Representative Telephone Survey Research Articles

Interactions between ENDS and cigarette use: evidence from a 2022 national telephone survey in South Africa

IntroductionElectronic nicotine delivery systems (ENDS) may serve as a cessation tool for people who smoke cigarettes. However, for people who do not smoke, ENDS may be a gateway to nicotine...

Exploring pre-pandemic patterns of vaccine decision-making with the 5C model: results from representative surveys in 2016 and 2018.

The 5C psychological antecedents of vaccination (Confidence, Complacency, Constraints, Calculation, and Collective Responsibility) facilitate understanding vaccination decisions in specific target groups as well as the general public's informational needs. This study aims to explain pre-pandemic vaccination behaviour (a) in general, (b) for specific vaccines such as influenza, and (c) for certain target groups (e.g. people over the age of 59years, parents, healthcare workers), using the 5C model and sociodemographic variables. The intention to get an influenza vaccination was also analysed for target groups. The 5C, self-reported vaccination behaviour and the intention to vaccinate were collected in two representative telephone surveys in Germany - one in 2016 (n1 = 5,012) and another in 2018 (n2 = 5,054). Parents, people over the age of 59years, chronically ill people, people with a migratory background, pregnant women and healthcare workers were target groups. Overall, the 5C model had higher explanatory power than sociodemographic variables. The pattern of vaccine hesitancy slightly differed between vaccinations and target groups. Confidence in safety and effectiveness was always a significant predictor. Complacency (the underestimation of disease risks) and Constraints were significant predictors as well. Calculation (of risks and benefits) was important for influenza vaccination intentions. This work builds an important benchmark for understanding potential changes in vaccine acceptance due to the pandemic. The benchmark can be used in research on potential effects of the pandemic on vaccination behaviours. Intervention designers can also use the results to understand specific audiences and their vaccination decisions.

Higher educational attainment associated with higher confidence in influenza vaccination in Norway

AimsTo explore public confidence in influenza vaccination through the use of attitudinal indicators, and study whether educational attainment is related to attitudes towards influenza vaccination. MethodsConfidence in influenza vaccination was measured with three questions adapted from the Vaccine Confidence Project. These questions have been included in four study years of a Norwegian nationally representative telephone survey that cover influenza seasons 2016/17, 2019/20, 2020/21 and 2021/22. Over these four years, a total of 8 436 individuals aged 18–79 years responded to the survey and are included in the analysis. Risk differences (RDs) with 95 % confidence intervals were estimated using multivariable Poisson regression. ResultsInfluenza vaccine confidence increased over time, with approximately 80 % of the general population expressing trust in the vaccine in the 2021/22 season. There was a tendency towards higher confidence in the oldest age group (65–79 years). Moreover, confidence increased with increasing educational attainment. The proportion of participants who agreed that influenza vaccine is compatible with their basic values was close to 20 percentage points lower among those with only compulsory education than among those with higher education at graduate level, RD = −18.4 % (95 % CI −21.4 % to −15.5 %). Educational attainment was consistently associated with influenza vaccine confidence in all seasons, among risk groups 18–64 years, and among health care workers. ConclusionsWe observed an increase in confidence in influenza vaccination over the seasons examined in the study. However, the increase has not been equal in all groups and there is a clear educational gradient in influenza vaccine confidence. These findings indicate that despite efforts to increase influenza coverage over several years, the implemented measures have failed to reach all parts of the population.

