Trust In Doctors Research Articles

Exploring Facets of Trust and Religiosity in Organ Donation for Black and White Americans.

This study examines how Black and White Americans perceive two facets of trust (trust in medical doctor and trust in medical care for racial group) and two facets of religiosity (religious service attendance and religious norms regarding organ donation) in relation to the topic of organ donation. Two hundred and one participants (N= 201)were surveyed across the United States using the Qualtrics survey company. Bivariate analyses found donor status was not related to religious service attendance (r = - .001, p > .05) or religious norms (r = .09, p > .05). Donor status was significantly related to trust in doctors, (r = - .25, p < .001) and trust in medical care for racial group, r = - .239, p < .001). Independent samples t-tests revealed Black Americans had significantly lower levels of trust in medical care for racial group than White Americans (t = - 5.14, p < .001) but did not differ in levels of trust in doctor (t = - 1.73, p > .05). The implications of these findings for future research and campaigns are discussed.

Disparities in Cervical Cancer Knowledge and Trust in Information Sources Among Diverse American Women.

Cervical cancer rates have declined due to prevention and screening, but disparities remain. This study examines how trust and preference in information sources affect knowledge and behaviors, alongside demographic differences to identify health disparities. This study used Health Information National Trends Survey data and employed weighted chi-square tests and multivariate logistic regression to analyze associations between knowledge, behaviors, and demographic differences. The results revealed significant disparities in HPV awareness, with lower awareness among Black (OR, 0.521), Hispanic (OR, 0.398), and Asian (OR, 0.138) women compared to Whites. Age and education also played roles, as older and less-educated women were less informed. Trust in doctors was crucial; women with low trust in doctors (aOR, 0.499; 95% CI, 0.252-0.989) had lower odds of having heard of HPV. Preference for written materials as a primary information source (aOR, 0.312; 95% CI, 0.122-0.793) also correlated with lower HPV awareness compared to preferring information from doctors. Furthermore, women with low trust in charity organizations (aOR, 0.647; 95% CI, 0.461-0.909) were less likely to believe HPV causes cervical cancer, while those who preferred the internet as an information source (aOR, 1.544; 95% CI, 1.026-2.324) had higher odds of having heard of HPV compared to those preferring doctors. Minority populations, older women, and those with lower education levels had significantly lower HPV knowledge. These findings highlight the need for tailored communication, community outreach, policy initiatives, culturally sensitive approaches, digital health interventions, and strategies promoting patient-provider trust to address these disparities.

EMSIG: Uncovering Factors Influencing COVID-19 Vaccination Across Different Subgroups Characterized by Embedding-Based Spatial Information Gain.

Background/Objectives: COVID-19 and its variants continue to pose significant threats to public health, with considerable uncertainty surrounding their impact. As of September 2024, the total number of deaths reached 8.8 million worldwide. Vaccination remains the most effective strategy for preventing COVID-19. However, vaccination rates in the Deep South, U.S., are notably lower than the national average due to various factors. Methods: To address this challenge, we developed the Embedding-based Spatial Information Gain (EMSIG) method, an innovative tool using machine learning techniques for subgroup modeling. EMSIG helps identify subgroups where participants share similar perceptions but exhibit high variance in COVID-19 vaccine doses. It introduces spatial information gain (SIG) to screen regions of interest (ROI) subgroups and reveals their specific concerns. Results: We analyzed survey data from 1020 participants in Alabama. EMSIG identified 16 factors encompassing COVID-19 hesitancy and trust in medical doctors, pharmacists, and public health authorities and revealed four distinct ROI subgroups. The five factors, including COVID-19 perceived detriment, fear, skepticism, side effects related to COVID-19, and communication with pharmacists, were commonly shared across at least three subgroups. A subgroup primarily composed of Democrats with a high flu-shot rate expressed concerns about pharmacist communication, government fairness, and responsibility. Another subgroup, characterized by older, white Republicans with a relatively low flu-shot rate, expressed concerns about doctor trust and the intelligence of public health authorities. Conclusions: EMSIG enhances our understanding of specific concerns across different demographics, characterizes these demographics, and informs targeted interventions to increase vaccination uptake and ensure equitable prevention strategies.

