Undecided Individuals Research Articles

"I Would Never Push a Vaccine on You": A Qualitative Study of Social Norms and Pressure in Vaccine Behavior in the U.S.

Previous researchers have established the influence of social norms on vaccine behavior. However, little work has been performed contextualizing individuals’ experience with these social factors and how they operate to persuade individuals’ acceptance or refusal of a vaccine. We aimed to determine the mechanisms of familial and societal pressure or expectations that contribute to COVID-19 vaccine decision-making. We conducted four focus groups and eleven individual interviews (total n = 32) with participants from across the U.S. of different vaccination statuses. We identified three emergent themes: (1) Altruistic reasoning was particularly prevalent among initially hesitant late adopters—the desire to protect loved ones and others constituted a dominant motive, more powerful than protecting oneself. Vaccination was also reckoned as part of a joint effort to return to normal life; hence, it invoked a sense of responsibility or “obligation”; (2) expectation often became pressure; although most vaccinated participants stated that they respected others’ choices, late adopters or unvaccinated participants perceived differently and felt rushed or “forced” into choosing, and many resented being “targeted” or “bullied”; (3) vaccination status became a new label, frequently dividing families, thus producing familial mandates, exclusions, or social stratifications. This caused sadness and feelings of isolation, along with the formation of a camaraderie among the excluded unvaccinated. A vaccine decision builds from the complexities of individuals’ experiences and cultures. The vaccinated were not free of hesitancy nor were the unvaccinated all anti-vaxxers. Vigorous vaccine promotion successfully converted some undecided individuals but also fostered distrust of government; alarmingly, the push to receive the COVID-19 vaccine further triggered doubts about established vaccines. Communication strategies need to be developed and implemented carefully so as not to ostracize the unvaccinated community and strengthen their resistance.

Declared Intention (Not) to Be Vaccinated against COVID-19, and Actual Behavior-The Longitudinal Study in the Polish Sample.

AIMS: The aim of the study was to investigate the relation between declared intention to get/not get vaccinated against COVID-19, prior to the start of the global vaccination program, and actual vaccine uptake. Moreover, reasons for getting vaccinated or rejecting it were measured along with declared intent and behavior. METHODS: Within a longitudinal design, a representative sample of 918 Polish people was surveyed in February 2021 and August 2021. In February 2021, participants were asked about their intention to get vaccinated against COVID-19 and the reasons behind it. In August 2021, the same group was asked about having been vaccinated, along with the reasons. RESULTS: A significant pro-vaccine shift from declared intent to behavior was observed, with many participants turning away from being anti-vaccine or undecided and getting vaccinated. Significant correlations with attitudes toward general mandatory vaccination of children were found. Increased support for anti-vaccine arguments was seen over time in the unvaccinated sample, and decreased support for pro-vaccine arguments was seen in the vaccinated sample. Several key arguments for and against vaccination were identified. CONCLUSIONS: Declared attitude toward COVID-19 vaccination is not fully consistent with vaccination behavior. Pro-vaccine changes in attitudes of previously anti-vaccine and undecided individuals indicate that these groups may be influenced to potentially accept the COVID-19 vaccination over time.

Willingness to get the COVID-19 vaccine among patients with rheumatic diseases, healthcare workers and general population in Turkey: a web-based survey.

ObjectivesVaccination against COVID-19 emerges as an effective strategy for combating the pandemic. While many of our patients with rheumatic diseases (RD) wonder whether it is safe to get the vaccine, vaccine hesitancy is rising among the general population. We assessed the willingness to get vaccination and its probable predictors among patients with RD compared to healthcare workers and a sample from the general population.MethodsWe conducted a web-based questionnaire survey in a cross-sectional design in 3 groups of participants just before the mass vaccination program in Istanbul, Turkey. The questionnaire sought socio-demographic variables, COVID-19 related risk factors, willingness to get vaccination, and concerns and thoughts about vaccine. COVID-19 anxiety scale (CAS) was also evaluated.ResultsWe studied in total 732 patients with RD (Group 1), 763 individuals representing general population (Group 2) and 320 hospital workers (Group 3). Dysfunctional anxiety related to COVID-19 was found in 4.9%, 3.8% and 4.1%, in Group 1, 2 and 3, respectively. Of the patients with RD, 29.2% were willing to be vaccinated, 19.0% were unwilling and 51.8% were undecided. These were somewhat similar among the general population (yes: 34.6%, no: 23.3% and unsure: 42.1%), with significantly less undecided individuals (p < 0.001). On the other hand, hospital workers were significantly more willing (yes: 52.5%, no: 20.9% and unsure: 26.6%) (p < 0.001). Main concerns were probable side effects, unknown scientific results and having no trust. Being male, older age, working in a hospital, not having contracted COVID-19 and high scores on CAS were found to be independently associated with willingness.ConclusionsThe low rate of vaccine acceptance among patients with RD, as well as general population sampling is worrying. Healthcare policies should aim to implement communication, promote confidence and increase demand for COVID-19 vaccine.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00296-021-04841-3.