Factors influencing the likelihood of accessing healthcare during the COVID-19 pandemic in Ireland: lessons for the future

Background Implementation of public health measures during the first wave of the coronavirus disease (COVID-19) pandemic, including travel restrictions and physical distancing, may have impacted population behaviour in seeking medical care. Identifying barriers to accessing healthcare is important, especially for vulnerable groups. Methods Data were collected through a nationally representative cross-sectional telephone survey during the first period of easing of COVID-19 restrictions in May and June 2020. Secondary data analysis of the dataset was carried out to examine the factors influencing the likelihood of individuals avoiding General Practitioner (G.P.) and hospital-based care. Poisson regression analyses were conducted to estimate risk ratios with robust variance estimation of the association between selected demographic and self-reported health factors and the risk of avoiding G.P. and hospital-based healthcare. Results Of the 969 participants, 152 (15.7%) deliberately avoided contacting their G.P. about non COVID-19 related concerns while 81 (8.4%) reported avoiding hospitals. Three groups, women (Rate Ratio (RR): 1.75, 95% Confidence Interval (CI): 1.28 – 2.40), individuals who reported experiencing an adverse life event within the last 3 months (RR: 1.79, 95% CI: 1.33 – 2.40), and those at an increased risk of infection (RR: 1.65, 95% CI: 1.06 – 2.58) were more likely to avoid contact with their G.P. Individuals at a higher risk of avoiding hospital-based care were those aged 50 – 59 years (RR: 2.27, 95% CI: 1.03 – 4.98) and 70 years+ (RR: 2.73, 95% CI: 1.24 – 6.01), individuals at an increased risk of infection (RR: 2.07, 95% CI: 1.20 – 3.56), smokers (RR: 1.68, 95% CI: 1.02 – 2.77) and those who agreed they were “likely to catch COVID-19” (RR: 2.80, 95% CI: 1.25 – 6.25). Conclusion These findings highlight the importance of public health awareness and education regarding accessing healthcare during a pandemic and should be considered in future pandemic preparedness.

Factors associated with intentions to quit tobacco use in Lebanon: A cross-sectional survey

IntroductionThe prevalence of tobacco smoking in Lebanon is among the highest globally. This study aims to determine past attempts to quit smoking among adults and identify factors associated with intentions to quit. MethodsA nationally representative telephone survey was conducted between June and August 2022. Eligibility criteria included people aged >=18 years residing in Lebanon. The questionnaire was divided into three components: socio-demographic characteristics, cigarette and waterpipe tobacco use behaviours. Binary logistic regression was used to examine factors associated with intention to quit cigarette and waterpipe tobacco use. ResultsA total of 2003 respondents were included in the study. The prevalence of any tobacco product use was 41%, the prevalence of current cigarette smoking was 41% and the prevalence of current waterpipe tobacco use was 20%. Approximately 24% of adults who smoke cigarettes and 26% of those who use waterpipe tobacco had previous quit attempts mainly due to health concerns. Intentions to quit smoking within the next 6 months were reported among 12% of survey respondents. Among adults who smoke, past quit attempts increased the likelihood of intentions to quit cigarette smoking by 5-fold (OR: 5.11; 95% CI: 1.80–14.47, p = 0.002) and waterpipe tobacco use by 7-fold (OR: 6.98, 95% CI: 2.63–18.51, p = <0.001). Age and income were associated with intentions to quit cigarette but not waterpipe tobacco use. ConclusionIntention to quit smoking was strongly associated with past quitting attempts. Understanding factors associated with intentions to quit can help inform the development of context specific smoking cessation interventions.

A vasárnapi ebédtől a szavazóurnáig

Political socialisation is the process of forming an individual’s political identity, in the course of which the individual’s attitude to politics and political worldview is formed. Political socialisation takes place in different spheres, of which the family and parents are of particular importance. Previous research in Hungary has confirmed that the family is an “incubator” of citizenship. However, there is little data available in Hungary that would allow for a more precise understanding of the transmission of political attitudes. This study investigates political homophily within the family (between parent and child) and the effects of parental political characteristics on the individual in Hungary. Our data are drawn from a nationally representative telephone survey of 2000 respondents sampled in 2023. The results show that in nearly two-thirds of Hungarian families, family members held the same political views during the respondent’s childhood, with the highest proportions of homophily indicators, fathers’ and respondents’ voting activity, and mothers’ and respondents’ conservative-liberal attitudes. The effect of parental characteristics was tested using structural equation modelling (SEM). Parents’ political interests and ideological positions had a strong direct effect on the same child characteristics, but the individual’s political participation and party preference were only indirectly influenced by parents. The success of attitudinal transmission was strongly enhanced if the parents were themselves, homophiles, along with the trait in question. Our results point to the important role of the family as a primary agent in political socialisation and suggest new research directions.