EHKP-Res: An explainable dynamic security solution for medical healthcare

An increasing number of medical institutions and patients are adopting the practice of storing their data on medical cloud servers, which greatly facilitates the sharing of medical data. However, when many nodes are connected to the medical big data architecture, the overall system's security can be compromised. To address this, an explainable dynamic security protection scheme for medical healthcare, named EHKP-Res, has been proposed. This scheme aggregates data relevance features and integrates them with a deep residual network to predict the behavior of medical staff, addressing the issue of sudden changes in their behavioral credibility. To tackle the black-box problem, a model post-interpretation scheme using Bayesian networks to generate perturbed datasets has been proposed. It calculates sample weights and performs nonlinear fitting, deriving model interpretation through the eigenvalues of the instances. Experimental results show that the proposed Hidden KP-ABE method reduces time overhead by 14.95% compared to other access control methods and achieves a prediction accuracy of 98.34% for doctor trust metrics, effectively preventing malicious behavior by doctors.

Impact of perceived neighborhood social cohesion on vaccination intentions in the post-pandemic era

ObjectiveTo examine the relationship between perceived neighborhood social cohesion (NSC) and intentions to obtain seasonal influenza and COVID-19 vaccines among US adults post COVID-19 pandemic. MethodsWe conducted a cross-sectional, nationally representative survey of US residents (N = 2189) in May 2023 on their perceived NSC, COVID-19 and seasonal influenza vaccination intentions, healthcare access, perceived risk of COVID-19 or flu infection, loneliness, and trust in doctors. We used bivariate probit regressions to examine joint associations between perceived NSC and intentions to receive influenza and COVID-19 vaccines, controlling for several participant characteristics (e.g., race). Results2164 respondents provided consent to study questions. Trust-related NSC (trust in neighbors) was positively associated with intentions to become vaccinated against both influenza and COVID-19 viruses. Higher relational NSC (perception of a close-knit neighborhood) was positively associated while higher value-based NSC (perception that neighbors share the same values) was negatively associated with intentions to become vaccinated against COVID-19. Healthcare access, perceived risk of infection (COVID-19 or flu), and trust in doctors were positively associated with intentions to become vaccinated against both viruses. ConclusionsIn a post-pandemic era, higher trust-related and relational, perceived NSC (vaccine-dependent), greater access to healthcare, higher perceived risk of infection, and greater trust in doctors were related to higher influenza and COVID-19 vaccination intentions, while higher value-based NSC was related to lower COVID-19 vaccination intentions among US adults. Thus, specific aspects of NSC, healthcare access barriers, misinformation on infection risk, and medical mistrust may influence an individual's willingness and ultimate decision to become vaccinated.

Internet usage time and trust in doctors: evidence from China

BackgroundThe growth of internet use has greatly impacted many societal sectors, including healthcare. However, current evidence about the relationship between internet usage time and public trust on doctors is insufficient.ObjectiveTo examine the relationship between the time spent on the internet and the level of trust in doctors, and explore its mechanism.MethodsMultiple regression models are employed, utilizing a sample of 19,193 observations from the China Family Panel Studies (CFPS) in 2020. First, we regress the relative trust in doctors compared to trust in strangers on internet usage time. Subsample results across distinct population groups are explored. Second, we examine the mechanism of using the internet as an information channel through the mediation method, and further investigate the role of the internet as a communication platform by analyzing the moderation effects of socializing activity as well as social media engagement.ResultsWe find a significant negative relationship between increased internet usage time and trust in doctors. This correlation remains robust across different model specifications and variable measurements. The negative correlation is more pronounced among population groups who are elderly, male, married, with low educational levels, insured and residing in urban areas. The role of the internet as a source of information is validated as a mechanism producing the negative influence. The role of the internet as a communication platform tends to mitigate the negative consequences of internet usage, as engaging in online socializing activity can have a positive moderation effect. However, for social media engagement, its overall effect on trust in doctors is negative, potentially due to social media’s dual function as a communication platform and an information source.ConclusionsAlthough individual-focused literature tends to demonstrate a positive impact of the internet on trust in doctors in China, our study, which focuses on the general public, reveals contrasting results. Our findings imply that the primary manner in which internet usage, encompassing social media usage, influences public trust in doctors is by molding a collective perception of them. Consequently, the medical community may need to take a more proactive approach in expanding online communication channels for interacting with patients and the wider public.