Fact vs Fallacy: The Anti-Vaccine Discussion Reloaded

In the light of the COVID-19 pandemic, anti-vaccine sentiments have been on the rise, with a recent seminal study on the development of anti-vaccine views in social media even making its way into Nature Communications. Yet, with the current scientific consensus being in overwhelming agreement over the safety and efficacy of vaccines, many scientists lose their grasp on the fears, concerns, and arguments that the opposition may hold. This paper discusses and evaluates vaccine-hesitant individuals on a socioeconomic, historical, and philosophical landscape. It also provides an analysis of common argumentative patterns and the psychological impact that these arguments may have on undecided individuals. The discussion also explores why anti-vaccine sentiments are on the rise, and how members of the scientific and medical community require a more structured approach to communicating key arguments. This is particularly important if vaccination rates and herd immunity are to be sustained. No longer is it sufficient to win arguments based on a factual and scientific basis, but rather scientists and medical practitioners have to focus on conveying confidence and reassurance on both an informative and emotional level to those with doubts and fears.

Critical analysis of communication strategies in public health promotion: An empirical-ethical study on organ donation in Germany.

Given the need for organs, public organizations use social marketing strategies to increase the number of donors. Their campaigns employ a variety of moral appeals. However, their effects on audiences are unclear. We identified 14 campaigns in Germany from over the last 20 years. Our approach combined a multimodal analysis of categorized posters with a qualitative analysis of responses, collected in interviews or focus groups, of 53 persons who were either skeptical or undecided about organ donation. The combined analyses revealed that the posters failed to motivate laypersons in general to donate, and were even less effective on skeptical or undecided individuals. We explain this in terms of the types of moral messages found on posters and the limits of such social marketing strategies. Furthermore, we discuss certain ethical aspects of organ donation campaigns pertaining to communicating norms and trust in public institutions.

The online competition between pro- and anti-vaccination views.

Distrust in scientific expertise1-14 is dangerous. Opposition to vaccination with a future vaccine against SARS-CoV-2, the causal agent of COVID-19, for example, could amplify outbreaks2-4, as happened for measles in 20195,6. Homemade remedies7,8 and falsehoods are being shared widely on the Internet, as well as dismissals of expert advice9-11. There is a lack of understanding about how this distrust evolves at the system level13,14. Here we provide a map of the contention surrounding vaccines that has emerged from the global pool of around three billion Facebook users. Its core reveals a multi-sided landscape of unprecedented intricacy that involves nearly 100million individuals partitioned into highly dynamic, interconnected clusters across cities, countries, continents and languages. Although smaller in overall size, anti-vaccination clusters manage to become highly entangled with undecided clusters in the main online network, whereas pro-vaccination clusters are more peripheral. Our theoretical framework reproduces the recent explosive growth in anti-vaccination views, and predicts that these views will dominate in a decade. Insights provided by this framework can inform new policies and approaches to interrupt this shift to negative views. Our results challenge the conventional thinking about undecided individuals in issues of contention surrounding health, shed light on other issues of contention such as climate change11, and highlight the key role of network cluster dynamics in multi-species ecologies15.