Reduce, reuse, redeem: Deposit-refund recycling programs in the presence of alternatives

Understanding how consumers make recycling decisions is crucial in crafting sustainable recycling policies. We estimate consumer preferences and willingness to pay for current beverage container recycling methods, including curbside pick-up services, drop-off at government-subsidized recycling centers, and drop-off at non-subsidized centers. Using a representative online and telephone survey of California households, we estimate a revealed preference discrete choice model that identifies the key attributes explaining consumers’ beverage container disposal decisions, including the ability to receive a deposit refund (paid to consumers only if they recycle at drop-off centers) and the effort associated with bringing recyclable materials to recycling centers. Additionally, we use counterfactual policy analysis to show that increasing the refund amount increases overall household recycling rates. Infra–marginal households who are on the boundary between taking containers to recycling centers and recycling using curbside pick-up, namely white households and households with higher educational attainment, see the largest changes in consumer surplus generated by increasing refund payments. Conversely, we show that eliminating government-subsidized drop-off centers does not significantly alter consumer surplus for any major demographic group, and has little impact on whether a household chooses to recycle.

Cognitive Screening Beliefs and Behaviors Among Older US Adults: Results from the National Poll on Healthy Aging

AbstractBackgroundFewer than half of people with dementia have been formally diagnosed by a clinician. Consequently, the US National Plan to Address Alzheimer’s Disease (AD) has prioritized early disease detection. A critical first step to early detection is primary care‐based screening for cognitive decline. Greater understanding of public perceptions and use of cognitive screening is needed to optimize early detection of AD among older adults.MethodWe analyzed data from the March 2023 fielding of the University of Michigan National Poll on Healthy Aging, a nationally representative web and telephone survey of community‐dwelling US adults aged 50‐80 using the NORC AmeriSpeak panel. Respondents for this analysis were aged 65‐80 without AD or dementia. Our primary outcome was self‐reported history of cognitive screening (never versus ever had screening). Logistic regression was used to estimate associations between respondent characteristics (i.e., sociodemographic factors, health factors, beliefs about cognitive screening) and self‐report of cognitive screening, and to examine whether primary care provider status moderates the association between screening beliefs and self‐report of screening.ResultOf 1,242 respondents, 42% reported having ever undergone cognitive screening (21% within the past year). In adjusted analyses, sociodemographic factors (i.e., older age, higher level of education), insurance status (Medicare Advantage vs. traditional Medicare) and poorer physical health were associated with greater likelihood of cognitive screening (all p&lt;0.05). Respondents with positive versus negative beliefs about cognitive screening were 45% more likely to report screening (adjusted risk ratio: 1.45, p&lt;0.001). The probability of cognitive screening did not vary overall by provider status; however, among respondents with negative beliefs about screening, having a provider was associated with greater probability of having undergone screening (35% versus 11%, p&lt;0.05).ConclusionWe identified a range of factors associated with older adults’ self‐report of cognitive screening including age, health, and beliefs about the pros and cons of screening. Primary care providers may play an important role in cognitive screening decisions, particularly among patients with negative beliefs about screening. Providers can play an active role in initiating conversations about cognition with older adult patients on the advantages and disadvantages of screening to help patients make informed decisions.

