failure, 2019 – 2022. Specifically, the study interrogated how government’s attitude to healthcare delivery undermined covid-19 protocols and policing in Nigeria; and how multidimensional poverty in the country undermined Nigeria’s lockdown protocols and policing in the fight against the virus. By adopting documentary method of data collection, expost facto research design and securitisation theory, the study found that government’s historical attitude towards healthcare delivery for its citizens led to the failure of its covid-19 protocols and policing, as result of the poor compliance of citizens. The study further found that multidimensional poverty among Nigerians led to the undermining of governments lockdown measures and guidelines during the pandemic. This were borne out of the citizens’ distrust of their government who have hoarded palliatives meant to cushion the effect of the pandemic. The study concluded and recommended amongst others, that the government must invest in quality healthcare by increasing its spending and budget allocations to the healthcare sector. It must also ensure that it desist from playing politics with palliatives meant to help cushion the effect of the pandemic on its citizens.

COVID-19 clinical trial participation and awareness in Texas

ABSTRACT The COVID-19 pandemic required the rapid development of COVID-19 vaccines and treatments, necessitating quick yet representative clinical trial enrollment to evaluate these preventive measures. However, misinformation around the COVID-19 pandemic and general concerns about clinical trial participation in the U.S. hindered clinical trial enrollment. This study assessed awareness of, willingness to participate in, and enrollment in COVID-19 vaccine and treatment clinical trials in Texas. A quota sample of 1,089 Texas residents was collected online from June – July 2022. Respondents were asked if they were aware of, willing to participate in, and had enrolled in clinical trials for COVID-19 vaccines or treatments. Overall, 45.8% of respondents reported being aware of clinical trials for COVID-19 treatments or vaccines, but only 21.7% knew how to enroll and only 13.2% had enrolled in a COVID-19 clinical trial. Respondents with bachelor’s or graduate degrees were more likely to be aware of clinical trials, more likely to have enrolled in trials, and more willing to participate in treatment trials. Women were less willing to participate and less likely to have enrolled in COVID-19 clinical trials than men. Respondents aged 55 years and older were more willing to participate, but less likely to have enrolled in COVID-19 clinical trials than 18-to-24-year-olds. Common reasons given for not participating in clinical trials included concerns that COVID-19 treatments may not be safe, government distrust, and uncertainty about what clinical trial participation would entail. Substantial progress is needed to build community awareness and increase enrollment in clinical trials.

Food security, the agriculture value chain, and digital transformation: The case of Jamaica's agricultural business information system (ABIS)

Digital transformation has potential for improving food security through agriculture development. While these transformations are welcomed and while societies are generally moving towards modernization and digitalization, farmers in the Global South have not been transitioning into the age of digitalization, and so are unable to take full advantage in ways that can enhance the agro value chain. Considering this, what may account for the sub-optimal take up from digital transformation deployment in agriculture sector in a small island developing state? Has there been any successes to the agriculture value-chain? What are the lessons to be learned? While the systems are available and farmers may have an interest in using them, their lack of ability to maneuver these new technologies leads to non-take up/use of the new beneficial technologies. A general distrust in government further compounded by a general distrust in the use of the internet has polarized farmers from digital technologies. The sluggish operations of governments of the South have inhibited the innovation that is required to enhance take up of digital technologies in agriculture. Privatization of digitalization in agriculture is therefore proffered as an alternative to a state-owned and state-operated digital transformation of agriculture. A policy options framework is proposed as a starting point to mitigating some of the challenges faced and improving digital transformation efforts in agriculture.

COVID-19 vaccination of at-risk and marginalised groups: recentering the state in vaccine uptake

Recent studies have used the World Health Organization's new Behavioural and Social Drivers (BeSD) framework to analyse vaccine uptake. However, this study of COVID-19 vaccination among marginalised population groups highlights the framework's limitations regarding the centrality of the state in shaping people's vaccination intentions in high income countries. We conducted interviews and focus groups with service providers and community members to explore COVID-19 vaccination amongst Western Australians experiencing homelessness and/or from other marginalised populations (such as people with substance use dependence). Analysing this data iteratively to emphasise the state's role and functions, we elaborate how trauma and mistrust of government drive thoughts, feelings, and social interactions regarding vaccination programs, which are mutually reinforcing and which inhibit individuals' willingness to engage. Government systems that leave some populations behind increase those populations' susceptibility to misinformation. Policies may generate new unintended problems: social service providers worried about vaccine advocacy damaging clients' trust, especially in the context of vaccine mandates. Reframing the state's responsibility for designing culturally and socially appropriate services, we outline how end-users and trusted providers can lead this process. We share a new framework, “Recentering the State in Vaccine Uptake,” arising from our analyses.

