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  • 1.
    Ahorsu, Daniel Kwasi
    et al.
    Hong Kong Polytech Univ, Dept Rehabil Sci, Hung Hom, Hong Kong 999077, Peoples R China..
    Lin, Chung-Ying
    Natl Cheng Kung Univ, Coll Med, Inst Allied Hlth Sci, Tainan 701, Taiwan..
    Alimoradi, Zainab
    Qazvin Univ Med Sci, Res Inst Prevent Noncommunicable Dis, Social Determinants Hlth Res Ctr, Qazvin 3419759811, Iran..
    Griffiths, Mark D.
    Nottingham Trent Univ, Psychol Dept, Nottingham NG1 4FQ, England..
    Chen, Hsin-Pao
    E DA Hosp, Dept Surg, Div Colon & Rectal Surg, Kaohsiung 824, Taiwan.;I Shou Univ, Coll Med, Sch Med, Kaohsiung 824, Taiwan..
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jonkoping Univ, Sch Hlth & Welf, Dept Nursing, S-55333 Jonkoping, Sweden..
    Timpka, Toomas
    Linkoping Univ, Dept Hlth Med & Caring Sci, S-58183 Linkoping, Sweden..
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Qazvin Univ Med Sci, Res Inst Prevent Noncommunicable Dis, Social Determinants Hlth Res Ctr, Qazvin 3419759811, Iran.;Jonkoping Univ, Sch Hlth & Welf, Dept Nursing, S-55333 Jonkoping, Sweden..
    Cyberchondria, Fear of COVID-19, and Risk Perception Mediate the Association between Problematic Social Media Use and Intention to Get a COVID-19 Vaccine2022In: Vaccines, E-ISSN 2076-393X, Vol. 10, no 1, article id 122Article in journal (Refereed)
    Abstract [en]

    Vaccination is the most effective way to control the COVID-19 pandemic, but vaccination hesitancy threatens this effort worldwide. Consequently, there is a need to understand what influences individuals' intention to get a COVID-19 vaccine. Restriction of information gathering on societal developments to social media may influence attitudes towards COVID-19 vaccination through exposure to disinformation and imbalanced arguments. The present study examined the association between problematic social media use and intention to get the COVID-19 vaccine, taking into account the mediating roles of cyberchondria, fear of COVID-19, and COVID-19 risk perception. In a cross-sectional survey study, a total of 10,843 residents of Qazvin City, Iran completed measures on problematic social media use, fear of COVID-19, cyberchondria, COVID-19 risk perception, and intention to get a COVID-19 vaccine. The data were analyzed using structural equation modeling (SEM). The results showed that there was no direct association between problematic social media use and intention to get a COVID-19 vaccine. Nonetheless, cyberchondria, fear of COVID-19, and COVID-19 risk perception (each or serially) mediated associations between problematic social media use and intention to get a COVID-19 vaccine. These results add to the understanding of the role of problematic social media use in COVID-19 vaccine hesitancy, i.e., it is not the quantity of social media use per se that matters. This knowledge of the mediating roles of cyberchondria, fear of COVID-19, and COVID-19 risk perception can be used by public health experts and policymakers when planning educational interventions and other initiatives in COVID-19 vaccination programs.

  • 2.
    Alimoradi, Z.
    et al.
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, 3415613911, Iran.
    Lin, C. -Y
    Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Worldwide Estimation of Parental Acceptance of COVID-19 Vaccine for Their Children: A Systematic Review and Meta-Analysis2023In: Vaccines, E-ISSN 2076-393X, Vol. 11, no 3, article id 533Article in journal (Refereed)
    Abstract [en]

    Currently, the best method to well control the spread of COVID-19 without severe mental health problems is to reach herd immunity. Therefore, the vaccination rate of the COVID-19 vaccine is critical. Among the populations, children are the vulnerable ones to get vaccinated; therefore, it is important to assess parents’ and guardians’ willingness to have their children vaccinated. The present systematic review and meta-analysis synthesized evidence to estimate the parents’ acceptance rate of COVID-19 vaccination toward their children. Additionally, factors explaining the acceptance rate were investigated. Four academic databases (PubMed, Scopus, Web of Science, and ProQuest) together with Google Scholar were searched, and the references of the included publications were searched as well. Using the PECO-S framework (population, exposure, comparison, outcome, and study design), observational studies of cross-sectional, cohort, or case-control studies were included. The outcome was parents’ or guardians’ willingness to let their children be vaccinated. The studies included in the present review were restricted to English and peer-reviewed papers published between December 2019 and July 2022. A total of 98 papers across 69 different countries with 413,590 participants were included. The mean age of the parents was 39.10 (range: 18–70) years and that of their children was 8.45 (range: 0–18) years. The pooled estimated prevalence of parental acceptance to vaccinate their children with the COVID-19 vaccine was 57% (98 studies, 95% CI: 52–62%, I2: 99.92%, τ2: 0.06). Moreover, data collection time was a significant factor explaining parental willingness in the multivariable meta-regression, with a 13% decrease in parental willingness by each month increase in time, explaining 11.44% of variance. Qualitative synthesis results showed that parents’ COVID-19 vaccine knowledge, trust in theCOVID-19 vaccine, and facilitators in vaccination (e.g., low cost, good vaccine accessibility, and government incentive) were significant factors for higher willingness, while mental health problems (e.g., having worries and psychological distress) were significant factors for lower willingness. Given that the acceptance rate was relatively low (57%) and does not achieve the requirement of herd immunity (i.e., 70%), governments and healthcare authorities should try to elevate parents’ knowledge and trust in the COVID-19 vaccine, facilitate in vaccination, and reduce their mental difficulties to improve the overall vaccination rate among children.