Global warming vs. climate change frames: revisiting framing effects based on new experimental evidence collected in 30 European countries

Existing evidence suggests that climate change beliefs can be subject to how the issue is framed. Particularly, the choice between a “global warming” versus a “climate change” framing influenced survey responses in some previous experiments. Furthermore, since the issue of climate change has become strongly polarized politically, framing effects were found to be moderated by political identification. Nevertheless, most of these framing effects were observed in the USA and may not be generalized in other cultures. To contribute to this area of research, we embedded an experiment in nationally representative telephone surveys conducted in 30 European countries in August–September 2021. We manipulated the wording of four climate change-related questions (“global warming” vs. “climate change”) and assessed treatment effects both in the full sample and separately among leftist, rightist, green, and right-wing party voters. Our results regarding climate change existence belief replicated earlier findings since existence belief was significantly higher in the climate change group. We also found that the perceived negative impact was slightly lower when the issue was framed as “climate change.” In contrast, little evidence was found of people being more skeptical or less worried when asked about “global warming” compared to “climate change.” In general, skepticism was higher on the political right; however, leftists, rightists, green, and right-wing voters reacted similarly to the two frames in our European sample. We consider possible explanations for the null findings and argue that the use of “climate change” framing in communication strategies promoting climate action itself will do little to lower skepticism in Europe.

Mental distress during the COVID-19 Infodemic in Ireland, a prospective national survey over time

Abstract Background The World Health Organisation (WHO) declared an ‘infodemic’ in 2020, that resulted in distrust in health authorities and impacted public mental health promoting confusion, worry, and fear. The aim of this study is to identify indicators associated with mental distress during the first year of the COVID-19 pandemic in Ireland. Methods A nationally representative cross-sectional telephone survey conducted data collection during 3 study periods: May, July, September 2020. Mental health outcomes were assessed by the Patient Health Questionnaire Anxiety Depression Scale (PHQ-ADS), mental distress defined as a score of 10 or more. Analysis included descriptive and logistic regression. Results Of the 2,914 participants, 27.6% experienced mental distress during 2020(n = 804). The prevalence of mental distress did not significantly change over time, from 28% in May2020 to 25.3% in Sept2020. Women were significantly more likely to experience mental distress than men; 34% compared to 21% (OR:1.91;95%CI:1.62-2.26). Mental distress was highest in the youngest age groups (43% in &amp;lt; 30years,OR:3.24;95%CI:2.36-4.45), with a significant decreasing trend with increasing age. Mental distress was associated with trust in the pandemic response, those with the lowest levels of trust had the highest levels of mental distress at 37% (OR:1.84;95%CI:1.26-2.68), with a significant decreasing trend with increasing trust. During May2020, those experiencing mental distress were significantly less likely to seek healthcare when required, 41% compared to 21% (OR:2.59;95%CI:1.94-3.46). Education, employment and household income were also studied. Conclusions This study identified indicators associated with mental distress, such as trust and healthcare avoidance, which can inform future emergency management policy. The WHO recommends promoting the understanding of risk to mitigate harm to the public's mental and physical health, which could increase public trust and reduce mental distress. Key messages • The COVID-19 ‘infodemic’ impacted the public's mental health, with 27.6% of the study experiencing mental distress. • Mental distress is associated with trust and healthcare avoidance which can inform future management strategies.

Whose financial grievances go unobserved?

Financial inclusion around the world is developing rapidly and reaching 76% of the world’s population. However, the gap between access to formal financial products and the long-term use of them remains. We present the results of a first representative telephone survey in India, which explores a major friction that creates this gap: Redressing consumer complaints. Consumer complaints behaviour is product-invariant. Conditional on a grievance, vulnerable consumer groups such as the poor and low-educated are significantly less likely to complain owing to lack of procedural knowledge and belief that resolution is unlikely. They go unobserved in the official data. At the minimum, policy steps to address this friction will require a large-scale overhaul of the current grievance redress framework to be consumer-focused and stop assuming consumers have the education, means and faith to resolve their complaints.

Are Perceptions of Government Intervention Related to Support for Prevention? An Australian Survey Study.