Segmented assimilation trajectories of physician trust among internal migrants in Shanghai, China: A cross-sectional study

Physician trust is necessary for improving physician–patient relationships and maintaining an effective health-care system. Most studies on the theory of segmentation assimilation have mainly focused on comparing immigrants in different countries and few studies have applied segmented assimilation to clarify physician–patient relationships, especially physician trust among internal migrants in the context of Chinese megacities. A random sample of 1200 internal migrants was collected through an online questionnaire conducted in Shanghai from August to December 2021. An exploratory K-means cluster analysis and multivariate logistic regression models were employed to identify patterns of segmented assimilation and examine their relationships with physician trust, as well as the factors influencing physician trust among internal migrants in Shanghai. Results show four main patterns were revealed, namely first-generation classic assimilation, first-generation integrative assimilation, first-generation segmentation, and second-generation underclass assimilation, supporting the theory of segmented assimilation. Association between assimilation pattern and physician trust was observed. A relationship was found between assimilation patterns and trust in physicians. Migrants belonging to the first-generation classic and integrative assimilation groups exhibited a higher level of trust in doctors compared to those in the segmented assimilation groups. Additionally, undergraduate and postgraduate education attainment, an annual income of <400 000 yuan, visiting the physician ≥2 times in the past year, and self-rated health status before and after population floating were significant contributing factors for good physician trust. The government can implement corresponding measures to maintain physician trust, improve cultural adaptability instead of only at the economic level among internal migrants, achieving the facilitation of their understanding of the health system and health service utilization to increase physician trust.

Factors impacting breast cancer survivors' performance of annual follow-up mammograms: A nationally representative study.

ObjectiveGuided by the PRECEDE-PROCEDE model, this study explores the factors associated with completing an annual screening mammogram among breast cancer survivors (BCS). MethodsWe used multiple cycles of survey data from the Health Information National Trends Survey (HINTS) (2017–2020). Logistic regression analyses were conducted to examine the correlates of past year mammograms among breast cancer survivors. ResultsWe included a sample of 909 breast cancer survivors in the study. Seventy percent of the sample reported at least one mammography screening in the prior 12 months. The more time since diagnosis, the fewer participants performed screening. Consistent with the PRECEDE-PROCEDE Model, annual screening was associated with enabling factors (having health insurance), reinforcing factors (trust in doctors, patient-centered communication), and predisposing factors (cancer-related worry and quality of care). ConclusionsFindings suggest that thirty percent of BCS may experience barriers to receipt of follow-up mammograms. Additional research is needed to identify strategies that address demographic, enabling, reinforcing, and predisposing factors with the ultimate goal of improving access to follow-up mammography and ensuring the well-being of breast cancer survivors.Practice ImplicationsCancer surveillance among BCS is vital to improving health outcomes. Provider and practice-based interventions can potentially increase access and engagement with annual screening recommendations.

