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Article ; Online: A qualitative study to identify thematic areas for HIV related patient-reported outcome measures (PROM) and patient-reported experience measures (PREM)

Anna-Leena Lohiniva / Sanna Isosomppi / Sini Pasanen / Jussi Sutinen

Journal of Patient-Reported Outcomes, Vol 7, Iss 1, Pp 1-

2023 Volume 10

Abstract: Abstract Background The use of patient-reported outcome measures (PROM) and patient-reported experience measures (PREM) provide health providers with valuable feedback on how to improve clinical care and patient outcomes. This paper describes a ... ...

Abstract	Abstract Background The use of patient-reported outcome measures (PROM) and patient-reported experience measures (PREM) provide health providers with valuable feedback on how to improve clinical care and patient outcomes. This paper describes a qualitative study that was conducted to learn about factors influencing the well-being of people living with HIV (PLHIV) in Finland. The findings will be used to develop themes for HIV-specific PROM and PREM questions. Methods PROMs and PREMs were developed by the Finnish Institute for Health (THL) as a part of a project to develop a national quality-of-care registry for HIV. The study aimed to identify issues and concerns among people living with HIV (PLHIV) that influence their well-being (PROMs) and their experiences in the healthcare system (PREMs). The data were collected through face-to-face in-depth interviews and focus group discussions based on open-ended and semi-structured questions. The data were analyzed using thematic analysis. Results The assessment identified the following PROMs of concern: psychological well-being, concerns about stigma, physical health, social well-being, sexual well-being, medication uptake, managing other medications with antiretrovirals (ARVs), and growing old. The assessment identified the following PREMs: helping patients understand their own health status, proving an opportunity for patients to discuss physical health, psychological and sexual well-being, supporting the uptake of ARVs, assisting patients with medication use, showing compassion towards patients, and empowering patients against stigma. Conclusion These findings of the study can be used to develop domain-specific PROM and PREM questions for the national HIV quality care register.
Keywords	HIV ; Patient-centered care ; PROM ; PREM ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2023-05-01T00:00:00Z
Publisher	SpringerOpen
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Exploring Political Mistrust in Pandemic Risk Communication

Ali Unlu / Sophie Truong / Tuukka Tammi / Anna-Leena Lohiniva

Journal of Medical Internet Research, Vol 25, p e

Mixed-Method Study Using Social Media Data Analysis

2023 Volume 50199

Abstract: BackgroundThis research extends prior studies by the Finnish Institute for Health and Welfare on pandemic-related risk perception, concentrating on the role of trust in health authorities and its impact on public health outcomes. ObjectiveThe paper aims ... ...

Abstract	BackgroundThis research extends prior studies by the Finnish Institute for Health and Welfare on pandemic-related risk perception, concentrating on the role of trust in health authorities and its impact on public health outcomes. ObjectiveThe paper aims to investigate variations in trust levels over time and across social media platforms, as well as to further explore 12 subcategories of political mistrust. It seeks to understand the dynamics of political trust, including mistrust accumulation, fluctuations over time, and changes in topic relevance. Additionally, the study aims to compare qualitative research findings with those obtained through computational methods. MethodsData were gathered from a large-scale data set consisting of 13,629 Twitter and Facebook posts from 2020 to 2023 related to COVID-19. For analysis, a fine-tuned FinBERT model with an 80% accuracy rate was used for predicting political mistrust. The BERTopic model was also used for superior topic modeling performance. ResultsOur preliminary analysis identifies 43 mistrust-related topics categorized into 9 major themes. The most salient topics include COVID-19 mortality, coping strategies, polymerase chain reaction testing, and vaccine efficacy. Discourse related to mistrust in authority is associated with perceptions of disease severity, willingness to adopt health measures, and information-seeking behavior. Our findings highlight that the distinct user engagement mechanisms and platform features of Facebook and Twitter contributed to varying patterns of mistrust and susceptibility to misinformation during the pandemic. ConclusionsThe study highlights the effectiveness of computational methods like natural language processing in managing large-scale engagement and misinformation. It underscores the critical role of trust in health authorities for effective risk communication and public compliance. The findings also emphasize the necessity for transparent communication from authorities, concluding that a holistic approach to public health ...
Keywords	Computer applications to medicine. Medical informatics ; R858-859.7 ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2023-10-01T00:00:00Z
Publisher	JMIR Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Trust and willingness towards COVID-19 vaccine uptake

Joshua Amo-Adjei / Anastasiia Nurzhynska / Ruth Essuman / Anna-Leena Lohiniva

Archives of Public Health, Vol 80, Iss 1, Pp 1-

a mixed-method study in Ghana, 2021

2022 Volume 12

Abstract: Abstract Background On the account of limited doses of COVID-19 available to the country, the Government of Ghana created a priority list of persons to target for its vaccination agenda. In this paper, we look at trust and how it informs willingness to ... ...