In Australia, despite the success of tobacco control policy interventions, policymakers remain resistant to policy-based approaches to diet, alcohol, physical inactivity and obesity, concerned about community perceptions of such interventions as "nanny-statist". We examined how people's general positions on government intervention related to their positions on different preventive policy options. Data were from a 2018 nationally representative cross-sectional telephone survey of 2601 Australian adults. Survey questions related to endorsement of different conceptualisations of government intervention (nanny state, paternalistic, shared responsibility and communitarian) and support for specific health interventions, using forced-choice questions about preferences for individual/treatment measures versus population/preventive health measures. We analysed associations between scores on different conceptualisations of government intervention and support of different policy options for tobacco and diet, and preferences for prevention over treatment. The Nanny State Scale showed an inverse relationship with support for tobacco- and diet-related interventions, and alternative conceptualisations (paternalistic, shared responsibility and communitarian) showed a positive relationship. Effect sizes in all cases were small. Those aged 55+ demonstrated greater support for policy action on tobacco and diet, and greater preference for systemic rather than individual-level interventions. General disposition towards government intervention, although correlated with support for specific policy actions, is not deterministic.

Short report: A trend analysis of attitudes towards early diagnosis of dementia in Germany.

Early detection of dementia provides numerous benefits for those living with dementia and their relatives and healthcare systems at large. Methods available for early diagnosis have improved significantly over the past years. Therefore, we examined whether support for offering an early diagnosis of dementia and willingness to pursue a respective early diagnosis have changed in Germany over the last decade. We compared findings from two representative telephone surveys conducted among older adults in Germany (≥ 60 years of age) in 2011 and 2022, assessing support for offering an early diagnosis of dementia and willingness to pursue a respective early diagnosis in a sample of n = 879 individuals (mean age: 72.9, range: 60-98 years, % female: 58.8). Group comparisons using Chi2- and t-tests and multivariable regression analyses were conducted, regressing support of an early diagnosis of dementia and willingness to pursue a respective early diagnosis on age, gender, education, employment status, belief in preventability of dementia and time of survey. Support for offering an early diagnosis of dementia was high both in 2011 (90.7%) and 2022 (79.2%), but declined over time (OR: .39; 95% CI: .25; .63). Willingness to pursue an early diagnosis of dementia declined from 70.7% to 60.1% in the same period (OR: .62; 95% CI: .45; .86). Belief in preventability of dementia was linked to support for offering an early diagnosis (OR: 1.88, 95% CI: 1.25; 2.83) and willingness to pursue an early diagnosis of dementia (OR: 1.52; 95% CI: 1.12; 2.07). Older participants less often supported offering an early diagnosis of dementia (OR: .97, 95% CI: .95; .99). Support for offering an early diagnosis of dementia and willingness to pursue a respective diagnosis is high in the older German public, but lower than reported previously. Improving knowledge on modifiable risk factors and better understanding of individual motives underlying endorsement or refusal of an early diagnosis may increase acceptance in the general public.

Social inequalities in aggravating factors of somatic symptom persistence (SOMA.SOC): study protocol for a mixed-method observational study focusing on irritable bowel syndrome and fatigue

IntroductionSome studies indicate that persistent somatic symptoms (PSS) are more prevalent among individuals with a low socioeconomic status (SES) and a migration background. However, factors explaining social inequalities in PSS...

Trends in elder abuse and age discrimination during the COVID‐19 pandemic in Hong Kong: Findings from a two‐wave representative telephone survey study

Empirical evidence about the heightened risks of elder abuse and age discrimination during the COVID-19 pandemic is scarce. This study aimed to track the changes in rates of both, and investigated their associated factors in the community-dwelling older population in Hong Kong. In this two-wave, cross-sectional telephone survey, we interviewed a population-based sample of individuals (≥55years), and captured the situation of elder abuse and age discrimination before the COVID-19 outbreak (n=1209, Wave 1: October-December 2019) and during the pandemic (n=891, Wave 2: December 2020-January 2021). Participants reported their experiences of different types of abuse and discrimination, financial health, subjective well-being, satisfaction with environment, health and social services, and resilience. Abuse was reported by 20.2% of the sample before the outbreak and 17.8% during the pandemic; while discrimination was reported by 24.6% and 29.8% at the two time points, respectively. A drop in physical abuse was observed, but it was accompanied by a rise in discrimination in the form of harassment or refusal of services. Findings of logistic regression analysis show that abuse during the pandemic was associated with younger age, poorer subjective well-being, and lower resilience; while discrimination was associated with female gender, being married, and poorer subjective well-being. Elder abuse and discrimination were prevalent across time points. The pandemic has highlighted the marginalization of older persons in our communities. There is an urgent need for development of effective interventions to end abuse and discrimination.