  • 3.
    Huang, P. -C
    et al.
    Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
    Hung, C. -H
    Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
    Kuo, Y. -J
    Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, 116081, Taiwan.
    Chen, Y. -P
    Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, 116081, Taiwan.
    Ahorsu, D. K.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Yen, C. -F
    Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung, 807377, Taiwan.
    Lin, C. -Y
    Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
    Griffiths, M. D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, NG1 4FQ, United Kingdom.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Expanding protection motivation theory to explain willingness of covid-19 vaccination uptake among Taiwanese university students2021In: Vaccines, E-ISSN 2076-393X, Vol. 9, no 9, article id 1046Article in journal (Refereed)
    Abstract [en]

    Vaccination appears to be one of the effective strategies to control the COVID-19 pan-demic. However, the challenge of vaccine hesitancy may lower the uptake rate and affect overall vaccine efficacy. Being a low-risk group in terms of serious consequences of infection, university students may possess low motivation to get vaccinated. Therefore, an expanded Protection Motivation Theory (PMT) incorporating perceived knowledge, adaptive response, and maladaptive response was proposed to investigate the COVID-19 vaccination intention among Taiwanese university students. University students (n = 924; 575 males; mean age = 25.29 years) completed an online survey during January to February 2021. The proposed expanded PMT model was examined using structural equation modeling (SEM). The results showed that perceived knowledge was significantly associated with coping appraisal (standardized coefficient (β) = 0.820; p < 0.001), and coping appraisal was significantly associated with adaptive response (β = 0.852; p < 0.001), maladaptive response (β = 0.300; p < 0.001) and intention (β = 0.533; p = 0.009). Moreover, maladaptive response (β = −0.173; p = 0.001) but not adaptive response (β = 0.148; p = 0.482) was significantly and negatively associated with intention. The present study’s results demonstrated a positive path between perceived knowledge, coping appraisal, and intention among university students. Therefore, improv-ing knowledge among this population may increase the intention to uptake the vaccine.

  • 4.
    Wang, P. -W
    et al.
    Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
    Ahorsu, D. K.
    Department of Rehabilitation Sciences, Faculty of Health & Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Lin, C. -Y
    Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan.
    Chen, I. -H
    School of Education Science, Minnan Normal University, Zhangzhou, 363000, China.
    Yen, C. -F
    Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
    Kuo, Y. -J
    Department of Orthopedic Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 110, Taiwan.
    Griffiths, M. D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, NG1 4FQ, United Kingdom.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Motivation to have covid-19 vaccination explained using an extended protection motivation theory among university students in china: The role of information sources2021In: Vaccines, E-ISSN 2076-393X, Vol. 9, no 4, article id 380Article in journal (Refereed)
    Abstract [en]

    Background: The aims of the present study were to examine the prediction of the threat and coping appraisal utilizing an extended protection motivation theory (PMT) for the motivation to have COVID-19 vaccination and the influence of various information sources on coping appraisal among university students in China. Methods: The sample comprised 3145 students from 43 universities in China who completed an online survey including PMT constructs as well as constructs added to PMT. The PMT constructs comprised motivation to have COVID-19 vaccination, threat appraisal, and coping appraisal. The extended PMT constructs comprised knowledge about mechanisms and information sources of COVID-19 vaccination. Results: Perceived severity of COVID-19 was positively associated with motivation to have COVID-19 vaccination. Receiving information concerning COVID-19 vaccination from medical personnel was associated with greater self-efficacy, response efficacy, and knowledge, whereas receiving information concerning COVID-19 vaccination from coworkers/colleagues was associated with less response efficacy and knowledge. Receiving online information concerning COVID-19 vaccination was associated with greater response cost of vaccination efficacy and less knowledge. Conclusions: This study supported the prediction of perceived severity in the PMT for motivation to have COVID-19 vaccination among university students in China. Vaccination information sources have different effects on students’ coping appraisal of COVID-19 vaccination.

