Intrapersonal Factors Research Articles

A Social-Ecological Model Exploring Gestational Diabetes Mellitus Screening Practices Among Antenatal Health Care Providers.

Gestational diabetes mellitus (GDM) is associated with adverse health outcomes for the pregnant individual and their baby. Screening approaches for GDM have undergone several iterations, introducing variability in practice among healthcare providers. As such, our study aimed to explore the views of antenatal providers regarding their practices of, and counseling experiences on the topic of, GDM screening in Ontario. We conducted a qualitative, grounded theory study. The study population included antenatal providers (midwives, family physicians, and obstetricians) practicing in Hamilton, Ottawa, or Sudbury, Ontario. Semi-structured telephone interviews were conducted and transcribed verbatim. Transcripts were analyzed using inductive coding upon which codes, categories, and themes were developed to generate a theory grounded in the data. Twenty-two participants were interviewed. Using the social-ecological theory, we created a model outlining four contextual levels that shaped the experiences of GDM counseling and screening: Intrapersonal factors included beliefs, knowledge, and skills; interpersonal factors characterized the patient-provider interactions; organizational strengths and challenges shaped collaboration and health services infrastructure; and finally, guidelines and policies were identified as systemic barriers to health care access and delivery. A focus on patient-centered care was a guiding principle for all care providers and permeated all four levels of the model. Patient-centered care and close attention to barriers and facilitators across intrapersonal, interpersonal, organizational, and policy domains can minimize the impact of variations in GDM screening guidelines. Among care providers, there is a desire for additional skill development related to GDM counseling, and for national consensus on optimal screening guidelines.

Malevolent Monitoring: Dark Triad Traits, Cyber Dating Abuse, and the Instrumental Role of Self-Control.

Cyber dating abuse (CDA) concerns the use of digital technology to control, monitor, and hurt one's intimate partner. CDA can have profound detrimental outcomes, such as mental health problems. As such, it is important to identify intrapersonal factors that may explain these behaviors. Previous research suggests that one such factor is the personality cluster of Dark Triad traits (DTT), comprising Machiavellianism, narcissism, and psychopathy. Additionally, DTT and CDA perpetration have both been linked to poor self-control ability, but these relationships have not yet been tested together in one model. As such, the present study examines if individuals' poor self-control ability mediates the relationship between the DTT and CDA perpetration. To test these associations, we conducted a survey study among a representative sample of Belgian adults (n = 1,144; Mage = 47.66 years; 51.3% female). Findings from correlation analyses revealed that all three DTT were individually associated with CDA perpetration, such that higher scores on these traits corresponded with more CDA perpetration. Additionally, pathway analyses from structural equation modeling revealed that individuals' poor self-control ability fully explained the relationship between Machiavellianism and narcissism and CDA perpetration, and partially explained the relationship between psychopathy and CDA perpetration. As our findings suggest that self-control plays an instrumental role in explaining why individuals control and monitor their partner via digital technology, prevention and intervention efforts should seek ways to improve individuals' self-control ability in situations that may trigger such harmful interpersonal behaviors, particularly among individuals who exhibit Dark Triad personality traits.

Investigating EFL teacher candidates’ acceptance and self-perceived self-efficacy of augmented reality

The mixed-methods sequential explanatory design study presented here sought to investigate the acceptance and self-perceived self-efficacy of Augmented Reality technology among English as a Foreign Language teacher candidates. This study’s contribution to the field of AR as an instructional technology lies in that research on the using AR technology in language teacher education are particularly limited. To bridge this research gap, one-group pre-test-post-test design was used in this study, in which ten weeks of AR-enhanced English language teacher training treatment was carried out. To answer the research questions, quantitative data were gathered from 50 volunteers by using the Technology Acceptance Model survey and Self-Efficacy Scale. Qualitative data were received via semi-structured interviews carried out with 12 pre-service teachers. Findings revealed that there was a significant increase in EFL teacher candidates’ levels of AR technology acceptance whereas no significant difference was identified in their self-perceived self-efficacy. The interviewees proposed interpersonal, intrapersonal, technological, and technical factors to explain their low self-efficacy levels. Based on the findings, the paper offers implications and suggestions for researchers, teacher educators, and policymakers. The solutions to increase the level of acceptance and self-perceived self-efficacy levels to use AR among EFL Teacher Candidates include courses on Emergent Technologies (ICT, MALL, CALL, AR), training via seminars, workshops, input sessions through (inter)nationally funded projects, real-life examples, field-specific samples, and hands-on experiences.

