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      Using community influencer groups to address COVID-19 misinformation and vaccine hesitancy in Uganda: a protocol for a prospective quasi-experimental study

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          Abstract

          Introduction

          Coronovirus disease 2019 (COVID-19) misinformation has been reported globally and locally. This has the potential to influence public risk perception and reduce the acceptance of the COVID-19 vaccine. This study aims to determine the prevalence of COVID-19 misinformation and vaccine hesitancy in Buikwe district. The study will also pilot a social mobilisation intervention using community influencers and determine its effect on COVID-19 misinformation and vaccine hesitancy.

          Methods and analysis

          The study will be conducted using a quasi-experimental study design, in which two villages will be assigned to the intervention arm and two villages assigned controls. A mixed-methods technique employing both quantitative and qualitative methods will be employed. Data will be collected from healthy men and women aged 18 years and older who reside in the selected villages. The study will be implemented in three phases. First, a baseline study of 12 in-depth interviews with key informants and 6 focus group discussions and a household survey among 632 participants will be done. Second, an intervention employing dialogue-based social mobilisation approach using 10-man community groups per village will be developed and implemented. These will be trained and facilitated to educate and sensitise their communities about COVID-19. Third, an end-line household survey done after 6-months of intervention implementation in the four villages to assess the effect of the intervention on COVID-19 misinformation and vaccine hesitancy. Post-intervention qualitative evaluation will be done after the endline quantitative assessment. Preliminary analysis of the endline quantitative analysis will inform any revisions of the discussion guides. Qualitative data collected will be analysed using thematic content analysis while quantitative data will be analysed using χ 2 tests or logistic regression, by intention-to-treat analysis.

          Ethics and dissemination

          The study was reviewed for ethics and approved by the Makerere University School of Health Sciences Research Ethics Committee, reference number MakSHSREC-2020-45 and the Uganda National Council of Science and Technology, reference number HS1140ES. Study finding shall be presented to the district and national COVID-19 task force and at scientific gatherings and published in a peer-reviewed journal.

          Trial registration number

          PACTR202102846261362.

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          Most cited references13

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          Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination

          Background Monitoring the reasons why a considerable number of people do not receive recommended vaccinations allows identification of important trends over time, and designing and evaluating strategies to address vaccine hesitancy and increase vaccine uptake. Existing validated measures assessing vaccine hesitancy focus primarily on confidence in vaccines and the system that delivers them. However, empirical and theoretical work has stated that complacency (not perceiving diseases as high risk), constraints (structural and psychological barriers), calculation (engagement in extensive information searching), and aspects pertaining to collective responsibility (willingness to protect others) also play a role in explaining vaccination behavior. The objective was therefore to develop a validated measure of these 5C psychological antecedents of vaccination. Methods and findings Three cross-sectional studies were conducted. Study 1 uses factor analysis to develop an initial scale and assesses the sub-scales’ convergent, discriminant, and concurrent validity (N = 1,445, two German convenience-samples). In Study 2, a sample representative regarding age and gender for the German population (N = 1,003) completed the measure for vaccination in general and for specific vaccinations to assess the potential need for a vaccine-specific wording of items. Study 3 compared the novel scale’s performance with six existing measures of vaccine hesitancy (N = 350, US convenience-sample). As an outcome, a long (15-item) and short (5-item) 5C scale were developed as reliable and valid indicators of confidence, complacency, constraints, calculation, and collective responsibility. The 5C sub-scales correlated with relevant psychological concepts, such as attitude (confidence), perceived personal health status and invulnerability (complacency), self-control (constraints), preference for deliberation (calculation), and communal orientation (collective responsibility), among others. The new scale provided similar results when formulated in a general vs. vaccine-specific way (Study 2). In a comparison of seven measures the 5C scale was constantly among the scales that explained the highest amounts of variance in analyses predicting single vaccinations (between 20% and 40%; Study 3). The present studies are limited to the concurrent validity of the scales. Conclusions The 5C scale provides a novel tool to monitor psychological antecedents of vaccination and facilitates diagnosis, intervention design and evaluation. Its short version is suitable for field settings and regular global monitoring of relevant antecedents of vaccination.
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            Addressing Health-Related Misinformation on Social Media

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              ‘Vaccine hesitancy’ among university students in Italy during the COVID-19 pandemic

              The debate around vaccines has been in the spotlight over the last few years in Europe, both within the scientific community and the general public debate. In this regard, the case of the Italian vaccination debate is particularly worrying given that Italy has been one of the European countries with the highest number of measles cases in the recent past. According to this scenario, we conducted a cross-sectional study on a convenience sample of Italian university students aimed at: (1) exploring their attitudes towards a future vaccine to prevent COVID-19 and; (2) evaluating the impact of the university curricula (healthcare vs. non-healthcare curricula) on the intention to vaccinate. Descriptive analysis on the 735 students that answered to the question on the intention to vaccinate showed that 633 (86.1%) students reported that they would choose to have a vaccination for the COVID-19 coronavirus; on the other side, 102 (13.9%) students reported that they would not or be not sure to vaccine (low intention to vaccinate). This means that in our sample more than one student out of 10 shows low intention to vaccinate (vaccine hesitancy). Furthermore, when running analysis comparing healthcare students versus non-healthcare students we found no significant differences in responses’ percentage distribution (p = .097). Understanding the student’s perspective about the future COVID-19 vaccine and supporting their health engagement and consciousness may be useful in planning adequate response and multidisciplinary educational strategies—including the psychological perspective on vaccine hesitancy underlying factors - in the post-pandemic period.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2022
                26 August 2022
                26 August 2022
                : 12
                : 8
                : e057994
                Affiliations
                [1 ]departmentMakerere University School of Health Sciences , Sustainable Pharmaceutical Systems (SPS) Unit , Kampala, Uganda
                [2 ]departmentDepartment of Health Policy Planning and Management , Makerere University School of Public Health , Kampala, Uganda
                [3 ]departmentPharmacology and Therapeutics , Makerere University College of Health Sciences , Kampala, Uganda
                [4 ]departmentSchool of Medicine , Makerere University College of Health Sciences , Kampala, Uganda
                [5 ]departmentDepartment of Community Health and Behavioural Sciences , Makerere University School of Public Health , Kampala, Uganda
                [6 ]departmentSustainable Pharmaceutical Systems (SPS) Unit , Makerere University School of Health Sciences , Kampala, Uganda
                [7 ]departmentDepartment of Pharmacy , Makerere University School of Health Sciences , Kampala, Uganda
                Author notes
                [Correspondence to ] Dr Freddy Eric Kitutu; kitutufred@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-2636-4115
                http://orcid.org/0000-0003-1289-0111
                http://orcid.org/0000-0003-2277-9572
                Article
                bmjopen-2021-057994
                10.1136/bmjopen-2021-057994
                9421914
                36028272
                9243ca4a-39d4-4cb5-923c-ef25ff9cad4b
                © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 03 October 2021
                : 18 July 2022
                Funding
                Funded by: Sabin Vaccine Institute, Washington, DC, US;
                Award ID: 050112-00
                Categories
                Epidemiology
                1506
                2474
                1692
                Protocol
                Custom metadata
                unlocked
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                Medicine
                covid-19,epidemiology,protocols & guidelines,public health
                Medicine
                covid-19, epidemiology, protocols & guidelines, public health

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