Successful campaigns to combat the COVID-19 pandemic depend, in part, on people's willingness to be vaccinated. It is therefore critical to understand the factors that determine people's vaccination intentions. We applied a reasoned action approach - the theory of planned behavior - to explore these factors. We used data from an online survey of adults (18–74 years; n = 5044) conducted in Germany between April 9 and April 28, 2021 and found that attitudes toward getting vaccinated predicted vaccination intentions, while normative and control beliefs did not. In turn, positive attitudes toward getting vaccinated were supported by trust in science and fear of COVID-19 whereas negative attitudes were associated with acceptance of conspiracy theories and skepticism regarding vaccines in general. We advise policymakers, physicians, and health care providers to address vaccination hesitancy by emphasizing factors that support positive attitudes toward getting vaccinated, such as prevention of serious illness, death, and long-term health detriments, as opposed to exerting social pressure or pointing to the ease of getting vaccinated.

Most of the countries in Europe are experiencing a rapid aging of their populations and with this an increase in mental health challenges due to aging. Comparative research may help countries to assess the promotion of healthy aging in general, and mentally healthy aging in particular, and explore ways for adapting mental health policy measures. However, the comparative study of mental health indicators requires that the groups understand the survey questions inquiring about their mental health in the same way and display similar response patterns. Otherwise, observed differences in perceived mental health may not reflect true differences but rather cultural bias in the health measures. To date, research on cross-country equivalence of depression measures among older populations has received very limited attention. Thus, there is a growing need for the cross-country validation of existing depression measures using samples of the older population and establishing measurement equivalence of the assessment tools. Indeed, insights on mental health outcomes and how they compare across societies is paramount to inform policy makers seeking to improve mental health conditions of the populations. This study, therefore, aims to examine measurement equivalence of self-reported depressive symptoms among older populations in 17 European countries and Israel. The data for the current analysis are from the sixth wave (2015) of the Survey on Health, Ageing and Retirement in Europe (SHARE) and consist of the population of respondents 50 years of age and older. The measurement of depression is based on the EURO-D scale, which was developed by a European consortium. It identifies existing depressive symptoms and consists of the 12 items: depression, pessimism, suicidality, guilt, sleep, interest, irritability, appetite, fatigue, concentration, enjoyment, and tearfulness. We examine the cross-country comparability of these data by testing for measurement equivalence using multigroup confirmatory factor analysis (MGCFA) and alignment. Our findings reveal partial equivalence thus allowing us to draw meaningful conclusions on similarities and differences among the older population across 18 countries on the EURO-D measure of depression. Findings are discussed in light of policy implications for universal access to mental health care across countries.

Background: The COVID-19 pandemic has created a global health crisis, leading to stigmatization and discriminatory behaviors against people who have contracted or are suspected of having contracted the virus. Yet the causes of stigmatization in the context of COVID-19 remain only partially understood. Using attribution theory, we examine to what extent attributes of a fictitious person affect the formation of stigmatizing attitudes towards this person, and whether suspected COVID-19 infection (vs. flu) intensifies such attitudes. We also use the familiarity hypothesis to explore whether familiarity with COVID-19 reduces stigma and whether it moderates the effect of a COVID-19 infection on stigmatization. Methods: We conducted a multifactorial vignette survey experiment (2⁸-design, i.e., N_Vignettes = 256) in Germany (N_Respondents = 4,059) in which we experimentally varied signals and signaling events (i.e., information that may trigger stigma) concerning a fictitious person in the context of COVID-19. We assessed respondents’ cognitive (e.g., blameworthiness) and affective (e.g., anger) responses as well as their discriminatory inclinations (e.g., avoidance) towards the character. Furthermore, we measured different indicators of respondents’ familiarity with COVID-19. Results: Results revealed higher levels of stigma towards people who were diagnosed with COVID-19 versus a regular flu. In addition, stigma was higher towards those who were considered responsible for their infection due to irresponsible behavior. Knowing someone who died from a COVID infection increased stigma. While higher self-reported knowledge about COVID-19 was associated with more stigma, higher factual knowledge was associated with less. Conclusion: Attribution theory and to a lesser extent the familiarity hypothesis can help better understand stigma in the context of COVID-19. This study provides insights about who is at risk of stigmatization and stigmatizing others in this context. It thereby allows identifying the groups that require more support in accessing healthcare services and suggests that basic, factually oriented public health interventions would be promising for reducing stigma.

In Search of the Healthy Immigrant Effect in Four West European Countries

The comparative study of perceived physical and mental health in general—and the comparative study of health between the native-born and immigrants, in particular—requires that the groups understand survey questions inquiring about their health in the same way and display similar response patterns. After all, observed differences in perceived health may not reflect true differences but rather cultural bias in the health measures. Research on cross-country measurement equivalence between immigrants and natives on self-reported health measures has received very limited attention to date, resulting in a growing demand for the validation of existing perceived health measures using samples of natives and immigrants and establishing measurement equivalence of health-related assessment tools. This study, therefore, aims to examine measurement equivalence of self-reported physical and mental health indicators between immigrants and natives in the United States. Using pooled data from the 2015–2017 IPUMS Health Surveys, we examine the cross-group measurement equivalence properties of five concepts that are measured by multiple indicators: (1) perceived limitations in activities of daily life; (2) self-reported disability; (3) perceived functional limitations; (4) perceived financial stress; and (5) nonspecific psychological distress. Furthermore, we examine the comparability of these data among respondents of different ethnoracial origins and from different regions of birth, who report few versus many years since migration, their age, gender, and the language used to respond to the interview (e.g., English vs. Spanish). We test for measurement equivalence using multigroup confirmatory factor analysis. The results reveal that health scales are comparable across the examined groups. This finding allows drawing meaningful conclusions about similarities and differences among natives and immigrants on measures of perceived health in these data.