Abstract	Abstract Background On the account of limited doses of COVID-19 available to the country, the Government of Ghana created a priority list of persons to target for its vaccination agenda. In this paper, we look at trust and how it informs willingness to take the COVID-19 vaccine among persons targeted for the first phase of COVID-19 vaccination program in Ghana. Methods A sequential mixed-method investigation was conducted among the priority population - persons 60 years and above, frontline government functionaries, health workers, persons with underlying health conditions and, religious leaders and teachers. We sampled 415 respondents from the target population for a survey and 15 religious and traditional leaders from three cities; Accra, Cape Coast and Tamale for follow-up in-depth interviews based on the results of the survey data. Quantitative data is presented with descriptive proportions and multinomial logistic regression and thematic approach is applied to the interview data. Results Trust and willingness to take the vaccine are high in this priority population. Trust in the effectiveness and safety of the vaccine, rather than socioeconomic characteristics of respondents better predicted acceptance. From interview narratives, mistrust in political actors - both local and foreign, believe in superior protection of God and seeming misunderstanding of vaccine development processes countermand acceptance. On the other hand, the professional influence of people in one’s social networks, and past triumphs of vaccination programmes against concerning childhood diseases embed trust and acceptance. Conclusions Attention ought to be given to trust enhancing triggers while strategic communication approaches are used to remove triggers of mistrust.
Keywords	Trust ; Vaccine uptake ; Willingness ; Ghana ; Public aspects of medicine ; RA1-1270
Subject code	320
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Identifying factors influencing COVID-19 vaccine uptake in Finland – a qualitative study using social media data

Anna-Leena Lohiniva / Annika Pensola / Suvi Hyökki / Jonas Sivelä / Vuokko Härmä / Tuukka Tammi

Frontiers in Public Health, Vol

2023 Volume 11

Abstract: IntroductionVaccine demand creation requires understanding what is driving the uptake of the vaccine. 24 Qualitative research methods are paramount to gaining a localized understanding of behavioral 25 drivers and barriers to vaccine uptake, but they are ...

Abstract	IntroductionVaccine demand creation requires understanding what is driving the uptake of the vaccine. 24 Qualitative research methods are paramount to gaining a localized understanding of behavioral 25 drivers and barriers to vaccine uptake, but they are often underutilized.MethodsThis is a qualitative study that 26 used public comments on the Facebook and Twitter posts of the Finnish Institute for Health and 27 Welfare (THL) as data sources to identify behavioral drivers for COVID-19 vaccine uptake in 28 Finland. The participatory data analysis utilized thematic analysis and the Theoretical Domains 29 Framework (TDF). NVIVO was used to assist in the coding process.ResultsThe greatest number of FB and 30 Twitter comments were linked with six TDF domains: knowledge, environmental context and 31 resources, beliefs in consequences, beliefs in capabilities, social and professional role, and social 32 influences. The domains included 15 themes that were interlinked. The knowledge domain 33 overlapped with all other domains.DiscussionBy using public discourse on Facebook and Twitter, and rapid 34 qualitative data analysis methods within a behavioral insight framework, this study adds to the 35 emerging knowledge about behavioral drivers of COVID-19 vaccines that can be used by public 36 health experts to enhance the uptake of vaccines during future pandemics and epidemics.
Keywords	COVID-19 vaccine ; vaccine hesitancy ; vaccine demand creation ; behavioral insights ; qualitative research ; social media 2 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Learning about COVID-19-related stigma, quarantine and isolation experiences in Finland.