Socio-emotional Skills in consumers of psychoactive substances

Nowadays people increasingly deal with stress in their day-to-day and the way they adapt involves intrapersonal (emotional relationship), interpersonal and environmental factors, when this adaptation develops in a negative way it can lead to the consumption of psychoactive substances, hence the relevance of the study's theme. The objective of this investigation is to know the profile of emotional competence in consumers of psychoactive substances, making use of an anonymous and confidential questionnaire applied to consumers of psychoactive substances, divided in two parts: the first part, considering variables of sociodemographic and professional character and one second part consisting of the "Veiga Scale of Emotional Competence" (EVCE) (Veiga-Branco, 2005, 2011, 2015, 2016, 2017, 2018). The sample is made up of 78 consumers of psychotic substances, of whom 48 were female, most of the respondents are over 30 years old, are single, have no children, have higher education, live with the family and have a social life. The results obtained reveal that there is no influence of sociodemographic variables nor on the characteristics of substance use on the profile of emotional competence or on the dimensions of the same of consumers of psychoactive substances.

Childhood maltreatment and NSSI in prisoners: mediation through self-identity and moderation by sensation-seeking.

The prevalence of non-suicidal self-injury (NSSI) among prisoners is widely recognized. However, most research conducted in prisons setting has focused on lifetime engagement in NSSI, with limited knowledge about its correlates and risk factors during imprisonment. Drawing on the integrated theoretical model of NSSI, this study aimed to examine the combined effects of childhood maltreatment (an environmental factor) and two intrapersonal factors, namely self-identity and sensation-seeking, on NSSI. 1042 Chinese male offenders participated in the current study, and regression analyses is used to examine the relationship among variables. The results revealed that self-identity mediated the association between childhood maltreatment and prisoners' NSSI. Sensation-seeking moderated the relationship between self-identity and NSSI, and this connection was only significant for offenders with high sensation-seeking. We discuss the results of the current research and possible practical implications.

LGBTQIA+ Cultural Competence in Physical Therapy: An Exploratory Qualitative Study From the Clinician's Perspective.

The purpose of this study was to understand the lesbian, gay, bisexual, transgender, queer, intersex, agender, and other gender and sexually diverse identities (LGBTQIA+) health care experience and associated cultural competence from the physical therapist perspective (physical therapist and physical therapist assistant). An exploratory qualitative approach implementing semi-structured focus groups and private interviews was utilized. To further anonymity, researchers allowed subjects to keep their camera off on Zoom. An interview protocol included questions guided by Campinha-Bacote domains of cultural competence (cultural awareness, skill, knowledge, encounter, and desire) to collect individual experiences, stories, discussions, thoughts, and opinions. Physical therapist clinicians were recruited from the clinical education affiliation lists of Regis University and Thomas Jefferson University. Seventy-one practicing physical therapists from the USA agreed to be part of the study. Themes were organized using the Social Ecological Model Framework. Themes are in parentheses following each level of the Social Ecological Model and include intrapersonal level (psychological stress and implicit and explicit biases), interpersonal (acceptance and competency), organizational (experience), community (advocacy), and society and policy (explicit biases and policy). Cultural competence in physical therapy is influenced by intrapersonal, interpersonal, organizational, community, and social and policy factors. Themes of psychological stress, limited awareness, decreased acceptance, and competency as well as limited exposure and experience, and a lack of advocacy and broader societal and policy issues prevent adequate LGBTQIA+ cultural competency of physical therapist providers. Further research in the physical therapist profession is needed to elaborate on the student, educator, and patient perspectives and how this information informs the LGBTQIA+ cultural competence of clinicians. This project may have a significant impact on suggestions for the delivery of content for health profession education to best impact health equity goals and save lives. Implementation of this content may have a direct impact on health disparities in LGBTQIA+ populations by reducing stigma and discrimination from health care providers, thus improving quality of health care and decreasing rates of patient mortality for LGBTQIA+ individuals.

Interpersonal and intrapersonal factors contributing to women's posttraumatic growth following perinatal loss.

