Should we do battle with antivaccination activists?

Antivaccination activists have existed since variolation was introduced in Europe in the 18th century. Today, they continue to attempt to influence the vaccination decisions of parents. Commentators have expressed concern about the impact of such activists on vaccination rates and disease outbreaks. Some argue that public health advocates should engage in adversarial approaches involving public attempts to discredit or stop an antivaccination group or individual. This article argues that such adversarial advocacy may not be the most effective way to support vaccine programs. It argues this on the basis of what is known to influence vaccination attitudes and uptake, and the unintended negative consequences that can arise from an adversarial approach. These include drawing attention to such activists and their arguments, and potentially alienating the most important audience – hesitant parents – where the primary goal is to establish trust. The exception is when the antivaccination activists’ actions may cause direct harm, such as encouraging a ‘disease party’ or illegal activities. Generally, however, advocacy should focus on areas where real gains can be made – on policies that directly address determinants of low coverage such as lack of opportunity to vaccinate and lack of acceptance of vaccination. This includes advocacy for accessible and affordable vaccines. In addressing the global problem of vaccine hesitancy, public health has a responsibility to better monitor public attitudes, support health professionals in communication, and develop and test strategies that engage vaccine-hesitant parents and communities

Media coverage of health issues and how to work more effectively with journalists: a qualitative study

<p>Abstract</p> <p>Background</p> <p>The mass media has enormous potential to influence health-related behaviours and perceptions. Much research has focused on how the media frames health issues. This study sought to explore how journalists in Australia select and shape news on health issues.</p> <p>Methods</p> <p>The study involved semi-structured interviews with 16 journalists from major Australian print, radio and television media organisations reporting on avian influenza and pandemic planning. Journalists, including reporters, editors and producers, were interviewed between October 2006 and August 2007. Thematic analysis was used to draw out major lessons for health communicators.</p> <p>Results</p> <p>Journalists routinely attempted to balance different, sometimes competing, aims amidst significant operational constraints. They perceived the most trusted sources on health issues to be respected and independent doctors. Specialist health and medical reporters had a more sound technical knowledge, channels to appropriate sources, power within their organisations, and ability to advocate for better quality coverage.</p> <p>Conclusions</p> <p>An awareness of how to work with the media is essential for health communicators. This includes understanding journalists' daily routines, being available, providing resources, and building relationships with specialist health reporters.</p

Not In My Back Yard (NIMBY), an endemic syndrome influencing Environmental Policies

Not In My Back Yard (NIMBY), an endemic syndrome influencing Environmental Policie

Understanding non-vaccinating parents\u27 views to inform and improve clinical encounters: A qualitative study in an Australian community

Objectives: To explain vaccination refusal in a sample of Australian parents. Design: Qualitative design, purposive sampling in a defined population. Setting: A geographically bounded community of approximately 30 000 people in regional Australia with high prevalence of vaccination refusal. Participants: Semi structured interviews with 32 non-vaccinating parents: 9 fathers, 22 mothers and 1 pregnant woman. Purposive sampling of parents who had decided to discontinue or decline all vaccinations for their children. Recruitment: via local advertising then snowballing. Results: Thematic analysis focused on explaining decision-making pathways of parents who refuse vaccination. Common patterns in parents\u27 accounts included: perceived deterioration in health in Western societies; a personal experience introducing doubt about vaccine safety; concerns regarding consent; varied encounters with health professionals (dismissive, hindering and helpful); a quest for the real truth\u27; reactance to system inflexibilities and ongoing risk assessment. Conclusions: We suggest responses tailored to the perspectives of non-vaccinating parents to assist professionals in understanding and maintaining empathic clinical relationships with this important patient group

Associations between exposure to and expression of negative opinions about Human Papillomavirus vaccines on social media: an observational study