  • 5.
    Yahaghi, Rafat
    et al.
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Ahmadizade, Safie
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Fotuhi, Razie
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Taherkhani, Elham
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Ranjbaran, Mehdi
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Buchali, Zeinab
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Jafari, Robabe
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Zamani, Narges
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Shahbazkhania, Azam
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Simiari, Hengame
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Rahmani, Jalal
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Yazdi, Nahid
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Alijani, Hashem
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Poorzolfaghar, Leila
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Rajabi, Fatemeh
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Lin, Chung-Ying
    Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Griffiths, Mark D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Fear of covid-19 and perceived covid-19 infectability supplement theory of planned behavior to explain iranians’ intention to get covid-19 vaccinated2021In: Vaccines, E-ISSN 2076-393X, Vol. 9, no 7, article id 684Article in journal (Refereed)
    Abstract [en]

    One of the most efficient methods to control the high infection rate of the coronavirus disease 2019 (COVID-19) is to have a high coverage of COVID-19 vaccination worldwide. Therefore, it is important to understand individuals’ intention to get COVID-19 vaccinated. The present study applied the Theory of Planned Behavior (TPB) to explain the intention to get COVID-19 vaccinated among a representative sample in Qazvin, Iran. The TPB uses psychological constructs of attitude, subjective norm, and perceived behavioral control to explain an individual’s intention to perform a behavior. Fear and perceived infectability were additionally incorporated into the TPB to explain the intention to get COVID-19 vaccinated. Utilizing multistage stratified cluster sampling, 10,843 participants (4092 males; 37.7%) with a mean age of 35.54 years (SD = 12.00) completed a survey. The survey assessed TPB constructs (including attitude, subjective norm, perceived behavioral control, and intention related to COVID-19 vaccination) together with fear of COVID-19 and perceived COVID-19 infectability. Structural equation modeling (SEM) was performed to examine whether fear of COVID-19, perceived infectability, and the TPB constructs explained individuals’ intention to get COVID-19 vaccinated. The SEM demonstrated satisfactory fit (comparative fit index = 0.970; Tucker-Lewis index = 0.962; root mean square error of approximation = 0.040; standardized root mean square residual = 0.050). Moreover, perceived behavioral control, subjective norm, attitude, and perceived COVID-19 infectability significantly explained individuals’ intention to get COVID-19 vaccinated. Perceived COVID-19 infectability and TPB constructs were all significant mediators in the relationship between fear of COVID-19 and intention to get COVID-19 vaccinated. Incorporating fear of COVID-19 and perceived COVID-19 infectability effectively into the TPB explained Iranians’ intention to get COVID-19 vaccinated. Therefore, Iranians who have a strong belief in Muslim religion may improve their intention to get COVID-19 vaccinated via these constructs. 

  • 6.
    Yeh, Y. -C
    et al.
    Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
    Chen, I. -H
    School of Education Science, Minnan Normal University, Zhangzhou, 363000, China.
    Ahorsu, D. K.
    Department of Rehabilitation Sciences, Faculty of Health & Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Ko, N. -Y
    Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
    Chen, K. -L
    Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
    Li, P. -C
    Department of Occupational Therapy, I-Shou University, Kaohsiung, 824005, Taiwan.
    Yen, C. -F
    Department of Psychiatry, Kaohsiung Medical University Hospital & School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung, 807378, Taiwan.
    Lin, C. -Y
    Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
    Griffiths, M. D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, NG14FQ, United Kingdom.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Measurement invariance of the drivers of covid-19 vaccination acceptance scale: Comparison between taiwanese and mainland chinese-speaking populations2021In: Vaccines, E-ISSN 2076-393X, Vol. 9, no 3, article id 297Article in journal (Refereed)
    Abstract [en]

    The impacts of novel coronavirus disease-2019 (COVID-19) on human life continue to be serious. To control the spread of COVID-19, the production of effective vaccines is likely to be one of the best solutions. However, vaccination hesitancy may decrease individuals’ willingness to get vaccinated. The Drivers of COVID-19 Vaccination Acceptance Scale (DrVac-COVID19S) was recently developed to help healthcare professionals and researchers better understand vaccination acceptance. The present study examined whether DrVac-COVID19S is measurement invariant across different subgroups (Taiwanese vs. mainland Chinese university students; males vs. females; and health-related program majors vs. non-health-related program majors). Taiwanese (n = 761; mean age = 25.51 years; standard deviation (SD) = 6.42; 63.5% females) and mainland Chinese university students (n = 3145; mean age = 20.72 years; SD = 2.06; 50.2% females) were recruited using an online survey between 5 January and 21 February 2021. Factor structure and measurement invariance of the two DrVac-COVID19S scales (nine-item and 12-item) were tested using confirmatory factor analysis (CFA). The findings indicated that the DrVac-COVID19S had a four-factor structure and was measurement invariant across the subgroups. The DrVac-COVID19S’s four-factor structure was supported by the CFA results is a practical and valid instrument to quickly capture university students’ willingness to get COVID-19 vaccination. Moreover, the DrVac-COVID19S can be used to compare university students’ underlying reasons to get COVID-19 vaccination among different subgroups.

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