Transparent precision: Explainable AI empowered breast cancer recommendations for personalized treatment

&lt;p&gt;Breast cancer stands as a prevalent global concern, prompting extensive research into its origins and personalized treatment through Artificial Intelligence (AI)-driven precision medicine. However, AI's black box nature hinders result acceptance. This study delves into Explainable AI (XAI) integration for breast cancer precision medicine recommendations. Transparent AI models, fuelled by patient data, enable personalized treatment recommendations. Techniques like feature analysis and decision trees enhance transparency, fostering trust between medical practitioners and patients. This harmonizes AI's potential with the imperative for clear medical decisions, propelling breast cancer care within the precision medicine era. This research work is dedicated to leveraging clinical and genomic data from samples of metastatic breast cancer. The primary aim is to develop a machine learning (ML) model capable of predicting optimal treatment approaches, including but not limited to hormonal therapy, chemotherapy, and anti-HER2 therapy. The objective is to enhance treatment selection by harnessing advanced computational techniques and comprehensive data analysis. A decision tree model developed here for the prediction of suitable personalized treatment for breast cancer patients achieves 99.87% overall prediction accuracy. Thus, the use of XAI in healthcare will build trust in doctors as well as patients.&lt;/p&gt;

Influence of Medical Mistrust on Prevention Behavior and Decision-Making Among Minoritized Youth and Young Adults During the COVID-19 Pandemic.

Medical mistrust (MM) is seen as a barrier to assessing healthcare needs and addressing health disparities; however, limited literature has focused on assessing MM for vulnerable populations, especially racial/ethnic minority and sexual/gender minority youth and young adults (YYA). Between February 2021 and March 2022, we conducted the Youth and Young Adults COVID-19 Study, a prospective cohort of minoritized YYA aged 14 to 24years (n = 1027), within the United States and its territories. Participants were recruited through a combination of paid social media ads, outreach with organizations serving marginalized youth, and an existing registry, targeting racial and ethnic minority and LGBTQ + youth for a study on COVID-19 health behaviors. Multiple multinomial logistic regression models were developed to examine associations between demographics and three dimensions of MM including healthcare experience, government information, and scientific information. Most participants were between the ages of 18 and 21years (48.3%), identified as Hispanic (33.3%) or white (22.5%), and bisexual or pansexual (34.3%). Queer YYA had higher odds of reporting worse personal healthcare experiences than their straight peers. The odds of gay/lesbian YYA that reported somewhat or extreme trust in doctor's sources were two times higher than their straight peers. Except for those who identified as Asian, racial/ethnic minority YYA were less likely to report somewhat or extreme trust in the CDC's general information or its COVID-19 data than white YYA. Transgender and gender diverse YYA were more than twice as likely to report being very or extremely influenced by statistics of the dangers of COVID-19 than cisgender YYA. Our study indicated the importance of incorporating marginalized identities into the assessment of medical mistrust to better understand YYA's health prevention and treatment behaviors and to develop public health prevention and treatment strategies, especially for minoritized communities.

Patient experience and satisfaction with shared decision-making: A cross-sectional study among outpatients

ObjectivesThis study aimed to investigate how doctor-patient communication, trust in doctors impacted patients’ experience and satisfaction in shared decision-making (SDM). MethodsThis study is based on the data from a cross-sectional survey (n = 12,401) conducted in 27 public specialist outpatient clinics in Hong Kong. ResultsThe multivariable regression models revealed that doctors’ better communication skills were associated with lower decision-making involvement (odd ratio, 0.75 [95 % CI, 0.88–0.94], P < .001) but higher satisfaction with involvement (odd ratio, 6.88 [95 % CI, 5.99–7.93], P < .001). Similarly, longer consultation durations were associated with reduced involvement in decision-making (odd ratio, 0.71 [95 % CI, 0.66–0.73], P < .001) but increased satisfaction with involvement (odd ratio, 1.91 [95 % CI, 1.80–2.04], P < .001). Trust in doctors significantly mediated these associations, except for the association between consultation duration and patients’ satisfaction with decision-making involvement. ConclusionDoctors’ better communication skills and longer consultations might not necessarily increase patient involvement in SDM but correlated with increased satisfaction with involvement. Trust in doctors emerged as a mediator for participation and satisfaction in decision-making. Practice implicationsClinics should consider patients’ preferences and capabilities when tailoring communication strategies about decision-making and optimizing patient satisfaction.

