Even though vaccination is the most effective measure against COVID-19 infections, vaccine rollout efforts have been hampered by growing anti-vaccine attitudes. Based on current knowledge, we identified three domains (beliefs, discrimination, and news) as our correlates of primary interest to examine the association with anti-vaccine attitudes. This is one of the first studies to examine key correlates of anti-vaccine attitudes during the critical early stages of vaccine implementation in the United States. An online survey was administered in May 2021 to a non-representative, nationally based sample of adults (N = 789). Using multivariable logistic regression analysis, we found that individuals who expressed worry about COVID-19 (OR = 0.34, 95% CI 0.21, 0.55) and had greater knowledge of COVID-19 (OR = 0.50, 95% CI 0.25, 0.99) were less likely to hold anti-vaccine attitudes. Conversely, individuals who held stigmatizing views of COVID-19 (OR = 2.47, 95% CI 1.53, 3.99), had experienced racial discrimination (OR = 2.14, 95% CI 1.25, 3.67) and discrimination related to COVID-19 (OR = 2.84, 95% CI 1.54, 5.24), and who had been watching Fox News (OR = 3.95, 95% CI 2.61, 5.97) were more likely to hold anti-vaccine attitudes. These findings suggest COVID-19 beliefs, experiences of discrimination, and news sources should be considered when designing targeted approaches to address the anti-vaccine movement.
In summarizing the proceedings of a longitudinal meeting of experts in substance use disorders (SUDs) among young adults, this special article reviews principles of care concerning recovery support services for this population. Young adults in recovery from SUDs can benefit from a variety of support services throughout the process of recovery. These services take place in both traditional clinical settings and settings outside the health system, and they can be delivered by a wide variety of nonprofessional and paraprofessional individuals. In this article, we communicate fundamental points related to guidance, evidence, and clinical considerations about 3 basic principles for recovery support services: (1) given their developmental needs, young adults affected by SUDs should have access to a wide variety of recovery support services regardless of the levels of care they need, which could range from early intervention services to medically managed intensive inpatient services; (2) the workforce for addiction services for young adults benefits from the inclusion of individuals with lived experience in addiction; and (3) recovery support services should be integrated to promote recovery most effectively and provide the strongest possible social support.
Cervical cancer remains a public health issue in the United States, particularly among stigmatized racial and ethnic populations. The human papillomavirus (HPV) vaccine has been clinically proven to prevent cervical cancers, and other HPV-associated cancers, among men and women. However, HPV vaccine uptake is suboptimal; only 55% of adolescents complete the two-dose series by age 15. Past research has shown that provider HPV vaccine communication for people of marginalized races/ethnicities is subpar. This article focuses on provider communication strategies to promote HPV vaccine uptake effectively and equitably. The authors reviewed the literature on evidence-based patient–provider HPV vaccine communication techniques to create a set of communication language providers could use and avoid using to enhance HPV vaccine acceptance and uptake among adolescents of marginalized racial and ethnic groups. Evidence has shown that information and the manner of dissemination are critical for influencing HPV vaccine uptake. These communication strategies must be suited to the context of the targeted population, and the message content can be broadly categorized into source, content, and modality. Strategies to improve patient–provider communication among adolescents of color using source, modality, and content include the following: (1) Source: increase provider self-efficacy to provide the recommendation, building rapport between providers and parents; (2) Content: persistent, forceful language with minimal acquiescence should be employed, reframing the conversation focus from sex to cancer; and (3) Modality: use multiple vaccine reminder modalities, and work with the community to culturally adapt the vaccination language. Utilizing effective behavior-change communication adapted for adolescents of color can reduce missed opportunities for HPV prevention, potentially decreasing racial and ethnic disparities in HPV-related morbidity and mortality.
ObjectiveTo assess the changes in prevalence of past-year self-reported sexually transmitted infections (STIs) and its symptoms among married couples between 2006 and 2016 in India, overall and by socioeconomic status.DesignThis cross-sectional study uses the two most recent waves (2005–2006 vs 2015–2016) of nationally representative health surveys in India. We examined the changes of self-reported STI and symptoms among married couples aged 15–54 by overall and by socioeconomic status. Adjusted logistic regression was used to assess the changes, accounting for covariates and the complex survey design.SettingCross-sectional, nationally representative population-based survey in 2005–2006 and 2015–2016 from National Family Health Survey data from Demographic and Health Survey.Participants39 257 married couples aged 15–49 years for the 2005–2006 survey wave and 63 696 married couples aged 15–49 years for the 2015–2016 wave.Outcome measureSelf-reported STI was used as a primary outcome measure.ResultsIn 2016, 2.5% of married women reported having had an STI in the past year, a significant increase from 1.6% in 2006 (p<0.001). The past-year self-reported STI prevalence among married men significantly increased from 0.5% in 2006 to 1.1% in 2016 (p<0.001). Adjusted results showed that the uptrend of couples’ self-reported STI was more significant among those whose husbands are currently employed and those families in middle or higher wealth quintiles. Alarmingly, among couples who reported STI or symptoms, they were less likely to seek advice or treatment in 2016 as compared with 2006 (adjusted OR=0.50, p<0.001, 95% CI=0.40 to 0.61).ConclusionThe study identifies a substantial increase in self-reported STI prevalence with a notable treatment seeking gap among married couples in India over the past decade.
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