Problem gambling in Germany: results of a mixed-mode population survey in 2021

ABSTRACT Since 2006, representative telephone surveys among the German general population have not detected any significant changes with respect to gambling-related problems. This is remarkable, as in the meantime not only the availability of gambling services and the turnover and gross gambling revenues of gambling providers have increased, but also the demand for treatment from people with gambling problems has grown. Not only in the gambling field have population surveys of this type recently been associated with certain methodological problems. These include a decreasing willingness to participate among and limited access to specific subgroups. The prevalence study at hand is based on a mixed-mode design which combines both a telephone and an online survey. The weighting of both samples in a ratio of 2 to 1 was checked against plausibility data. The sample consists of 12,303 complete interviews (telephone: 61%, online: 39%). The results show that 2.3% of the German population aged 18–70 years are identified as having a ‘gambling disorder’ according to DSM-5 (mild disorder: 1.1%, moderate disorder: 0.7%, and severe disorder: 0.5%). The prevalence detected in this study is significantly higher than that of previous surveys. Finally, we discuss the results primarily within the context of the new survey methodology.

Risks to Child Development and School Readiness Among Children Under Six in Pakistan: Findings from a Nationally Representative Phone Survey.

This paper analyzes the risks to child development and school readiness among children under age 6 in Pakistan. Drawing on a nationally representative telephone survey conducted in the midst of a global pandemic, between December 2021 and February 2022, we present the first nationally representative estimates of child development for children under 3 years of age and school readiness for children 3-6 years of age, using internationally validated instruments. The paper examines how risk factors that were exacerbated due to the COVID-19 pandemic, such as parental distress, lack of psychosocial stimulation, food insecurity, low maternal education, no enrollment in early childhood education, and living in a rural area, are associated with children's outcomes. The data indicate that more than half (57 percent) of parents with children under age 3 were distressed and that 61 percent of households reported cutting down on the size of or skipping meals since the start of the pandemic. The data reveal that over half of parents fail to engage in adequate psychosocial stimulation with their child and enrollment in early childhood education is very low (39 percent). The paper finds that child development outcomes decline rapidly as the number of risks increase. Specifically, for children under 3 years, lack of psychosocial stimulation at home and higher levels of parental distress were most significantly associated with lower child development levels. For a child aged 3-6 years, early childhood education enrollment and the amount of psychosocial stimulation the child received at home had the strongest association with school readiness scores.

Determinants of Patient-Perceived Primary Healthcare Quality in Lithuania

Patient-centered care is considered to be one of the essential pillars of a modern healthcare system. Thus, quality assessment based on patients' perceptions, views and experiences in their journey through the healthcare system is recognized as one of the key principles for quality improvement initiatives. Measuring patient satisfaction can be confounded by expectations and prior experiences, which can be at least partly overcome by evaluating patient-perceived healthcare quality (PPHQ). Understanding the principal constituents of PPHQ may aid healthcare professionals and decision makers in the healthcare management process and help in creating instruments to meaningfully measure patient feedback. Herein, we aimed to analyze the primary determinants of PPHQ and their interactions, with a focus on patient experiences and healthcare accessibility, using the example of Lithuanian primary healthcare. For this purpose, we conducted a cross-sectional representative telephone survey that included a total of 1033 respondents (48% male) who had encountered primary healthcare during last 3 years. Survey questions consisted of sociodemographic characteristics, patient perceptions of healthcare service provision, patient experiences, self-reported health status and overall PPHQ ranked with a 5-point Likert scale as the primary outcome. The classification-regression tree (CRT) technique was used to analyze the relationship between different explanatory variables and PPHQ, as well as their relative importance and interactions. The majority of respondents (89%) evaluated PPHQ as acceptable or good. CRT analysis identified staff behavior, organizational accessibility and financial accessibility as the most important factors affecting PPHQ. Importantly, the latter factors surpassed the effect of other known PPHQ determinants, such as sociodemographic characteristics or health status. Further analysis has revealed that the relative importance of staff behavior, including understanding, attention and empathy, increased when more problems with organizational accessibility were encountered. In conclusion, our study suggests that PPHQ in primary healthcare may primarily be determined by organizational and financial accessibility and staff behavior, which may also act as an important mediating factor.