What Determines Support for Donor Registration Systems? The Influence of Sociopolitical Viewpoint, Attitudes Toward Organ Donation, and Patients\u2019 Need

BackgroundIn forming opinions about donor registration systems such as opt-in versus opt-out, the sociopolitical implications of these systems may be confounded with attitudes toward organ donation itself, causing people to talk at cross purposes. The goal of the present research was to examine the interactive effects of sociopolitical viewpoint, attitude toward donation (as evidenced by current registration status in study 1 and registration intention of unregistered individuals in study 2), and patients’ need for organs on people’s support for a particular system.MethodIn study 1, we randomly assigned registered donors, registered nondonors, and nonregistered individuals to one of three sociopolitically inspired solutions to reducing the organ shortage, distinguishing between solutions based on autonomy, coercion by the state, and reciprocity, respectively. In study 2, we concentrated specifically on young and unregistered people in order to examine how prior donation intentions or indecision with respect to donor registration affect responses to the three different sociopolitical viewpoints. In both studies, we also manipulated salience of patients’ need.ResultsRegistered donors in study 1 and unregistered individuals with donation intention in study 2 (high in sympathy, low in anxiety) were highly and equally supportive of a solution based on autonomy and coercion. In contrast, registered nondonors in study 1 and unregistered and undecided individuals in study 2 (lower in sympathy, higher in anxiety) were less supportive of a solution based on coercion than autonomy. Study 2 also found that, for undecided individuals, a more salient need state was associated with a drop in anxiety and stronger support for coercion. Results for a system based on reciprocity were more difficult to interpret.ConclusionIndividuals most concerned with the need of patients waiting for an organ are relatively indifferent with respect to the sociopolitical implications of a registration system, while those strongly objecting to a coercive role for the state express reservations against organ donation itself. In order to help people to form balanced opinions about organ donation systems, we recommend to make the prosocial and sociopolitical aspects equally salient and deserving of debate.

Selective Exposure in Decided and Undecided Individuals

People often show a preference for information that confirms their attitudes and beliefs, and this tendency is reduced for opinions that are not held with conviction. The present study shows that both decided and undecided individuals show a tendency to selectively expose themselves to confirmatory information, albeit with different antecedents and consequences. Whereas selective exposure in decided participants was predicted by conscious beliefs and not by automatic associations, selective exposure in undecided participants was predicted by automatic associations and not by conscious beliefs. Moreover, selective exposure led undecided participants to adopt conscious beliefs that were in line with their preexisting automatic associations. Conversely, for decided participants, selective exposure shifted automatic associations in a direction that was in line with their preexisting conscious beliefs. Implications for decision making and mutual influences of automatic associations and conscious beliefs in attitude change are discussed.

Career Decision Statuses Among Portuguese Secondary School Students

Career indecision is a complex phenomenon and an increasing number of authors have proposed that undecided individuals do not form a group with homogeneous characteristics. This study examines career decision statuses among a sample of 362 12th-grade Portuguese students. A cluster-analytical procedure, based on a battery of instruments designed to assess career and personality dimensions, was employed to understand the heterogeneous groupings that underlie the concept of career indecision. Three groups of career decision statuses were identified and their characteristics described. Finally, implications for career counseling interventions are discussed.

Phase change in an opinion-dynamics model with separation of time scales

We define an opinion formation model of agents in a one-dimensional ring, where the opinion of an agent evolves due to its interactions with close neighbors and due to its either positive or negative attitude toward the overall mood of all the other agents. While the dynamics of the agent's opinion is described with an appropriate differential equation, from time to time pairs of agents are allowed to change their locations to improve the homogeneity of opinion (or comfort feeling) with respect to their short-range environment. In this way the timescale of transaction dynamics and that of environment update are well separated and controlled by a single parameter. By varying this parameter we discovered a phase change in the number of undecided individuals. This phenomenon arises from the fact that too frequent location exchanges among agents result in frustration in their opinion formation. Our mean field analysis supports this picture.

Smearing the opposition: Implicit and explicit stigmatization of the 2008 U.S. Presidential candidates and the current U.S. President.

