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Understanding the impact of chronic diseases on COVID‐19 vaccine hesitancy using propensity score matching: Internet‐based cross‐sectional study

Abstract

Aims and Objectives

To investigate whether chronic diseases are associated with higher COVID-19 vaccine hesitancy and explore factors that influence COVID-19 vaccine hesitancy in patients with chronic diseases.

Background

Vaccine hesitancy has been acknowledged as one of the greatest hazards to public health. However, little information is available about COVID-19 vaccine hesitancy among patients with chronic diseases who may be more susceptible to COVID-19 infection, severe disease or death.

Methods

From 6 to 9 August 2021, we performed an internet-based cross-sectional survey with 22,954 participants (14.78% participants with chronic diseases). Propensity score matching with 1:1 nearest neighbourhood was used to reduce confounding factors between patients with chronic diseases and the general population. Using a multivariable logistic regression model, the factors impacting COVID-19 vaccine hesitancy were identified among patients with chronic diseases.

Results

Both before and after propensity score matching, patients with chronic diseases had higher COVID-19 vaccine hesitancy than the general population. In addition, self-reported poor health, multiple chronic diseases, lower sociodemographic backgrounds and lower trust in nurses and doctors were associated with COVID-19 vaccine hesitancy among patients with chronic diseases.

Conclusions

Patients with chronic diseases were more hesitant about the COVID-19 vaccine. Nurses should focus on patients with chronic diseases with poor health conditions, low socioeconomic backgrounds and low trust in the healthcare system.

Relevance to Clinical Practice

Clinical nurses are recommended to not only pay more attention to the health status and sociodemographic characteristics of patients with chronic diseases but also build trust between nurses and patients by improving service levels and professional capabilities in clinical practice.

Patient or Public Contribution

Patients or the public were not involved in setting the research question, the outcome measures, or the design or implementation of the study. However, all participants were invited to complete the digital informed consent and questionnaires.

Hospital-based caregiver intervention for people following hip fracture surgery (HIP HELPER): multicentre randomised controlled feasibility trial with embedded qualitative study in England

Por: Smith · T. O. · Khoury · R. · Hanson · S. · Welsh · A. · Grant · K. · Clark · A. B. · Ashford · P.-A. · Hopewell · S. · Pfeiffer · K. · Logan · P. · Crotty · M. · Costa · M. L. · Lamb · S. · The HIP HELPER Study Collaborators · Clifford · Freeman · Gray · Cunningham · Langford · Baxter
Objectives

To assess the feasibility of conducting a pragmatic, multicentre randomised controlled trial (RCT) to test the clinical and cost-effectiveness of an informal caregiver training programme to support the recovery of people following hip fracture surgery.

Design

Two-arm, multicentre, pragmatic, open, feasibility RCT with embedded qualitative study.

Setting

National Health Service (NHS) providers in five English hospitals.

Participants

Community-dwelling adults, aged 60 years and over, who undergo hip fracture surgery and their informal caregivers.

Intervention

Usual care: usual NHS care. Experimental: usual NHS care plus a caregiver–patient dyad training programme (HIP HELPER). This programme comprised three, 1 hour, one-to-one training sessions for a patient and caregiver, delivered by a nurse, physiotherapist or occupational therapist in the hospital setting predischarge. After discharge, patients and caregivers were supported through three telephone coaching sessions.

Randomisation and blinding

Central randomisation was computer generated (1:1), stratified by hospital and level of patient cognitive impairment. There was no blinding.

Main outcome measures

Data collected at baseline and 4 months post randomisation included: screening logs, intervention logs, fidelity checklists, acceptability data and clinical outcomes. Interviews were conducted with a subset of participants and health professionals.

Results

102 participants were enrolled (51 patients; 51 caregivers). Thirty-nine per cent (515/1311) of patients screened were eligible. Eleven per cent (56/515) of eligible patients consented to be randomised. Forty-eight per cent (12/25) of the intervention group reached compliance to their allocated intervention. There was no evidence of treatment contamination. Qualitative data demonstrated the trial and HIP HELPER programme was acceptable.