Despite the high prevalence of perinatal loss and its potential for negative impact on mental health, specific risk and resilience factors contributing to adjustment following perinatal loss have not been fully explored. This study investigated the relationship between attachment security, dyadic coping, and posttraumatic growth (PTG). Women who had experienced miscarriage or stillbirth (n = 244) were recruited via social media and completed an online survey that assessed their attachment security, dyadic coping, and PTG. Loss context factors and demographics were also collected. Hypotheses were tested via hierarchical multiple regression and PROCESS macro. Attachment security was related to couples' relational functioning. Dyadic coping mediated the relationship between attachment anxiety, attachment avoidance and PTG. This study contributes to the literature by providing evidence that relational security and ability to utilize a partner to reduce distress following perinatal loss is an important factor contributing to positive psychological change. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Dynamics of Perceived Barriers to Change Physical Activity and Eating Habits in Adults Before and During a Lifestyle Intervention in a Primary Care Setting: A Mixed Methods Approach.

There is scarcity of data exploring the dynamics of barriers to changing physical activity (PA) and eating habits during a lifestyle intervention in a primary care setting. The aim of the present study was to investigate barriers to lifestyle change before and during a primary care lifestyle intervention in adults with different sociodemographic backgrounds. Barriers to healthy eating and PA were assessed in 114 adults (age = 55 ± 9 years) using a questionnaire before inclusion in the intervention. During the lifestyle intervention, factors perceived as obstacles to reach goals for PA and healthy eating habits were collected using focus group interviews in a sub-sample of 25 adults and analyzed using thematic analysis. At least 1 barrier to changing eating and PA habits was reported in 65% and 67% of the population, respectively, without differences due to sex, place of birth, and educational level. Before entering the lifestyle intervention, intrapersonal factors including lack of willpower and lack of enjoyment were the dominant barriers to PA and healthy eating, irrespective of place of birth, sex, and education level. In contrast, environmental factors such as lack of support from family and work-related constraints emerged as important barriers to overcome during the action phase of the lifestyle intervention. The present study highlights the dynamics of barriers to changing PA and eating habits in a primary care lifestyle intervention, emphasizing the need for barrier assessment during the different phases of an intervention to tailor support activities for successful lifestyle behavioral change.

FACTORS INFLUENCING SCHOOL-BASED PHYSICAL ACTIVITY PARTICIPATION AMONG EARLY ADOLESCENTS IN ETHIOPIA

Many studies have confirmed the health benefits of participating in physical activity during childhood and adolescence that are known to track into their adult lifespan. Therefore, the current research focused on exploring the level of physical activity and influencing factors among early adolescents. A cross-sectional study design was employed. Multi-stage sampling techniques were used to select schools and students. Eight hundred thirty-five students were recruited from 14 schools, grades five to eight, aged 11 to 14,with a mean age of 12.95 ±0.937 S.D. The PAQ-C and SEM measures were analyzed using IBM SPSS (Ver. 29).The findings were significantly correlated, and the internal consistency was acceptable (alpha = 0.828). Physical activity participation has a mean average score of 2.49 and t (833) = 7.465, with a p-value of 0.000 < 0.05. The results of this study demonstrated that participation in physical activity lowers in early adolescence, but levels remain higher in boys than girls. Furthermore, intrapersonal factors were more influential than other related factors. As a result, the studys findings revealed that early adolescents did not meet the minimum requirements of the WHO physical activity recommendation level to sustain a healthy lifestyle in the Gamo Zone, southern Ethiopia.

Multidimensional factors of burnout in general practice: a cross sectional survey.

GPs are particularly vulnerable to job burnout. Tailored prevention and intervention strategies are needed. To investigate organisational, interpersonal, and individual factors contributing to exhaustion and disengagement at work among GPs. We conducted a cross-sectional study in a sample of Belgian GPs. A total of 358 doctors (73% females, 301 with complete data) completed an online anonymous questionnaire assessing job burnout, psychosocial characteristics of the work environment, perceived social support in the private domain, emotional competence, and self-compassion. GPs reported moderate levels of exhaustion and disengagement. Regression models showed that included factors jointly explained 69% of the variance in exhaustion and 63% in disengagement. Exhaustion was significantly predicted by female sex (β effect size = -0.1), high perceived emotional demands (β = 0.19), as well as low self-compassion (β = -0.14) and low emotional competence (β = 0.09). Disengagement was significantly predicted by low seniority (β = -0.12) and limited opportunities for development (β = -0.16). Both exhaustion and disengagement were predicted by low perceived quality of work (β = -0.19 and -0.14, respectively), meaning of work (β = -0.17 and -0.31, respectively), and role clarity (β = 0.09 and 0.12, respectively), as well as high perceived work-life conflict (β = 0.46 and 0.21, respectively). Moreover, GPs working in a multidisciplinary group reported lower levels of exhaustion and disengagement than those working in a monodisciplinary group or a solo practice, and this difference was associated with factors such as work-life conflict. Organisational, interpersonal, and intrapersonal factors interact to predict a substantial part of burnout in general practice. The most significant risk factors were perceived work-life conflict and poor meaning of work. Policymakers should work to support more sustainable practices based on the specific needs and constraints reported by GPs.