Anna-Leena Lohiniva / Timothee Dub / Lotta Hagberg / Hanna Nohynek

PLoS ONE, Vol 16, Iss 4, p e

2021 Volume 0247962

Abstract: Background The COVID-19 pandemic has intensely changed the everyday lives of people worldwide. This study explores the forms and outcomes of coronavirus and COVID-19-related social stigma and the experiences of people who were home quarantined or ... ...

Abstract	Background The COVID-19 pandemic has intensely changed the everyday lives of people worldwide. This study explores the forms and outcomes of coronavirus and COVID-19-related social stigma and the experiences of people who were home quarantined or isolated in Finland during the spring 2020. The findings of this study can be used to improve support for those quarantined or isolated and to develop strategies to reduce the stigma associated with coronavirus and COVID-19. Methods The study is based on qualitative one-to-one interviews with households with at least two members and at least one PCR confirmed COVID-19 case. Recruitment took place via website or SMS messages sent to PCR confirmed cases in the capital area of Helsinki. Sampling was based on maximum variation to acquire different types of respondents. The framework of health stigma was used to develop question guides and analyze stigma. Quarantine and isolation experiences were explored through open-ended questions. The analysis was based on thematic analysis. Results The study included 64 participants from 24 households. Perceived stigma among respondents was driven by fear and blame for infection, and it manifested in various ways leading to a reluctance to disclose their coronavirus status to others. Self-stigma developed from conflicting information and advice about coronavirus and COVID-19 led to difficulties interacting with others outside of the house and reluctance to meet people after quarantine and isolation. Quarantine and isolation experiences included uncertainty, health concerns, and boredom. Communication with others in similar situations was perceived vital, whereas discussions with family members about worries and fears related to coronavirus and COVID-19 was not preferred. Conclusions This study shed light on the lives of those quarantined or isolated at home and provided a set of operational recommendations to minimize coronavirus and COVID-19-associated stigma and to reduce challenges faced by those in quarantine or isolation.
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Qualitative Insights into Vaccine Uptake of Nursing Staff in Long-Term Care Facilities in Finland

Anna-Leena Lohiniva / Idil Hussein / Jaana-Marija Lehtinen / Jonas Sivelä / Suvi Hyökki / Hanna Nohynek / Pekka Nuorti / Outi Lyytikäinen

Vaccines, Vol 11, Iss 530, p

2023 Volume 530

Abstract: Vaccine hesitancy and refusal have undermined COVID-19 vaccination efforts of nursing staff. This study aimed to identify behavioral factors associated with COVID-19 vaccine uptake among unvaccinated nursing staff in long-term care facilities (LTCF) in ... ...

Abstract	Vaccine hesitancy and refusal have undermined COVID-19 vaccination efforts of nursing staff. This study aimed to identify behavioral factors associated with COVID-19 vaccine uptake among unvaccinated nursing staff in long-term care facilities (LTCF) in Finland. Methodology: The study was based on the Theoretical Domains Framework. Data were collected through qualitative in-depth interviews among nursing staff and managers of LTCFs. The analysis was based on thematic analysis. We identified seven behavioral domains, with several themes, that reduced the staff’s intention to get vaccinated: knowledge (information overload, inability to identify trustworthy information sources, lack of vaccine-specific and understandable scientific information), beliefs about consequences (incorrect perceptions about the vaccine effectiveness, and lack of trust in the safety of the vaccine), social influences (influence of family and friends), reinforcement (limited abilities of the management to encourage vaccination), beliefs about capabilities (pregnancy or desire to get pregnant), psychological factors (coping with changing opinion), and emotions (confusion, suspicion, disappointment, and fatigue). We also identified three behavioral domains that encouraged vaccine uptake: social influences (trust in health authorities), environmental context and resources (vaccination logistics), and work and professional role (professional pride). The study findings can help authorities to develop tailored vaccine promotion strategies for healthcare workers in LTCFs.
Keywords	COVID-19 vaccine ; long-term care facilities ; Theoretical Domains Framework ; behavior change ; Medicine ; R
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A theory-based exploration of antibiotic use in primary healthcare in Gezira state, Sudan

Anna-Leena Lohiniva / Einas Elwali / Duha Abuobaida / Ashwag Abdulrahim / Paul Bukuluki / Maha Talaat

Implementation Science Communications, Vol 2, Iss 1, Pp 1-

2021 Volume 13

Abstract: Abstract Background Inappropriate use of antibiotics is a major contributing factor to the emergence of antimicrobial resistance globally, including in Sudan. Objectives The project aimed to develop a theory-driven behaviour change strategy addressing ... ...