The relationship between weight history and psychological health-Differences related to gender and weight loss patterns.

The prevalence and burden of obesity continues to grow worldwide. Psychological comorbidities may not only influence quality of life, but may also hinder successful weight loss. The causality between excess weight and mental health issues is still not fully understood. The aim of the study was to investigate whetherweight history parameters, (ie.age of onset) are related to psychological comorbidities. The data were derived from a representative telephone survey in Germany, collecting information on weight loss patterns and mental health outcomes among individuals with BMI>30kg/m2. Overall, 787 participants were examined in terms of depressive symptoms (Patient Health Questionnaire, PHQ-9) and anxiety (Generalized Anxiety Disorder Questionnaire, GAD7). In addition, participants were asked about different aspects of their weight history (ie. weight loss patterns and trajectories) over the lifespan. The relationship between weight history and mental health was analyzed using multivariate statistics. According to regression analyses, having had more weight loss attempts, a greater weight loss being desired and being a "weight maintainer" was associated with more symptoms of depression (p < 0.001), whereas a greater desired weight loss and being categorized as a "weight maintainer" was associated with more anxiety (p < 0.001). Moroever, the prevalence of depressive symptoms was significantly higher in male individuals who desire to lose more weight or had more weight loss attempts in the past. Gender-specific differences were observed in terms of weight history parameters, as well as mental health outcomes. Especially for men, weight loss patterns seem to be related to depressive symptoms. Concerning the overall results, it becomes clear that screening for weight history at the beginning of a multidisciplinary weight loss program in the context of gender-specific psychological comorbidities is important. The question remains why some aspects of weight history seem to be more important than others.

Social and demographic patterns of influenza vaccination coverage in Norway, influenza seasons 2014/15 to 2020/21.

To examine influenza vaccination coverage among risk groups (RG) and health care workers (HCW), and study social and demographic patterns of vaccination coverage over time. Vaccination coverage was estimated by self-report in a nationally representative telephone survey among 14919 individuals aged 18-79years over seven influenza seasons from 2014/15 to 2020/21. We explored whether belonging to an influenza RG (being >=65years of age and/or having >=1 medical risk factor), being a HCW or educational attainment was associated with vaccination status using logistic regression. Vaccination coverage increased from 27% to 66% among individuals 65-79years, from 13% to 33% among individuals 18-64years with >=1 risk factor, and from 9% to 51% among HCWs during the study period. Being older, having a risk factor or being a HCW were significantly associated with higher coverage in all multivariable logistic regression analyses. Higher education was also consistently associated with higher coverage, but the difference did not reach significance in all influenza seasons. Educational attainment was not significantly associated with coverage while coverage was at its lowest (2014/15-2017/18), but as coverage increased, so did the differences. Individuals with intermediate or lower education were less likely to report vaccination than those with higher education in season 2018/19, OR=0.61 (95% CI 0.46-0.80) and OR=0.58 (95% CI 0.41-0.83), respectively, and in season 2019/20, OR=0.69 (95% CI 0.55-0.88) and OR=0.71 (95% CI 0.53-0.95), respectively. When the vaccine was funded in the COVID-19 pandemic winter of 2020/21, educational differences diminished again and were no longer significant. We observed widening educational differences in influenza vaccination coverage as coverage increased from 2014/15 to 2019/20. When influenza vaccination was funded in 2020/21, differences in coverage by educational attainment diminished. These findings indicate that economic barriers influence influenza vaccination decisions among risk groups in Norway.