Barriers and Drivers of Physical Activity Participation Among Older Adults in Malaysia: A Systematic Review

Introduction: Ageing is commonly linked with physical inactivity. This review was performed to identify the factors associated with participation in physical activity among older adults in Malaysia. Methods: A systematic review was conducted using five databases; Pubmed, Sagepub, Scopus, Cochrane Library and Science Direct. Observational and intervention studies published between January 2010 and December 2020 were included, with Malaysian older adults aged 55 years and older being the main subject. Results: A total of 9 articles were included in the review. Analysis was guided by the Social Ecological Model for Health Promotion. The review had successfully identified gender, age, education level, health reasons, ethnicity and attitude as intrapersonal factors, social support (friend) and marital status as interpersonal factors, and locality as well as availability of facilities as environmental factors. Conclusions: Physical activity participation among Malaysian older adults were mainly determined by intrapersonal factors, particularly gender, health condition and educational level.

The psychological well-being of schoolteachers in South Africa: A critical review

Teaching is a stressful occupation associated with various challenges that may adversely affect schoolteachers’ psychological well-being (PWB) and the provision of quality basic education. The nature and effects of teacher PWB may depend on their work context. This critical review aimed to synthesise and evaluate the evidence from available scientific literature on schoolteacher PWB within the South African context. We searched the following databases: African Journals, NWU-IR, Academic Search Complete, Africa-Wide Information, APA PsycInfo, OAlster, Directory of Open Access Journals, Library Catalogue, SciELO, SocINDEX with Full Text, MEDLINE, ERIC, CINAHL with Full Text, Springer Nature Journals, Teacher Reference Center, SPORTDiscus with Full Text, and Business Source Complete. For rigour of the search and analysis process, we employed the Search, AppraisaL, Synthesis, and Analysis (SALSA) method. This critical review research study included a final sample of 12 studies. Thematic analysis was used to analyse the data, and the following themes were identified: teaching as a stressful occupation; intrapersonal factors that affect teachers’ PWB; contextual factors that influence teachers’ PWB; differences in levels of teacher PWB; and the consequences of high or low levels of teacher PWB. To work towards the provision of quality basic education, it is vital to first acknowledge the importance of schoolteachers’ PWB in South Africa. With a clear and comprehensive understanding of teacher PWB, it is possible to implement interventions to promote and enhance teachers’ PWB in schools in South Africa.

Attitude, Facilitators, and Barriers Regarding Physical Activity in Pregnant Women: A Cross-sectional Study

Context: The benefits of physical activity extend to the mother and the developing child. Pregnant women who are physically active had lower incidence of problems throughout pregnancy and postpartum than pregnant women who are not physically active. It is crucial to have a thorough understanding of women’s attitudes toward childbirth and the factors that affect their involvement in physical activity (influencing factors) since childbirth poses numerous physical, emotional, and practical problems to women and is known to interfere with regular physical exercise. Aim: The aim of the study was to study attitude and influencing factors (facilitators and barriers) regarding physical activity in pregnant women. Setting and Design: The study design was a cross-sectional observational study. Methods: Approval for the current cross-sectional study was taken by the institutional ethical committee. This study was planned for primi gravida from all three trimesters, and high-risk pregnancy was excluded from the study. Participants had filled the self-designed validated questionnaire which consists of six questions regarding attitude and factors which affected the participation in physical activity. Statistical Analysis Used: Descriptive analysis. Results: Out of 100 participants, 89% had a positive outlook toward physical activity during pregnancy and 91% thought that it is beneficial, 60% of them engage in physical activity on a regular basis. Factors that influenced their participation were mainly social (88%), environmental (45%), and intrapersonal factors (90%). Conclusion: Attitude toward physical activity during pregnancy is positive.in-spite of participation in physical activity on a regular basis, however it is limited due to the various influencing factors which act as barriers.

Psychosocial Correlates of Motivation for Abstinence Among People Who Used Drugs After Community Rehabilitation Treatment in China: A Structural Equation Modelling.