Four studies investigated whether political allegiance and salience of outgroup membership contribute to the phenomenon of acceptance of false, stigmatizing information (smears) about political candidates. Studies 1-3 were conducted in the month prior to the 2008 U.S. Presidential election and together demonstrated that pre-standing opposition to John McCain or Barack Obama, as well as the situational salience of differentiating social categories (i.e., for Obama, race; for McCain, age), contributed to the implicit activation and explicit endorsement of smearing labels (i.e., Obama is Muslim; McCain is senile). The influence of salient differentiating categories on smear acceptance was particularly pronounced among politically undecided individuals. Study 4 clarified that social category differences heighten smear acceptance, even if the salient category is semantically unrelated to the smearing label, showing that, approximately 1 year after the election, the salience of race amplified belief that Obama is a socialist among undecided people and McCain supporters. Taken together, these findings suggest that, at both implicit and explicit cognitive levels, social category differences and political allegiance contribute to acceptance of smears against political candidates.

Setting Up a Business: Challenges and Successes 'Migrants Tell Their Stories' Evaluation Report

Internal migration, although not as pervasive as international migration, remains a dynamic and evolving phenomenon. Reasons for migrating internally vary from economic, to family reunification, and seeking of better opportunities in the future. Return migration is a vital dimension of Albania’s migration even though it is often perceived with ambivalence among prospective returned migrants.Empirical evidence shows that the primary circumstances under which migrants would be willing to return on a permanent basis are: secured employment, acceptable level of security and living standards, while the main types of return assistance desired would be loans for business start-up and job-seeking assistance. Despite the variability of factors that lead to various forms of migration, there is a wide consensus in the literature about the importance of facilitating integration experiences through governmental and civil society support. Interventions should focus on providing resources (financial, informational, educational, and vocational) that can help undecided individuals to make informed choices. Similarly, return migration can also co-occur with internal mobility, which leads to depletion of human resources in prefectures of origin. More incentives, primarily employment and loans for starting-up small businesses, should become available to prospective returnees in their own communities, in order to facilitate smooth transition and re-integration experiences. Additionally, return migration often results in “best practices” which should become visible and accessible to individuals considering returning home.

Consensus Decision Making by Fish

Decisions reached through consensus are often more accurate, because they efficiently utilize the diverse information possessed by group members [1-3]. A trust in consensus decision making underlies many of our democratic political and judicial institutions [4], as well as the design of web tools such as Google, Wikipedia, and prediction markets [5, 6]. In theory, consensus for the option favored by the majority of group members will lead to improved decision-making accuracy as group size increases [2, 4]. Although group-living animals are known to utilize social information [7-10], little is known about whether or not decision accuracy increases with group size. In order to reach consensus, group members must be able to integrate the disparate information they possess. Positive feedback, resulting from copying others, can spread information quickly through the group, but it can also result in all individuals making the same, possibly incorrect, choice [8, 11, 12]. On the other hand, if individuals never copy each other, their decision making remains independent and they fail to benefit from information exchange [4]. Here, we show how small groups of sticklebacks (Gasterosteus aculeatus) reach consensus when choosing which of two replica fish to follow. As group size increases, the fish make more accurate decisions, becoming better at discriminating subtle phenotypic differences of the replicas. A simple quorum rule proves sufficient to explain our observations, suggesting that animals can make accurate decisions without the need for complicated comparison of the information they possess. Furthermore, although submission to peers can lead to occasional cascades of incorrect decisions, these can be explained as a byproduct of what is usually accurate consensus decision making.

Automatic Mental Associations Predict Future Choices of Undecided Decision-Makers

Common wisdom holds that choice decisions are based on conscious deliberations of the available information about choice options. On the basis of recent insights about unconscious influences on information processing, we tested whether automatic mental associations of undecided individuals bias future choices in a manner such that these choices reflect the evaluations implied by earlier automatic associations. With the use of a computer-based, speeded categorization task to assess automatic mental associations (i.e., associations that are activated unintentionally, difficult to control, and not necessarily endorsed at a conscious level) and self-report measures to assess consciously endorsed beliefs and choice preferences, automatic associations of undecided participants predicted changes in consciously reported beliefs and future choices over a period of 1 week. Conversely, for decided participants, consciously reported beliefs predicted changes in automatic associations and future choices over the same period. These results indicate that decision-makers sometimes have already made up their mind at an unconscious level, even when they consciously indicate that they are still undecided.