COVID-19 Vaccination in Historically Marginalized Communities: Examining Barriers and Facilitators in a Pediatric Population

ObjectiveCoronavirus disease (COVID-19) hospitalization rates among unvaccinated children are double that of vaccinated children, and this difference is greater among racial and ethnic minority children. Vaccination rates among children remain suboptimal. Few studies have characterized barriers to COVID-19 vaccination among historically marginalized communities. MethodsFrom January 2022 to May 2022, parents, and guardians of children ages 12 months to 18 years presenting for pediatric care at a hospital-based primary care clinic were surveyed about perceptions of COVID-19 vaccines, intentions to vaccinate their child, and trusted sources of information. Results113 parents/guardians participated, with 92% self-identifying with a historically marginalized racial/ethnic group. 54% of respondents either did not plan to vaccinate their child against COVID-19 or were unsure. The obstacles to vaccination most frequently cited were related to: 1) unknown side effects, 2) the rapid development of the vaccine, and 3) unsafe ingredients. Worries about being used as experimental subjects and potential impacts on fertility were also reported. Parents who planned to vaccinate their child reported higher rates of trust in doctors, local clinics, hospitals, and health departments. ConclusionsHigh rates of COVID-19 vaccination hesitancy exist among parents/guardians from historically marginalized groups. Barriers to vaccination were frequently related to side effects, while a high level of trust in healthcare providers as sources of information may be a facilitator. Strategies to improve health outcomes and boost vaccination rates should focus on equipping pediatric healthcare providers with the knowledge and skills necessary to address these known barriers to COVID-19 vaccination.

Perceived Penalties for Sharing Patient Beliefs with Health Care Providers.

Health care interactions may require patients to share with a physician information they believe but is incorrect. While a key piece of physicians' work is educating their patients, people's concerns of being seen as uninformed or incompetent by physicians may lead them to think that sharing incorrect health beliefs comes with a penalty. We tested people's perceptions of patients who share incorrect information and how these perceptions vary by the reasonableness of the belief and its centrality to the patient's disease. We recruited 399 United States Prolific.co workers (357 retained after exclusions), 200 Prolific.co workers who reported having diabetes (139 after exclusions), and 244 primary care physicians (207 after exclusions). Participants read vignettes describing patients with type 2 diabetes sharing health beliefs that were central or peripheral to the management of diabetes. Beliefs included true and incorrect statements that were reasonable or unreasonable to believe. Participants rated how a doctor would perceive the patient, the patient's ability to manage their disease, and the patient's trust in doctors. Participants rated patients who shared more unreasonable beliefs more negatively. There was an extra penalty for incorrect statements central to the patient's diabetes management (sample 1). These results replicated for participants with type 2 diabetes (sample 2) and physician participants (sample 3). Participants believed that patients who share incorrect information with their physicians will be penalized for their honesty. Physicians need to be educated on patients' concerns so they can help patients disclose what may be most important for education. Understanding how people think they will be perceived in a health care setting can help us understand what they may be wary to share with their physicians.People think that patients who share incorrect beliefs will be viewed negatively.Helping patients share incorrect beliefs can improve care.

What Encourages Patients to Recommend Their Doctor After an Online Medical Consultation? The Influence of Patient-Centered Communication, Trust, and Negative Health Information Seeking Experiences

ABSTRACT The doctor-patient relationship in China has become increasingly tense, with patients lacking trust in doctors. Meanwhile, online healthcare flourished, accelerated by the COVID-19 pandemic. This study utilized the direct and indirect pathway model of clinician-patient communication to health outcomes and online trust theory to examine the associations between online patient-centered communication (OPCC), benevolence and ability trust in doctors, negative online health information seeking experiences, and willingness to recommend doctors. The findings revealed that benevolence and ability trust mediated the relationship between OPCC and willingness to recommend doctors. Additionally, when participants had a high level of negative online health information seeking experiences, OPCC had a stronger effect on ability trust; meanwhile, the mediation effect of ability trust between the relationship of OPCC and willingness to recommend was stronger. This study also discussed theoretical and practical implications.

