This review aimed to synthesize evidence on the effectiveness of shared decision-making (SDM) tools for cancer screening and explored the preferences of vulnerable people and clinicians regarding the specific characteristics of the SDM tools. A mixed-method convergent segregated approach was employed, which involved an independent synthesis of quantitative and qualitative data. Articles were systematically selected and screened, resulting in the inclusion and critical appraisal of 55 studies. Results from the meta-analysis revealed that SDM tools were more effective for improving knowledge, reducing decisional conflict, and increasing screening intentions among vulnerable populations compared to non-vulnerable populations. Subgroup analyses showed minimal heterogeneity for decisional conflict outcomes measured over a six-month period. Insights from the qualitative findings revealed the complexities of clinicians’ and vulnerable populations’ preferences for an SDM tool in cancer screening. Vulnerable populations highly preferred SDM tools with relevant information, culturally tailored content, and appropriate communication strategies. Clinicians, on the other hand, highly preferred tools that can be easily integrated into their medical systems for efficient use and can effectively guide their practice for cancer screening while considering patients’ values. Considering the complexities of patients’ and clinicians’ preferences in SDM tool characteristics, fostering collaboration between patients and clinicians during the creation of an SDM tool for cancer screening is essential. This collaboration may ensure effective communication about the specific tool characteristics that best support the needs and preferences of both parties.

Background: Public health measures such as physical distancing and distance learning have been implemented during the COVID-19 pandemic. COVID-19 related knowledge deficit can increase fear that leads to negative mental health and COVID-19, especially among adolescents. Therefore, our study aimed to assess COVID-19 related knowledge deficit and its association with fear among higher education (HE) students during the first wave of COVID-19. Methods: A cross-sectional survey, COVID-19 International Students Well-being Study (C-19 ISWS) was conducted in 133 Higher Education Institutions (HEIs) in 26 countries between April 27 and July 7, 2020. A stratified convenience sampling technique was used. Descriptive, bivariate, mixed-effect logistic regression analyses were conducted using R software. Results: Out of 127,362 respondents, 72.1% were female, and 76.5% did not report a previous history of confirmed COVID-19. The majority of those without the previous infection 81,645 (83.7%) were from 21 European countries while the rest 15,850 (16.3%) were from 5 non-European countries. The most frequent correct response to COVID-19 related knowledge questions among respondents was having the virus without having symptoms (94.3%). Compared to participants with good knowledge, the odds of being afraid of acquiring SARS-COV-2 infection among those with poor knowledge was 1.05 (95%CI:1.03,1.08) and the odds of being afraid of contracting severe COVID-19 was 1.36 (95%CI:1.31,1.40). Conclusion: COVID-19 related knowledge was independently associated with both fear of acquiring SARS-COV-2 infection as well as contracting severe COVID-19. Our findings will serve as a basis for public health response for both the current and similar future pandemics by highlighting the need for addressing the COVID-19 knowledge deficit to fight the infodemic and prevent negative mental health outcomes.

Cardiovascular disease (CVD) poses a global health challenge, with modifiable risk factors, notably alcohol consumption, impacting its onset and progression. This review synthesizes evidence on the types and effectiveness of community-based interventions (CBIs) aimed at reducing alcohol consumption for CVD prevention. Electronic databases were systematically searched until October 31, 2019, with updates until February 28, 2023. Given the heterogeneity in outcome measures, we narratively synthesized the effectiveness of CBIs, adhering to the synthesis without meta-analysis (SWiM) guidelines for transparent reporting. For selected homogenous studies, a random-effects meta-analysis was utilized to estimate the effects of CBIs on alcohol consumption. Twenty-two eligible studies were included, with 16 demonstrating that CBIs reduced alcohol consumption compared to controls. Meta-analysis findings revealed reductions in above moderate-level alcohol consumption (pooled odds ratio (OR)=0.50, 95% confidence interval (CI): 0.37, 0.68), number of alcohol drinks per week (standardized mean difference=-0.08, 95% CI: -0.14, -0.03), and increased odds of low-risk drinking (pooled OR=1.99, 95% CI: 1.04, 3.81) compared to the control groups. Multi-component interventions (particularly those combining health education, awareness, and promotion activities) and those interventions with a duration of 12 months or more were notably effective. The beneficial effects of CBIs focusing on achieving a reduction in alcohol consumption showed promising outcomes. Implementing such interventions, especially multicomponent interventions, could play a significant role in mitigating the increasing burden of CVDs. Future studies should also consider employing standardized and validated tools to measure alcohol consumption outcomes to enhance the consistency and comparability of findings.