Conclusions

The HIP HELPER programme was acceptable to patient–caregiver dyads and health professionals. The COVID-19 pandemic impacting on site’s ability to deliver the research. Modifications are necessary to the design for a viable definitive RCT.

Trial registration number

ISRCTN13270387.

Women’s socioeconomic status and attitudes toward intimate partner violence in Eswatini: A multilevel analysis

by Garikayi B. Chemhaka, Stanzia Moyo, Maswati S. Simelane, Clifford Odimegwu

Introduction

Attitudes supportive of spousal violence retards developmental efforts worldwide, and in particular in patriarchal African settings. It is important to curb this behavior by designing preventative evidence-based policies. This study examines the acceptance of intimate partner violence among women residing in Eswatini and determines whether attitudes supportive of intimate partner violence are associated with women’s low socioeconomic status both at the individual- and community-level.

Methods

Cross-sectional secondary data from two Eswatini Multiple Indicator Cluster Surveys (MICS) conducted in 2010 and 2014 with representative samples of 4,686 and 4,761 women, respectively were analyzed using descriptive statistics and multilevel (random effect) logistic regressions.

Results

Overall, the prevalence of acceptance of intimate partner violence declined significantly between 2010 and 2014 in Eswatini (29.0% vs. 19.8%, p Conclusions

Secondary or higher education for individual women and a high proportion of women in the community with low socioeconomic disadvantage are important socioeconomic predictors of reducing women’s supportive attitudes toward intimate partner violence. Therefore, further gains in non-supportive attitudes toward acceptance of intimate partner violence could be achieved through efforts and intervention in the education of individual women and improving women’s socioeconomic status in the community.

A core outcome set for evaluating the effectiveness of mixed-diagnosis falls prevention interventions for people with Multiple Sclerosis, Parkinson’s Disease and stroke

by Nicola O’Malley, Susan Coote, Fiona McCullough Staunton, Eileen O’Connor, Amanda M. Clifford

Introduction

Clinical trials evaluating the effectiveness of falls prevention interventions for people with Multiple Sclerosis (MS), Parkinson’s Disease (PD) and stroke measure heterogeneous outcomes, often omitting those meaningful to patients. A core outcome set (COS) is a standardised set of outcomes that should be assessed in all trials within a research area. The aim of this study was to develop a COS for evaluating mixed-diagnosis falls prevention interventions for people with MS, PD and stroke in non-acute and community settings, with input from relevant stakeholder groups.

Methods

Previously published research undertaken by the team, including a qualitative study with 20 patients and a review of the literature, were used to derive a longlist of potential outcomes. Outcomes were prioritised for inclusion in the COS using a three-round online Delphi survey. A multi-stakeholder, consensus meeting was conducted to agree upon the final COS and to provide a recommendation for a single outcome measure for each outcome in the COS.

Results

Forty-eight participants were recruited across four stakeholder groups (researchers, patients, clinicians, and service-planners/policymakers). A total of 42 participants (87.5%) completed all three rounds of the surveys. Sixty-two outcomes were considered for inclusion in the COS throughout the Delphi process. A total of 15 participants attended the consensus meeting where they agreed upon the final COS and accompanying measurement instruments: fall incidence, injurious fall incidence, quality of life, falls self-efficacy, fear of falling, activity curtailment due to fear of falling, and cost-effectiveness. Attendees at the consensus meeting recommended that the proposed mechanism of impact of an intervention is considered when selecting additional outcomes outside of those in the COS to assess.

Conclusions

This study identified a COS for evaluating the effectiveness of mixed-diagnosis falls prevention interventions for people with MS, PD and stroke. It is recommended that this COS and accompanying measurement instruments be used in all future trials in this research area so that findings can be combined and compared.

Patterns of delivery assistance among adolescent mothers in Nigeria

This study examined the sociodemographic and sociocultural factors associated with the pattern of birth assistance used among adolescent mothers aged 15–19 in Nigeria.
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