High COVID-19 vaccine uptake following initial hesitancy among people in Australia who inject drugs

BackgroundPrevious studies have reported high COVID-19 vaccine hesitancy among people who inject drugs. We aimed to examine COVID-19 vaccine coverage, motivations and barriers to vaccination, and factors associated with uptake among this population in Australia, 1.5 years after vaccine rollout commenced. MethodsIn June-July 2022, 868 people (66.0 % male, mean age 45.6 years) who regularly inject drugs and reside in an Australian capital city reported the number of COVID-19 vaccine doses they had received and their primary motivation (if vaccinated) or barrier (if unvaccinated) to receive the vaccine. We compared vaccine uptake to Australian population estimates and used logistic regression to identify factors associated with ≥ 2 dose and ≥ 3 dose uptake. ResultsOverall, 84.1 % (n = 730) had received at least one COVID-19 vaccine dose, 79.6 % (n = 691) had received ≥ 2 doses, and 46.1 % (n = 400) had received ≥ 3 doses. Participants were less likely to be vaccinated than the Australian general population (prevalence ratio: 0.82, 95 % confidence interval [CI]: 0.76–0.88). Key motivations to receive the vaccine were to protect oneself or others from COVID-19, while barriers pertained to vaccine or government distrust. Opioid agonist treatment (adjusted odds ratio [aOR]: 2.49, 95 % CI: 1.44–4.42), current seasonal influenza vaccine uptake (aOR: 6.76, 95 % CI: 3.18–16.75), and stable housing (aOR: 1.58, 95 % CI: 1.02–2.80) were associated with receipt of at least two vaccine doses. Participants aged ≥ 40 years (versus < 40 years; aOR: 1.66, 95 % CI: 1.10–2.53) or who reported a chronic health condition (aOR: 1.71, 95 % CI: 1.18–2.47) had higher odds of receiving at least three vaccine doses. ConclusionWe observed higher COVID-19 vaccine uptake than expected given previous studies of vaccine acceptability among people who inject drugs. However, it was lower than the general population. People who inject drugs and reside in unstable housing are a subpopulation that require support to increase vaccine uptake.

COVID-19 AND PUBLIC SCEPTICISM OF VACCINATION AS A CONTROL MEASURE: A STUDY OF EDO SOUTH SENATORIAL DISTRICT, NIGERIA (2019-2021)

The world woke up to a global epidemic disease known as coronavirus in December 2019. Coronavirus also known as Covid-19 has taken many lives and disrupted the political economy of states around the world. Unfortunately, people are still dying of the virus to date. Scientists quickly came up with vaccines to halt the deaths and re-ignite the global economy which nose-dived after the epidemic broke out in China. Despite the presence of vaccines, a lot of people are still sceptical about its efficacy and the motive of the vaccination. This study based on Qualitative research was embarked upon to find out about the high rate of scepticism about the vaccines by people of Edo South Senatorial District, Nigeria. Using thematic analysis; the findings revealed that mistrust of government, social media, vaccine mandate, religion and other multi-faceted factors are responsible for the scepticism. The majority of the residents are against vaccine mandates, they believe they should be given the free will and liberty to opt for or decline vaccination. Hence, it is suggested that the Government, NGOs and Christian leaders need to carry out more enlightenment with empirical facts and introduce incentives to convince the unvaccinated to join the vaccinated queue.

Hyperpartisan, Alternative, and Conspiracy Media Users: An Anti-Establishment Portrait

ABSTRACT While there is growing academic attention to readers of hyperpartisan, alternative, and conspiracy (HAC) media, our understanding of these sites has developed in separate bodies of work. We make a case for studying HAC media in unison, recognizing them as different information sources that share the same underlying anti-establishment sentiment. We do so by painting a detailed portrait of HAC media users, detailing 1) who consumes HAC media; 2) how they access it; and 3) how its consumption relates to public opinion. This is made possible by the unique combination of panel surveys taken before and after the first COVID-19 lockdowns in Germany and Switzerland, and webtracking data capturing participants’ actual online behavior. Our results show that those exposed to HAC media have a strong distrust of government and place themselves at the ideological extremes. While social media was a quintessential entry point for such media, most visits were registered by a small percentage of repeat visitors. Lastly, we show that those who consumed HAC media developed distinct opinions about the threat posed by COVID-19, mirroring the sentiments expressed in HAC media that the danger of the virus was exaggerated and that the real threat was to individual freedoms. With this case study, we showcase the theoretical utility of taking an integrated approach to HAC media, while providing nuanced insights into their audience.

Assessing the public discourse on Twitter: Reactions to the JUUL e-cigarettes ban in the United States.