Background COVID-19 vaccination rates remain low for children aged 11 and below, and understanding the extent to which parental decisions impact their children’s vaccination status remains a challenge. This study aimed to explore the concordance and motivations for vaccination among parent–child dyads and determine the associated factors influencing their children’s vaccination status. Design A cross-sectional study was conducted from 1 March 2023 to 30 March 2023, recruiting parents from six representative primary schools across Butuan City, the Philippines. Pilot-tested, self-administered questionnaires were used during the face-to-face surveys with parent participants. To determine the associated factors of parental decisions to vaccinate their children, mixed-effects logistic regression was used, with school districts as a random effect. Participants A total of 593 participating parents were included in the study, with the majority being females (n=484, 81.6%) and underserved, characterised by lacking a college degree (n=305, 51.4%) and having low to no income (n=511, 86.1%). Results While 80.6% (n=478) of parents reported being vaccinated against COVID-19, only 36.2% (n=215) of them chose to vaccinate their children. A significant number of parents (n=285, 48.1%) reported psychological distress, with higher levels of distress prevalent among those who are indigenous, reside in rural areas and have lower income levels. Parental education and vaccination status emerged as influential factors. Specifically, parents with advanced degrees were 48% less likely to have unvaccinated children (adj OR (AOR)=0.52; 95% CI 0.30, 0.87), while unvaccinated parents had a sixfold increase in the likelihood of having unvaccinated children (AOR 6.1; 95% CI 3.14, 12.02) compared with their counterparts. Conclusions Efforts to increase paediatric vaccination rates should focus more on actively engaging parents, educating them about the vaccine’s benefits and necessity, rather than solely relying on mandates to improve paediatric vaccination rates. Further research is needed to understand the reluctance of unvaccinated parents to vaccinate themselves and their children against COVID-19, identifying specific facilitators and barriers to develop more effective communication strategies and bolster vaccine acceptance.

Background Public health measures such as physical distancing and distance learning have been implemented during the COVID-19 pandemic. Having inadequate COVID-19 related knowledge can lead to excessive worrying as well as negative COVID-19 outcomes. Our study aimed to assess COVID-19 related knowledge and its association with worries among higher education (HE) students during the first wave of COVID-19. Methods A cross sectional survey, COVID-19 International Students Well-being Study (C-19 ISWS) was conducted in 133 Higher Education Institutions (HEIs) in 26 countries between April 27 and July 7, 2020. A stratified convenience sampling technique was used. Descriptive, bivariate, mixed effect logistic regression analysis were conducted using R software. Results Out of 127,362 respondents, 72.1 % were female, and 76.5% did not report a previous history of confirmed COVID-19. Majority of those without the previous infection 81,645 (83.7%) were from 21 European countries while the rest 15,850 (16.3%) from 5 non-European countries. The most frequent correct response to COVID-19 related knowledge questions among respondents was having the virus without having symptoms (94.3%). Compared to participants with good knowledge, the odds of being worried of acquiring SARS-COV-2 infection with poor knowledge was 1.05 (95%CI:1.03,1.08) and the odds of being worried of contracting severe COVID-19 was 1.36 (95%CI:1.31,1.40). Conclusion COVID-19 related knowledge was independently associated with both worry of acquiring SARS-COV-2 infection as well as contracting severe COVID-19. We recommend scaling up of awareness campaigns through media to increase the comprehensive COVID-19 related knowledge in order to tackle excessive worries about acquiring severe COVID-19.

Primary healthcare professionals (PHCPs) are trusted sources of vaccine information, yet many report limited confidence in answering vaccine-related questions and insufficient vaccinology knowledge from standard education.We aimed to evaluate the validity and reliability of the Vaccine Training Barometer (VTB) scale, assess PHCPs’ confidence in answering vaccine-related questions and training needs, and quantify determinants of PHCPs’ confidence in answering questions and their willingness to pursue additional training. A cross-sectional survey was conducted (February-March 2023) using the CHARMING cohort. Of 1,511 PHCPs who reported a role in vaccination, 985 participated in the VTB questionnaire and were included. Psychometric properties were evaluated using factor and reliability analysis. Descriptive statistics and logistic regression examined confidence patterns, training needs and predictors of willingness to pursue training.Factor analysis identified three training domains—scientific foundations; vaccine knowledge and policies; and communication and practical application. The VTB showed strong internal consistency and acceptable structural validity. Only 405 PHCPs (41.1%) reported feeling consistently confident in answering vaccine-related questions, while 811 (82.3%) were willing to pursue additional training. Prioritized topics included vaccine safety, side effects, and pharmacovigilance. Willingness to pursue training was higher among PHCPs with inconsistent confidence (OR 1.55, 95% CI: 1.04–2.32), inadequate knowledge (OR 2.20, 95% CI: 1.18–4.32), prior vaccine training (OR 2.26, 95% CI: 1.38–3.65), and increased or stable patient question frequency (OR 1.52, 95% CI: 1.05–2.22).The VTB may help identify PHCPs’ vaccine-related training needs, including during pandemic preparedness, and for supporting tailored PHCP training design, evaluation, and monitoring.