"I Don't Need a Flu Shot Because I Lead a Healthy Lifestyle": Compensatory Health Beliefs Make Vaccination Less Likely.
Freie Universität Berlin, Germany.Journal of Health Psychology (Impact Factor: 1.88). 09/2012; 18(6). DOI: 10.1177/1359105312455076
Compensatory health beliefs, a self-defence strategy, were examined in a theory-guided intervention promoting influenza vaccination at the workplace. In total, 851 employees were randomised to one group aimed at enhancing intention formation (standard group) or to another one assisting self-regulation (intervention group). Assessments took place after the intervention and 5 months later, investigating whether the intervention would interfere with compensatory health beliefs. The intervention generated an indirect effect via planning on vaccination. Compensatory health beliefs mediated between intention and behaviour. An interaction between intervention group and compensatory health beliefs on behaviour transpired. At low compensatory health belief levels, the intervention group resulted in more vaccinations than the standard group.
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ABSTRACT: Purpose: In the context of worksite influenza vaccination programmes, social support, action planning and perceived self-efficacy were examined as predictors of participation. Mechanisms among these predictors were analysed by applying the enabling effect model to vaccination. Moreover, this model was extended by the inclusion of planning. Methods: In a large German company, a survey on influenza vaccination was launched with 200 employees taking part in the five-month follow-up. Using regression procedures, a sequential mediation model was examined, leading from social support via self-efficacy and planning to vaccination behaviour. Results: The three predictors jointly accounted for 47% of the vaccination participation variance. The enabling effect model was confirmed, highlighting how social support may promote self-efficacy beliefs. Further analysis yielded the extended model, revealing planning as a mediator between self-efficacy and subsequent behaviour while the indirect path from social support via self-efficacy to behaviour remained. Conclusions: Multiple step mediation analysis underscored the relevance of social support and self-efficacy. It also revealed planning as a proximal factor that may facilitate participation in a worksite influenza vaccination programme.Psychology Health and Medicine 05/2014; 20(2):1-8. DOI:10.1080/13548506.2014.920957 · 1.26 Impact Factor
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ABSTRACT: The purpose of this systematic review is to identify, describe and assess the potential effectiveness of strategies to respond to issues of vaccine hesitancy that have been implemented and evaluated across diverse global contexts. A systematic review of peer reviewed (January 2007-October 2013) and grey literature (up to October 2013) was conducted using a broad search strategy, built to capture multiple dimensions of public trust, confidence and hesitancy concerning vaccines. This search strategy was applied and adapted across several databases and organizational websites. Descriptive analyses were undertaken for 166 (peer reviewed) and 15 (grey literature) evaluation studies. In addition, the quality of evidence relating to a series of PICO (population, intervention, comparison/control, outcomes) questions defined by the SAGE Working Group on Vaccine Hesitancy (WG) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria; data were analyzed using Review Manager. Across the literature, few strategies to address vaccine hesitancy were found to have been evaluated for impact on either vaccination uptake and/or changes in knowledge, awareness or attitude (only 14% of peer reviewed and 25% of grey literature). The majority of evaluation studies were based in the Americas and primarily focused on influenza, human papillomavirus (HPV) and childhood vaccines. In low- and middle-income regions, the focus was on diphtheria, tetanus and pertussis, and polio. Across all regions, most interventions were multi-component and the majority of strategies focused on raising knowledge and awareness. Thirteen relevant studies were used for the GRADE assessment that indicated evidence of moderate quality for the use of social mobilization, mass media, communication tool-based training for health-care workers, non-financial incentives and reminder/recall-based interventions. Overall, our results showed that multicomponent and dialogue-based interventions were most effective. However, given the complexity of vaccine hesitancy and the limited evidence available on how it can be addressed, identified strategies should be carefully tailored according to the target population, their reasons for hesitancy, and the specific context. Copyright © 2015. Published by Elsevier Ltd.Vaccine 04/2015; 33(34). DOI:10.1016/j.vaccine.2015.04.040 · 3.62 Impact Factor
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