JUUL is a high-nicotine pod-based vaping device that is popular among adolescents and young adults. On 23 June 2022, the US Food and Drug Administration (FDA) denied authorization to market JUUL, and ordered JUUL Labs to remove products from the US market. The next day, a US federal appeals court temporarily suspended the ban. The mixed public discourse surrounding the FDA ban warrants further investigation. This study examined Twitter data to describe public reaction to these announcements. Posts containing terms 'JUUL' and/or '#JUUL' (N=97548 unique tweets) were collected from 23 June to 3 July 2022, from Twitter's Streaming Application Programming Interface (API). After removing retweets, we used an inductive approach to become familiar with the data, generated a codebook, and conducted a content analysis on a random sample of n=4000 tweets. A total of 2755 (68.9%) tweets discussed JUUL in the context of the FDA ban. News (n=1425/2755; 51.7%) about the JUUL ban, government distrust (n=588; 21.3%), and individual rights (n=253; 9.2%) were the most prevalent themes. Less commonly discussed themes included inconsistencies between policies (n=174; 6.3%), mentions of switching to other products (n=162; 5.9%), smoking cessation (n=99; 3.6%), and craving for JUUL (n=94; 3.4%). Sentiment analysis of JUUL ban-related posts (n=2755) demonstrated that 1989 (72.2%) tweets were categorized as neutral, while anti-ban posts (n=566; 20.5%) were more prevalent than pro-ban posts (n=200; 7.3%). Besides straightforward announcements of the JUUL ban and its suspension, Twitter posts discussed government distrust, individual rights, and policy inconsistencies. While most posts conveyed neutral sentiments, anti-ban posts were almost three times more prevalent than pro-ban posts. Our findings suggest that text-based social media platforms like Twitter may be an effective instrument to understand opinions, attitudes, and beliefs regarding the FDA's JUUL ban.

Adequacy of health message tailoring for ethnic minorities: Pasifika communities in Sydney, Australia, during COVID-19.

Ethnic minorities, such as Pasifika, residing in high-income countries were at higher risk of COVID-19 infection during the pandemic. To understand the experiences of Pasifika, including message dissemination and barriers to tailored public health messaging during the pandemic, a qualitative study was undertaken, underpinned by Laswell's Model of Communication and Bandura's social cognitive theory with data collected using Pasifika methods. Pasifika adults (n = 65) were recruited across Sydney from July 2020 to March 2022. Health care professionals (HCP) (n = 17) employed by four local health districts (LHDs) and Pasifika community-based organizations delivering multicultural COVID-19-related work within the study catchment, were also recruited. Five themes were constructed from the data of: (i) prevailing fear and uncertainty over COVID-19 infection and losing employment; (ii) limited knowledge of government perpetuating distrust in Government as a benevolent source of information; (iii) faith and trust as priorities for health decision-making; (iv) 'Coconut wireless'-the role of family, friends and community in disseminating public health messages through word of mouth; and (v) limited health literacy affecting compliance with public health orders. Community members identified important messages and resources had not been sufficiently distributed. Most HCPs understood the necessity of grassroots-level engagement but reported existing approaches were inadequate to navigate challenges. These findings highlight the need for public health promotion and communication strategies that consider both the social and cultural determinants of health. We propose a 7-point checklist as a cultural appropriateness lens to assist the development and rating of existing or new health promotion messaging and resources.

Disparities and effectiveness of COVID-19 vaccine policies in three representative European countries

ObjectiveThe aim of this study was to examine the Coronavirus disease 2019(COVID-19) vaccine policies disparities and effectiveness in Germany, Denmark and Bulgaria, with a view to providing lessons for global vaccination and response to possible outbreak risks.MethodsThis study analyzed big data through public information on the official websites of the Ministries of Health of the European Union, Germany, Denmark and Bulgaria and the official websites of the World Health Organization. We systematically summarized the COVID-19 vaccine policies of the three countries, and selected the following six indicators for cross-cutting vaccination comparisons: COVID-19 vaccine doses administered per 100 people, COVID-19 vaccination rate, the share of people with fully vaccinated, the share of people only partly vaccinated, cumulative confirmed COVID-19 cases per million, cumulative confirmed COVID-19 deaths per million. Meanwhile, we selected the following four indicators for measuring the effectiveness of COVID-19 vaccine policy implementation: daily cases per million, daily deaths per million, the effective reproduction rate (Rt), the moving-average case fatality rate (CFR).ResultsAlthough these three EU countries had the same start time for vaccination, and the COVID-19 vaccine supply was coordinated by the EU, there are still differences in vaccination priorities, vaccination types, and vaccine appointment methods. Compared to Germany and Denmark, Bulgaria had the least efficient vaccination efforts and the worst vaccination coverage, with a vaccination rate of just over 30% as of June 2023, and the maximum daily deaths per million since vaccination began in the country was more than three times that of the other two countries. From the perspective of implementation effect, vaccination has a certain effect on reducing infection rate and death rate, but the spread of new mutant strains obviously aggravates the severity of the epidemic and reduces the effectiveness of the vaccine. Among them, the spread of the Omicron mutant strain had the most serious impact on the three countries, showing an obvious epidemic peak.ConclusionsExpanding vaccination coverage has played a positive role in reducing COVID-19 infection and mortality rates and stabilizing Rt. Priority vaccination strategies targeting older people and at-risk groups have been shown to be effective in reducing COVID-19 case severity and mortality in the population. However, the emergence and spread of new variant strains, and the relaxation of epidemic prevention policies, still led to multiple outbreaks peaking. In addition, vaccine hesitancy, mistrust in government and ill-prepared health systems are hampering vaccination efforts. Among the notable ones are divergent types of responses to vaccine safety issue could fuel mistrust and hesitancy around vaccination. At this stage, it is also necessary to continue to include COVID-19 vaccination in priority vaccination plans and promote booster vaccination to prevent severe illness and death. Improving the fairness of vaccine distribution and reducing the degree of vaccine hesitancy are the focus of future vaccination work.