Nonadherence to oral cancer chemotherapy in hepatocellular carcinoma: prevalence and predictive factors in Vietnam

PurposeStandard oral cancer chemotherapy (OCT) or targeted therapy (OTT) has expanded the treatment methods for hepatocellular carcinoma (HCC). However, its principal nonadherence causes a reduction in efficacy. We aimed to evaluate the status of nonadherence and influencing factors among outpatient patients with HCC.Patients and methodsIn 2021, a prospective observational study was conducted on 384 patients with either old or newly diagnosed HCC treated with OTT. Nonadherence to OCT was determined using the eight-item Morisky Medication Adherence Scale, with a score < 6 points. The patients were finished with a six-month follow-up investigation by questionnaires.Results54,8% of HCC outpatients were nonadherent to OCT, with a mean Morisky score of 5.19. They dropped out of the treatment mainly because of drug side effects, such as fatigue (72.4%), hand-foot syndrome (42.7%), diarrhea (38.3%), nausea (25%), insomnia (24.7%), abdominal pain (12%), and anxiety about these adverse events (65.9%). Additionally, financial difficulties and low relative copayments were significantly correlated with the noncompliant treatment of patients (OR = 2.29, 95% CI = 1.32–3.98, P = 0.003; OR = 4.36, 95% CI = 0.95–19.93, P = 0.039, respectively). Moreover, inadequate individual information about the clinical course, the art of treatment, and medication usage instructions were suggestive barriers to adherence to treatment (OR = 1.96, 95% CI = 1.08–3.55, P = 0.024; OR = 1.86, 95% CI = 1.1–3.14, P = 0.02; OR = 2.34, 95% CI = 1.29–4.26, P = 0.004, respectively). Finally, a low level of trust in doctors was an essential factor in nonadherence (Mean of the Anderson Trust in Physician Scale scores counted 38.12 vs. 43.97, respectively for non-adherence vs. adherence, P = 0.00001).ConclusionsThis study suggests a high rate of primary nonadherence to standard oral targeted therapy among HCC outpatient patients because of drug side effects, patient awareness of treatment, and lack of confidence in healthcare providers. Close supervision, proper medication instructions, appropriate dosage reductions, and comprehensive patient counseling might be necessary to control nonadherence.

Understanding The Loss of Trust in Doctors through Artificial Intelligence Powered by Mind Genomics Thinking

Understanding The Loss of Trust in Doctors through Artificial Intelligence Powered by Mind Genomics Thinking

THE ANCIENT CHURCH AND THE ORIGINS OF THE MEDICAL ASSISTANCE SYSTEM

The writings of the Holy Fathers reveal a variety of attitudes towards medicine, ranging from acknowledging it and displaying extreme trust in doctors' prescriptions to reasons for distrust; however, there is almost always a Christian concern to legitimize medicine as a useful tool for healing, but at the same time to consider it a gift of God who instituted it. Numerous testimonies also convey the metaphor of Christ "medicus", variously described and circulated in both East and West. The combination of Christian care and professional medicine gave rise to the first hospitals, also inspired by the Christian hospitality and philanthropy available in various establishments in both East and West. The new structures were established as centres of treatment and effectively assumed a monopoly on universal medical practice

Views of children and young adults about Whole Genome Sequencing in newborn screening: a qualitative study