Enhancing abstinence motivation of drugs is an effective strategy for the rehabilitation of people who used drugs and prevention of drug use relapse. However, little is known about its risk and protective factors. This study aimed to examine the potential intrapersonal (ie, impulsivity, depression, anxiety, sleep quality) and interpersonal factors (ie, perceived social support) of abstinence motivation among people who completed the community rehabilitation treatment. A total of 222 participants (mean age = 43; male = 89.2%) were recruited from eleven communities located in Wenzhou, China. Data were collected using a self-reported questionnaire in counselling room settings between April and June 2021. The proportions of participants with depression, anxiety, and poor sleep quality were 38.8%, 19.5%, and 21.2%, respectively. Age and family history of physical disease were significant background factors of abstinence motivation. Impulsivity, depressive symptoms, anxiety symptoms, and poor quality of sleep were negatively associated with abstinence motivation. Perceived social support from family and important others was positively associated with abstinence motivation. Structural equation modeling fitted the data well in which impulsivity and perceived social support were both associated with abstinence motivation indirectly through mental health problems. The identified psychosocial factors should be addressed in community rehabilitation treatment and follow-up service to enhance abstinence motivation and the long-term effectiveness of the treatment.

Behind the invisible walls: Understanding constraints on Muslim solo female travel

This study aims to investigate the challenges faced by solo-female travelers in Iranian societies and proposes measures to improve their experiences. To achieve this objective, a mixed-methods research design was employed in three phases. First, two-phased exploratory surveys were conducted to identify seven key constraints that affect the behavioral intentions of solo-female tourists, namely sociocultural, interpersonal, intrapersonal, religious, physical safety, practical, and structural factors. Furthermore, cross-impact-balanced analysis was employed to generate four consistent scenarios for the development of solo female tourism in Iran. The findings of this study provide valuable insights for policymakers and tourism industry stakeholders to enhance the experiences of solo-female travelers in Iran. The study's plausible scenario presents a number of measures that hold promise for mitigating constraints and improving the experiences of solo female travelers. These measures include online-community-building, mutual-adaptation, self-psychological empowerment, the establishment of female free zones, the overcoming of travel fears, technological-empowerment, and feminist-participatory-action.

Exploring the Perceived Barriers of Effective Communication Within the Coach–Athlete Relationship: A Sample of Scandinavian Coaches and Athletes

Coaching is a process that guides development and is shaped by sound relationships between athletes and coaches. Interpersonal communication represents a mechanism for developing functional relationships. However, not all interactions between coaches and athletes are optimal, and limited research has attempted to understand the factors that impede the ability to engage in effective communication. This study aimed to contribute to the literature by exploring the barriers experienced by high-performance coaches and athletes that hinder interpersonal communication within the coach–athlete relationship. A qualitative design grounded in a pragmatic philosophical position was utilised, and 20 semistructured interviews with 12 coaches and eight athletes participating in elite team sports were carried out. Interviews were conducted either in person or digitally via an online platform and analysed through content analysis. Barriers were identified for either coaches, athletes, or both and categorised as follows: (a) intrapersonal (e.g., lack of skills and negative experiences), (b) interpersonal (e.g., lack of concern/interest and power imbalance), and (c) environmental factors (e.g., hierarchy and toxic culture). These results suggest efforts should be focused on equipping coaches and athletes with intra- and interpersonal skills and empowering them to co-create a safe and united culture for themselves and their sport.

Understanding the Relationship Between Self Referential and Socially Oriented Emotional Intelligence Constructs: A Cross-sectional Study

This article aims to investigate the influence of self-perception, self-regulation and motivation on the social awareness and social skills of university students. While Emotional Intelligence is a concept extensively researched in psychology with a substantial body of literature, there is limited empirical data connecting the constructs of self to the social constructs in Emotional Intelligence. The research recognizes the significance of understanding how these intrapersonal and interpersonal factors contribute to the development of social competence in the academic environment. A quantitative survey was used to explore the relationship between these. The sample comprised undergraduate students from diverse academic disciplines, and data were collected through validated self-report questionnaires. The findings underscore the importance of integrating targeted interventions and educational strategies that promote the development of these attributes to enhance students' overall social competence. By fostering a greater understanding of these dynamics, universities can better equip their students with the social skills necessary for successful interpersonal interactions, personal growth, and future professional success.