Improving Informed Consent and Enhancing Recruitment for Research by Understanding Economic Behavior

THE USE OF FINANCIAL COMPENSATION AS A RECRUITment tool in medical research continues to be debated on ethical grounds. Critics are against economic or market models, in which market forces determine payment practices, primarily because of the perceived undue inducement potential and on other grounds, including that participants from lower socioeconomic levels bear a disproportionate share of the research burden. Many of these arguments apply not only to the purest market model but to any model in which compensation to participants exceeds some threshold. We argue that economic forces operate regardless of how investigators choose to compensate participants. Thus, it is imperative that investigators acknowledge these forces and design compensation schemes that explicitly take economic forces into account. Economic principles predict that for otherwise undecided individuals, incentives serve as inducements, regardless of the compensation model used. If they did not, why would researchers pay research participants? In place of a model in which incentives do not substantially influence behavior, we describe a general positive model (describing how payments actually are determined) of costs and benefits factoring in the decision. This model is essentially the same as the market model rejected by Dickert and Grady, and the freedom of contract model proposed by Wilkinson and Moore, with an emphasis on nonpecuniary aspects of costs and benefits. Quite simply, we argue that individuals will participate in research if they think the benefit (including but not limited to monetary compensation) of doing so is greater than the cost. These costs and benefits vary across research projects, as well as across potential participants for any given project, as individuals perceive and value the costs and benefits of participation differently. Because monetary compensation is just one of many determinants of participation, regulating it alone will not prevent undue inducement. Several important implications flow from this model. First, research participants who fail to grasp the facts or implications of participation could be induced by low payment amounts: truly informed consent is thus integral to preventing undue inducement. Second, external validity, an important ethical dimension that depends on adequate and representative samples, will be limited unless compensation—monetary or otherwise—is recognized for what it is: a factor in real-world decision making. Third, financial gain is one of several factors in the research participation decision. By focusing on other factors, investigators may be able to enhance recruitment through other channels.

Understanding factors which influence tobacco (smoking and smokeless) in secondary school children in Delhi (India)

1024 Background: Study conducted to estimate the magnitude of tobacco consumption among adolescent school children in Delhi; the association of tobacco use with awareness, risk taking attitude and alcohol usage; and to understand the role of gender, age and socio-economic status. Methods: Cross sectional study of two randomly identified, co-educational schools of different socio-economic stratum. The questionnaire was pre-tested and administration was unlinked, anonymous. Apriori informed consent of all concerned was obtained. Analyzable sample size was 596. Analysis was done using SPSS ver 11. Appropriate statistics were used and models made using multiple logistic regression. Results: The prevalence of tobacco use (smoking and smokeless) and of tobacco and betel nut was 12.08% (CI 9.57 – 14.97) and 21.31% (CI 18.09 – 24.82), respectively. Risk taking attitude, prevalent in 16.11% (CI 13.25 – 19.31), was strongly linked with tobacco and betel nut use. Prevalence of correct knowledge about tobacco was only 37.75% (CI 33.84 – 41.78). Statistically significant associations were found between gender, type of school, risk taking attitude and use of tobacco (all forms) including betel nut chewing. Of the smokers, 41.6% started prior to the age of 12 years. Offer of cigarettes was made to 27.18% of children. Though 19.75% said they would smoke to gain acceptance, the number of undecided individuals was high (43.83%). Regression models showed that: students with less knowledge; higher risk taking attitude; and indulging in alcohol: used tobacco and betel nut more than others. Model also depicted that knowledge alone was not a good predictor of betel nut chewing. Conclusions: Statistically significant association of tobacco use in any form, with lack of knowledge, risk taking attitude and alcohol use, is consistent with predictors identified by other studies. A predictive model for children at risk for tobacco use has been proposed. Intensive efforts started early are needed for prevention of tobacco use in adolescents. No significant financial relationships to disclose.