Whole Genome Sequencing (WGS) in newborn screening is ethically complex. Parents will provide proxy consent for initial participation and 16-year-olds will be approached to consent to continued storage of their genome. We explored the views of 11–25-year-olds to understand the information needs of this age group and the views of the next generation of parents. This two-phase UK study involved: a secondary analysis of focus groups with young adults and a diary and focus group study with children with CF. Diaries were analysed using content analysis, focus group data were analysed using reflexive thematic analysis. Diaries illustrated how children formed genomic knowledge and their questions. Participants broadly supported WGS-NBS based on a belief that all results improve health. Pre-study knowledge was sometimes correct, other-times it drew on vicarious ideas that could cause distress. Children showed an ability to appreciate the complexity of deciding which results should be returned. Focus groups: All participants counterbalanced the benefits and risks of WGS-NBS. Children demonstrated innate trust in doctors, whereas young adults wanted parent-doctor collaboration in decision-making. Young adults conditionally supported WGS-NBS depending on treatability, severity, onset and consent. Children wanted parents to be informed of a broader range of results, but valued informed choice too. More research is needed to understand healthy children’s views. Although small samples, this work provides insight into the understanding and concerns of young adults and children which could help when trying to discuss this topic with them.

Examining the role of knowledge and trust on vaccine confidence in North Dakota among university students, faculty, and staff

BackgroundVaccination is one of the greatest tools for individuals to stay healthy. Individuals are, however, often exposed to misinformation via digital and social media, and thus, may miss the opportunity to develop scientific knowledge about vaccines and trust in relevant stakeholders. This has a damaging impact on vaccine confidence. Understanding vaccine confidence is particularly important in North Dakota, where vaccination rates are lower than national averages.ObjectivesThe objectives of this research are to examine the association between vaccine confidence and three potential sources of it, namely, trust, vaccine knowledge, and vaccine information sources and to investigate the relative strength of three vaccine confidence sources, while accounting for covariates.MethodsStudents (n = 517, 56.6%) and staff and faculty (n = 397, 43.4%) at the University of North Dakota (n = 914) completed an online survey. Logistic regressions estimated odds ratios (OR) and 95% confidence intervals (CI) for associations among trust in doctors, family/friends, government health agencies, charitable organizations, and religious organizations, vaccine knowledge, vaccine information sources as well as vaccine confidence, accounting for gender, race, marital status, age, religion, political ideology, education, and health status.ResultsThe mean age of participants was 29.43 years (SD = 13.48). Most were females (71.6%) and white (91.5%). Great trust in doctors (OR = 3.29, p < 0.001, 95%CI 1.89, 5.73) government health agencies (OR = 2.95, p < 0.001, 95%CI 2.13, 4.08) and vaccine knowledge (OR = 1.28, p < 0.001, 95%CI 1.18, 1.38) had higher odds of vaccine confidence. Using Internet Government source as the primary source of vaccine information (OR = 1.73, p < 0.05, 95%CI 1.22, 2.44) showed higher odds of vaccine confidence before all independent variables were introduced, but it became non-significant after they were introduced. Trust in government health agencies showed strongest associations with vaccine confidence.ConclusionMultiple stakeholders are necessary to ensure verified, accessible, and accurate information in order to advance vaccine confidence in rural, conservative areas.

Impacts of travel duration on urban-rural resident free vaccination behavior: Chinese COVID-19 vaccine booster dose evidence

ABSTRACT This study aimed to evaluate how the duration of travel affects the behavior of urban and rural residents regarding free COVID-19 vaccination, and provide scientific evidence for promoting free vaccination and building an immune barrier to cope with future epidemics. From August 3, 2022 to February,18,2023, A follow-up survey was conducted in urban and rural adults in four cities in China to collect information on socio-demographic factors, vaccination status and travel time for vaccination. Propensity score matching (PSM) analysis was deployed to measure the net difference of the enhanced vaccination rate between urban and rural residents in different traffic time distribution. A total of 5780 samples were included in the study. The vaccination rate of the booster dose of COVID-19 vaccine among rural residents was higher than that of urban residents with a significant P-value (69.36% VS 64.49%,p < .001). The traffic time had a significant negative impact on the COVID-19 booster vaccination behavior of urban and rural residents. There was a significant interaction between the travel time to the vaccination point and the level of trust in doctors. Travel time had a negative impact on the free vaccination behavior of both urban and rural residents. The government should optimize and expand the number of vaccination sites and enhance residents’ trust in the medical system. This is crucial for promoting free vaccination and effective epidemic management in the future.