Ageism is a widespread phenomenon and constitutes a significant threat to older people’s well-being. Identifying the factors contributing to ageism is critical to inform policies that minimise its societal impact. In this systematic review, we gathered and summarised empirical studies exploring the key determinants of ageism against older people for a period of over forty years (1970–2017). A comprehensive search using fourteen databases identified all published records related to the umbrella concept of “ageism”. Reviewers independently screened the final pool to identify all papers focusing on determinants, according to a predefined list of inclusion and exclusion criteria. All relevant information was extracted and summarised following a narrative synthesis approach. A total of 199 papers were included in this review. We identified a total of 14 determinants as robustly associated with ageism. Of these, 13 have an effect on other-directed ageism, and one on self-directed ageism. The quality of contact with older people and the positive or negative presentation of older people to others emerged as the most robust determinants of other-directed ageism; self-directed ageism is mostly determined by older adults’ health status. Given the correlational nature of most studies included in this review, inferences on causality should be made cautiously.

The children of today will be the adults of tomorrow and thus their attitudes toward older people lay the ground for their future self-concept and psychological well-being. Understanding how young children perceive older people is thus of crucial importance in an ageing world. The literature suggests mixed findings regarding the existence of ageism among children, which may be an artifact of the diversity measures used. This chapter presents a literature review that assesses most of these measures to assess children’s attitudes regarding older people and the assorted findings. We propose a classification based on two criteria: (i) the dimensions covered – cognitive, affective and behavioral (tripartite model of attitudes) and (ii) the four automaticity features (consciousness, controllability, intentionality and efficacy) which together led us to classify measures into three categories: solely explicit, solely implicit and partially both explicit and implicit measures. Based on this categorization, we delineate distinct patterns of results, associated with the participant’s age. In studies using explicit measures or a combination of both explicit and implicit measures, children revealed more positive or mixed attitudes regarding older people. The most positive attitudes were found in studies with older children and adolescents (e.g. using the Tuckman-Lorge Older People Scale”). When implicit measures were used, a different pattern of results emerged. Children expressed negative attitudes toward older people across childhood (e.g. behavioral measure). Based on this pattern of evidence, we make recommendations regarding the improvement of measures to assess children’s attitudes toward older people at different points in their social development.

Although healthism appears to be at the heart of the decision-making process of vaccine hesitancy, this matter has been understudied. We believe that the concept of healthism may be key to lessen the polarization of discourses around vaccination, offering a broad understanding of parents’ decision to not vaccinate their children. This article aims to deepen the knowledge on the relation between healthism and vaccine hesitancy, using Portugal as a case study. A qualitative research approach was adopted, and therefore, in-depth interviews were conducted with 31 vaccine-hesitant parents. The findings showed that vaccine-hesitant parents usually adopt several strategies based on natural living to prevent and tackle their children’s potential health issues. There appears to be a common approach towards health and life (i.e., healthism) among vaccine-hesitant parents. Drawing upon the healthism ideology, vaccine-hesitant parents make choices to ensure the good health of their child. These choices nevertheless represent a privileged position as the pursuit of healthfulness is constrained by sociodemographic aspects. Using vaccine hesitancy as the starting point, our findings show that healthism and its focus on personal accountability under the umbrella of neoliberalism may jeopardize global public health. Healthcare professionals should pay particular attention to healthism when addressing vaccine hesitancy in Portugal and elsewhere. Research evidence advocates the need to be sensitive to the broad spectrum of vaccine hesitancy as this encompasses multiple views on the subject.

Vaccine hesitancy presents significant challenges to public health, exacerbated by a lack of cohesive policies in Europe. Recognized as a complex social phenomenon influenced by various factors, vaccine hesitancy threatens health systems and public trust. This paper analyses the political background and current gaps in policies addressing vaccine hesitancy, with a specific focus on the role of healthcare authorities, organizations and professionals in shaping effective responses. The VAX-TRUST project, funded by H2020 and conducted in seven European countries, provides a framework for translating social scientific research into actionable strategies within healthcare settings. Using methodologies such as the Delphi method, the project developed the ASTARE model, which encompasses six dimensions: Awareness, Support, Training, Agency, Recognition, and Engagement. These dimensions guide tailored recommendations to strengthen the capacity of healthcare professionals, organizations, and authorities in addressing vaccine hesitancy, enhancing public trust, and vaccine confidence and uptake. The paper highlights the necessity of evidence-based, collaborative, and adaptive policies that raise public awareness, counteract misinformation, and support healthcare professionals. Effective policymaking requires understanding legislative processes, leveraging scientific evidence, and fostering stakeholder participation. By emphasizing context-sensitive interventions and culturally informed strategies, this study provides a comprehensive approach for health systems to address vaccine hesitancy and improve public health outcomes across Europe.

Evidence suggests that healthcare professionals often feel uncomfortable discussing vaccination with patients, largely due to a lack of training on the topic. In line with the scientific evidence gathered from the VAX-TRUST project, it is crucial to invest in training healthcare professionals and developing political measures to effectively address vaccine hesitancy. This paper explores the importance of training healthcare professionals to address vaccine hesitancy and provides concrete strategies for its implementation. A quantitative research design was used. The findings are based on a comprehensive Delphi survey conducted with a panel of 112 experts. Additionally, the study involved practical interventions carried out across seven European countries, engaging a total of 694 participants. These participants included general practitioners (GPs), paediatricians, nurses, as well as medical and nursing students. This robust and diverse dataset provides a well-rounded perspective on the subject matter, ensuring that the insights gained are both extensive and representative of various healthcare professionals across Europe. Three key themes emerged from the findings: the need for effective strategies to address communication challenges with vaccine-hesitant individuals, the importance of using evidence-based communication practices to improve these interactions, and the necessity of integrating social scientific knowledge on vaccination into the training of healthcare professionals. Training healthcare professionals is essential to equip them with skills and knowledge needed to deal with the complexities of vaccine hesitancy. Evidence was gathered on ways to reflect and act to develop this capacity, namely, by increasing the ability to communicate empathetically, responding to patients' concerns with evidence-based information, and to building stronger and more collaborative relationships with them.