Seeing others suffer and enjoying it? The Model of Individual and Social Appraisals of Misfortunes of others in media reception.

Suffering and misfortunes of other people are often portrayed in the media. Recipients react to these portrayals with different emotions. This article elucidates and clarifies schadenfreude (pleasure at the misfortune of others) and sympathy (feeling concern or sorrow over another person's distress) in media experiences. A thorough literature review provides in-depth insights into the formation of affective dispositions and schadenfreude from various psychological perspectives. This conceptual analysis leads to the "Model of Individual and Social Appraisals of Misfortunes of Others" (MISAM) which first reveals the determining intrapersonal factors within the emotional experience of schadenfreude and sympathy. Second, it discloses the social component vital for understanding the construction and regulation of these emotions. The model combines individual and social appraisal processes and identifies the factors involved in the elicitation and regulation of schadenfreude and sympathy in the media reception of misfortunes. With the aim of integrating different perspectives, we incorporated Affective Disposition Theory and recent work from social psychology and used an appraisal framework. The MISAM opens the path for further investigation of schadenfreude and sympathy in media reception, beyond entertainment experiences.

Motivations and Barriers to Leisure-Time Physical Activity Among Rural Women of Gipuzkoa

Women do less physical activity than men, and physical inactivity among women is higher during active years (ages 18–65). In addition, women residing in rural areas do less physical activity than those living in urban areas. The aim of this study was to analyze the habits, motivations, and barriers linked to leisure-time physical activity (LTPA) among women of rural areas of Gipuzkoa (Basque Country, Spain), from a socioecological and feminist approach. Two hundred and ninety-six rural women from Gipuzkoa, aged 18–65 (41.1 ± 11.2), answered the Gipuzkoa Women’s Physical Activity Questionnaire. Pearson’s chi-square test and independent samples test were used to compare the responses between the active and inactive groups. 62.8% of the participants were active, while 37.2% were inactive. In terms of intrapersonal factors, being fit was the main motivation for doing LTPA, and lack of time was the main barrier. Among the interpersonal factors, the main motivation was being in contact with friends and people they enjoyed, and the main barrier was not having someone to go with. Motherhood was not an impediment to do LTPA, and the support received from partners, family, and friends made it easier for the subjects to remain active. The influence of the physical environment and sociocultural factors was small, with the COVID-19 confinement being the main reason motivating LTPA, and the weather the main barrier. There are multiple factors that affect LTPA among rural women, and it is important to consider this collective’s diversity in order to promote healthy lifestyle habits.

The Social Ecology of Health Beliefs and Misinformation Framework: Examining the impact of misinformation on vaccine uptake through individual and sociological factors

BackgroundMisinformation presents a critical concern for academic and public health discourse, particularly around vaccine response. Before the COVID-19 pandemic, vaccine hesitancy was responsible for decreased immunization uptake for vaccine-preventable diseases. Misinformation connected to the novel COVID-19 vaccine has further fueled vaccine hesitancy in Colorado and the United States. Our study brings together three different perspectives – physicians, public health professionals, and parents – to understand the impact of misinformation on vaccine uptake in Colorado. Our study proposes a framework for combining the Health Belief Model with the Socio-Ecological model to account for societal factors in healthcare decision making. MethodsSemi-structured interviews and focus groups with public health professionals, physicians, and parents (n = 31) were conducted in late spring and summer 2022. Data were coded inductively using thematic analysis. Identified themes were deductively categorized according to the Socio-Ecological Model and Health Belief Model. ResultsUsing a theoretical framework that combined the Health Belief Model and the Socio-Ecological Model, we identified seven factors that influenced vaccine hesitancy in Colorado. Intrapersonal factors included routine vaccine hesitancy connected to perceptions of severity and susceptibility, efficacy, and benefits and barriers to vaccine uptake; interpersonal factors included social networks; institutional factors included mass mediated platforms, portrayals of uncertainty, distrust in institutional sources of information, and political influences in vaccine decision making; and structural factors included economic barriers behind vaccine hesitancy. ConclusionsOur study provides a unique, triangulated, post-positivist perspective on the role of misinformation in vaccine hesitancy in Colorado. The findings provide evidence that misinformation is an important barrier to vaccination uptake and can permeate multiple socio-ecological determinants/characteristics to influence vaccination behaviors including intrapersonal, interpersonal, institutional, and structural levels. We introduce the Social Ecology of Health Beliefs and Misinformation Framework to account for how misinformation may interrupt vaccine uptake.