Abstract	Abstract Background Inappropriate use of antibiotics is a major contributing factor to the emergence of antimicrobial resistance globally, including in Sudan. Objectives The project aimed to develop a theory-driven behaviour change strategy addressing both prescribers and patients based on factors that are driving antibiotic use in primary healthcare settings in Gezira state in Sudan. Methods The strategy was designed based on the Theoretical Domains Framework (TDF) to identify behavioural domains and the Behaviour Change Wheel (BCW) to select appropriate intervention functions. The process included (1) a formative qualitative research study and (2) a knowledge co-production workshop that utilized the results of the qualitative study to design a salient, appropriate, and credible behaviour change strategy. Results The TDF domains related to prescribers that emerged from the study included knowledge, skills, and intention. The selected BCW intervention functions included education, training, modelling, and persuasion. The main TDF domains related to patients included social influences and intention. The selected BCW intervention functions included enablement and education. Conclusion Using the TDF and BCW intervention functions, the study identified behavioural domains that influence antibiotic prescription and consumption in rural primary healthcare settings in Gezira state in Sudan and appropriate intervention functions to modify these behaviours. Knowledge co-production ensured that the evidence-based strategy was acceptable and practical in the local context.
Keywords	Behaviour change ; Theory-based intervention ; Antibiotic use ; Primary healthcare ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Strengthening polio vaccine demand in Ghana

Anna-Leena Lohiniva / Anastasia Nurzhynska / Abdul Mueed / Absar Ali / Khadeeja Ahmed / Paul Ayiku / Joshua Amo-Adjei / Yoshito Kawakatsu / Mrunal Shetye / Karen Greiner / Ross McIntosh

PLoS ONE, Vol 18, Iss 2, p e

Understanding the factors influencing uptake of the vaccine and the effectiveness of different message frames.

2023 Volume 0279809

Abstract: Background Ghana has experienced recent polio outbreaks. Behavioral insights can be used to understand behavior and create demand for the polio vaccine. Methods This cross-sectional study is based on an interactive mobile phone survey that explored ... ...

Abstract	Background Ghana has experienced recent polio outbreaks. Behavioral insights can be used to understand behavior and create demand for the polio vaccine. Methods This cross-sectional study is based on an interactive mobile phone survey that explored factors influencing the uptake of the polio vaccine among Ghanaian mothers with children younger than five years old. The survey also explores the mothers' intention to vaccinate their children in the future as well as an experiment with short polio vaccine voice message nudges to identify the most effective message frames in encouraging vaccination. The study sample was drawn from volunteers from a mobile service platform. Linear probability model regressions with Ordinary Least Squares (OLS) estimates were used to analyze the data. Results In total, data from 708 caregivers was assessed. Out of the sample, 35% (n = 250) had not vaccinated their children against polio, around 8% (n = 53) of respondents stated they did not plan to do so, while 28% expressed intent to do so during the next polio vaccination campaign. Higher vaccination of children against polio, i.e. better uptake of the polio vaccine, appeared to be associated with children's caregivers knowing that polio causes paralysis (with a coefficient of 0.13 (95% CI: 0.02, 0.24), i.e. 13% more likely than not to have their child vaccinated). Higher vaccine uptake also appeared to be associated with the perception that the polio vaccine is safe (with a coefficient of 0.11 (95% CI: 0.01, 0.22), i.e. 11% more likely than not to have their child vaccinated). Another factor in increasing vaccine uptake is whether caregivers receive support from healthcare workers with a coefficient of 0.11 (95% CI: 0.02, 0.20), i.e. 11% more likely than not to have their child vaccinated. Crucially, difficulty accessing the polio vaccine appeared to be associate with a negative change in vaccine uptake (with a coefficient of -0.16 (95% CI: -0.23, -0.08), i.e. 16% less likely to have their child vaccinated). Satisfaction with the ...
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A qualitative study of vaccine acceptability and decision making among pregnant women in Morocco during the A (H1N1) pdm09 pandemic.