Understanding factors which influence tobacco (smoking and smokeless) in secondary school children in Delhi (India)

1024 Background: Study conducted to estimate the magnitude of tobacco consumption among adolescent school children in Delhi; the association of tobacco use with awareness, risk taking attitude and alcohol usage; and to understand the role of gender, age and socio-economic status. Methods: Cross sectional study of two randomly identified, co-educational schools of different socio-economic stratum. The questionnaire was pre-tested and administration was unlinked, anonymous. Apriori informed consent of all concerned was obtained. Analyzable sample size was 596. Analysis was done using SPSS ver 11. Appropriate statistics were used and models made using multiple logistic regression. Results: The prevalence of tobacco use (smoking and smokeless) and of tobacco and betel nut was 12.08% (CI 9.57 – 14.97) and 21.31% (CI 18.09 – 24.82), respectively. Risk taking attitude, prevalent in 16.11% (CI 13.25 – 19.31), was strongly linked with tobacco and betel nut use. Prevalence of correct knowledge about tobacco was only 37.75% (CI 33.84 – 41.78). Statistically significant associations were found between gender, type of school, risk taking attitude and use of tobacco (all forms) including betel nut chewing. Of the smokers, 41.6% started prior to the age of 12 years. Offer of cigarettes was made to 27.18% of children. Though 19.75% said they would smoke to gain acceptance, the number of undecided individuals was high (43.83%). Regression models showed that: students with less knowledge; higher risk taking attitude; and indulging in alcohol: used tobacco and betel nut more than others. Model also depicted that knowledge alone was not a good predictor of betel nut chewing. Conclusions: Statistically significant association of tobacco use in any form, with lack of knowledge, risk taking attitude and alcohol use, is consistent with predictors identified by other studies. A predictive model for children at risk for tobacco use has been proposed. Intensive efforts started early are needed for prevention of tobacco use in adolescents. No significant financial relationships to disclose.

Predictors of Generalized Indecision Among Portuguese Secondary School Students

Career indecision is a complex phenomenon and there is evidence that undecided individuals do not constitute a homogenous group. Although there is some controversy about the different types of career undecided individuals, there has been a relative consensus that simple or developmental indecision, which corresponds to a developmentally appropriate exploration of alternatives, can be distinguished from generalized indecision, which reflects difficulties in the decision-making process in other aspects of the individuals' lives. Although generalized indecision as been associated with high levels of anxiety, external locus of control, low self-esteem, low levels of psychological separation towards parents, and inadequate identity formation, studies of the construct have been limited by small sample sizes. The present study examined the contributions of the above predictors to generalized indecision with a sample of 345 secondary school students. Overall, the regression equation accounted for 50% of the variance in generalized indecision scores and trait anxiety emerged as the strongest single predictor. Implications for career counseling are discussed.

The Army, NEPA, and Risk Communication

AbstractIn the short period of two or perhaps three days of training, you can become aware of and practice the skills required to incorporate risk communications into your management philosophy. Risk communications training, to be effective, must incorporate role‐playing and include the following: effective listening; a stress on nonverbal communications; conflict handling modes; trust and credibility; dialogue; and positional and principled negotiation.Learning by doing is the best axiom in developing these oral communications skills. And while these skills are related to public relations, they are very different from public affairs skills you may have been exposed to such as dealing with media “sound bites.” Besides, most public relations are handled by the public affairs office. Risk communications is for when you're on your own.Seek out this training for yourself or even your entire environmental staff so that your effectiveness as an environmental manager is enhanced. You will never be able to win emotionally charged activists over to your position. However, by employing risk communication skills in addressing their opposition in public meetings, you will have a positive impact on open‐minded, undecided individuals who witness this exchange.You will most likely win them over to your position and thereby incrementally increase those who support a reasoned, balanced, and environmentally sound decision. © 2001 John Wiley &amp; Sons, Inc.

Effective Procedures for Conducting Genetic Prevalence Studies With Children1

In this study, the effectiveness of genetic screening study procedures was examined. One analysis was designed to explore whether having a genetic screening study simply introduced by a physician who had just completed a child's evaluation (vs. introduced by an unfamiliar individual) influenced whether the child's parent enrolled the child in the study. Also examined were explanations for nonenrollment and final enrollment decisions among individuals initially uncertain about enrollment. The primary finding was that a physician's introduction to the genetic screening study was associated with a 17% increase in enrollment, and with a 9.9% greater rate of enrollment overall. The rate of increase was greatest among physicians who were most consistent with introducing the screening study. Initially undecided individuals comprised 14% of the final sample. Many parents who chose not to participate felt that the research study was not important. A smaller percentage of parents chose not to enroll in the genetic study because of discomfort with genetic testing. The findings have important implications for designing effective procedures for prevalence research.