Background Groups and individuals that seek to negatively influence public opinion about the safety and value of vaccination are active in online and social media and may influence decision making within some communities. Objective We sought to measure whether exposure to negative opinions about human papillomavirus (HPV) vaccines in Twitter communities is associated with the subsequent expression of negative opinions by explicitly measuring potential information exposure over the social structure of Twitter communities. Methods We hypothesized that prior exposure to opinions rejecting the safety or value of HPV vaccines would be associated with an increased risk of posting similar opinions and tested this hypothesis by analyzing temporal sequences of messages posted on Twitter (tweets). The study design was a retrospective analysis of tweets related to HPV vaccines and the social connections between users. Between October 2013 and April 2014, we collected 83,551 English-language tweets that included terms related to HPV vaccines and the 957,865 social connections among 30,621 users posting or reposting the tweets. Tweets were classified as expressing negative or neutral/positive opinions using a machine learning classifier previously trained on a manually labeled sample. Results During the 6-month period, 25.13% (20,994/83,551) of tweets were classified as negative; among the 30,621 users that tweeted about HPV vaccines, 9046 (29.54%) were exposed to a majority of negative tweets. The likelihood of a user posting a negative tweet after exposure to a majority of negative opinions was 37.78% (2780/7361) compared to 10.92% (1234/11,296) for users who were exposed to a majority of positive and neutral tweets corresponding to a relative risk of 3.46 (95% CI 3.25-3.67, P<.001). Conclusions The heterogeneous community structure on Twitter appears to skew the information to which users are exposed in relation to HPV vaccines. We found that among users that tweeted about HPV vaccines, those who were more often exposed to negative opinions were more likely to subsequently post negative opinions. Although this research may be useful for identifying individuals and groups currently at risk of disproportionate exposure to misinformation about HPV vaccines, there is a clear need for studies capable of determining the factors that affect the formation and adoption of beliefs about public health interventions

Target the fence-sitters

Past waves of vaccine rejection in industrialized nations have a lot to teach us about preventing future ones

The whole of university experience: retention, attrition, learning and personal support interventions during undergraduate business studies

The Whole of University Experience (WoUE) project examined factors underpinning attrition in the first, second and third year of a business degree at six Australian universities – Griffith University, Monash University, Murdoch University, University of South Australia, University of Southern Queensland, and University of the Sunshine Coast. A questionnaire completed in 2008, 2009, and 2010 by a total of 7,486 students enabled gathering of data relating to demographics; students’ experience of university; their use and perceptions of the usefulness of student support interventions; open-ended comments about the best and worst aspects of the university experience; and aspects in need of improvement. In each year a small number of students were also interviewed for the purpose of fleshing out the survey data and exploring the interactions between various factors associated with attrition. Overall, the data strongly indicates that factors related to attrition are generally university-specific and reflect both student characteristics and their responses to the specific institutional culture and environment. The only attrition triggers which span most universities and most years of study are ‘lack of a clear reason for being at university’ and ‘the feeling of having insufficient ability to succeed at university’. Correlation analysis relating 70 statements probing students’ experience of university to the strength of their intention to leave before completing a degree revealed notable differentiation in attrition triggers on the basis of year of study. Follow-up analysis in one university indicated further differentiation in the triggers for attrition, semester by semester. It seems that many different factors underpin attrition decisions in any one institution and for any one individual, for whom attrition appears to be the result of the aggregation of diverse factors generally followed by ‘the straw that broke the camel’s back’. When responses are grouped by demographic variables some difference in the factors associated with domestic and international student attrition is apparent, but no difference in the factors associated with their sense of satisfaction or belonging is obvious. In the responses of international and domestic students to issues of teaching quality, differences primarily related to expectations regarding teaching staff approachability, availability and helpfulness. For students enrolled part-time or full-time different factors underpin attrition, and attrition triggers also differ on the basis of time spent on campus and average grades. Preliminary analysis suggests that having to take a loan or engage in full-time work to fund studies is a greater attrition risk factor in most universities than is the receipt of Centrelink benefits (which may be seen as a proxy indicator for low socio-economic status). Analysis of responses to questions about the use and usefulness of student support interventions indicates that, in general, when students use personal support interventions these are mostly seen as very useful. However, data also indicate that many, and often the majority of, students have either not used or are not aware of the support services available. Practically, the project has delivered, and will continue to deliver, significant value to the higher education sector. On the basis of evidence from the project, partner universities have begun addressing high-value student retention issues and it is expected that this evidence will continue to influence institutional decision-making for several years beyond the life of the project. Dissemination activities external to partner universities, including publication of five journal articles and numerous workshops or presentations, have assisted staff in other universities to reflect upon issues critical to student retention in both first year and beyond. Further publication outcomes are expected. Critically, as indicated in the independent project evaluation, “the project has directed much needed attention to factors associated with attrition in later years of the student experience (second and third years) … facilitated discussion around frameworks for evidence-based institutional responses that constitute effective interventions … [and] reinforced the need for institutions to collect their own data on the student experience to inform individual institutional responses and interventions”