Anna-Leena Lohiniva / Amal Barakat / Erica Dueger / Suzanne Restrepo / Rajae El Aouad

PLoS ONE, Vol 9, Iss 10, p e

2014 Volume 96244

Abstract: Vaccination uptake of pregnant women in Morocco during the A (H1N1) pdm09 pandemic was lower than expected. A qualitative study using open-ended questions was developed to explore the main determinants of acceptance and non-acceptance of the monovalent A ...

Abstract	Vaccination uptake of pregnant women in Morocco during the A (H1N1) pdm09 pandemic was lower than expected. A qualitative study using open-ended questions was developed to explore the main determinants of acceptance and non-acceptance of the monovalent A (H1N1) pdm09 vaccine among pregnant women in Morocco and to identify information sources that influenced their decision-making process. The study sample included 123 vaccinated and unvaccinated pregnant women who were in their second or third trimester between December 2009 and March 2010. They took part in 14 focus group discussions and eight in-depth interviews in the districts of Casablanca and Kenitra. Thematic qualitative analysis identified reasons for vaccine non-acceptance: (1) fear of the monovalent A (H1N1) pdm09 vaccine, (2) belief in an A (H1N1) pdm09 pandemic conspiracy, (3) belief in the inapplicability of the monovalent A (H1N1) pdm09 vaccine to Moroccans, (4) lack of knowledge of the monovalent A (H1N1) pdm09 vaccine, and (5) challenges of vaccination services/logistics. Reasons for vaccine acceptance included: (1) perceived benefits and (2) modeling. Decision-making was strongly influenced by family, community, mass media, religious leaders and health providers suggesting that broad communication efforts should also be used to advocate for vaccination. Meaningful communication for future vaccine campaigns must consider these context-specific findings. As cultural and religious values are shared across many Arab countries, these findings may also provide valuable insights for seasonal influenza vaccine planning in the Middle East and North Africa region at large.
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Understanding Antibiotic Use in Minya District, Egypt

Kathleen L. Dooling / Amr Kandeel / Lauri A. Hicks / Waleed El-Shoubary / Khaled Fawzi / Yasser Kandeel / Ahmad Etman / Anna Leena Lohiniva / Maha Talaat

Antibiotics, Vol 3, Iss 2, Pp 233-

Physician and Pharmacist Prescribing and the Factors Influencing Their Practices

2014 Volume 243

Abstract: Overuse of antibiotics has contributed to the emergence of antibiotic-resistant bacteria globally. In Egypt, patients can purchase antibiotics without a prescription, and we hypothesized frequent inappropriate antibiotic prescribing and dispensing. We ... ...

Abstract	Overuse of antibiotics has contributed to the emergence of antibiotic-resistant bacteria globally. In Egypt, patients can purchase antibiotics without a prescription, and we hypothesized frequent inappropriate antibiotic prescribing and dispensing. We interviewed physicians (n = 236) and pharmacists (n = 483) and conducted focus groups in Minya, Egypt, to assess attitudes and practices regarding antibiotic prescribing for outpatient acute respiratory infections (ARI). Antibiotics were reportedly prescribed most of the time or sometimes for colds by 150 (64%) physicians and 326 (81%) pharmacists. The most commonly prescribed antibiotics were β-lactams. Macrolides were the second most commonly prescribed for colds and sinusitis. The prescription of more than one antibiotic to treat pneumonia was reported by 85% of physicians. Most respondents thought antibiotic overuse contributes to resistance and reported “patient self-medication” as the biggest driver of overuse. Fifty physicians (21%) reported that they had prescribed antibiotics unnecessarily, citing patient over-the-counter access as the reason. Physicians <40 years of age and those who treat adults were more likely to prescribe antibiotics for colds. Overall, we found a high rate of unwarranted outpatient antibiotic prescribing and dispensing for ARIs. Patient access to OTC antibiotics contributes to over-prescribing. National guidelines for ARI treatment, provider education and national policy requiring a physician’s prescription for antibiotics may improve appropriate antibiotic use in Egypt.
Keywords	antibiotics ; antibiotic resistance ; acute respiratory infection ; cold ; bronchitis ; sinusitis ; pneumonia ; pharmacist ; Egypt ; Therapeutics. Pharmacology ; RM1-950 ; Medicine ; R
Language	English
Publishing date	2014-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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