The EQ-HWB: Overview of the Development of a Measure of Health and Wellbeing and Key Results

ObjectivesExisting measures for estimating quality-adjusted life-years are mostly limited to health-related quality of life. This article presents an overview of the development the EQ-HWB (EQ Health and Wellbeing), which is a measure that encompasses health and wellbeing.MethodsStages: (1) Establishing domains through reviews of the qualitative literature informed by a conceptual framework. (2) Generation and selection of items to cover the domains. (3) Face validation of these items through qualitative interviews with 168 patients, social care users, general population, and carers across 6 countries (Argentina, Australia, China, Germany, United Kingdom, United States). (4) Extensive psychometric testing of candidate items (using classical, factor analysis, and item response theory methods) on > 4000 respondents in the 6 countries. Stakeholders were consulted throughout.ResultsA total of 32 subdomains grouped into 7 high-level domains were identified from the qualitative literature and 97 items generated to cover them. Face validation eliminated 36 items, modified 14, and added 3. Psychometric testing of 64 items found little difference in missing data or problems with response distribution, the conceptual model was confirmed except in China, and most items performed well in the item response theory in all countries. Evidence was presented to stakeholders in 2 rounds of consultation to inform the final selection of items for the EQ-HWB (25-item) and the short version of EQ-HWB (9-items).ConclusionsEQ-HWB measures have been developed internationally for evaluating interventions in health, public health, and social care including the impact on patients, social care users, and carers.     

Immunity debt or vaccination crisis? A multi-method evidence on vaccine acceptance and media framing for emerging COVID-19 variants

Renewed COVID-19 outbreaks, stemming from the highly infectious Delta and Omicron variants, prompted rising fears of a ‘pandemic among the unvaccinated’. To address this prevalent vaccination crisis, media framing communication strategies can amplify the scientific evidence on COVID-19 vaccines to reach diverse geographic and socio-economic communities. The critical role of media framing strategies to engage and encourage large populations regarding vaccine acceptance has been rarely studied, despite growing evidence on vaccine hesitancy. The present study used a multi-method approach (i.e., content analysis and quasi-experiments) that unpacked the framing practices employed by the mainstream media in Pakistan. The findings of the content analysis revealed that the media extensively used uncertainty, conflict, consequences, and action rather than new evidence and reassurance frames in its COVID-19 related campaigns. In a series of quasi-experiments involving 720 participants, we manipulated these six frames of COVID-19 related news coverage (i.e., uncertainty, conflict, consequences, action, new evidence, and reassurance) to investigate the underlying mechanism that influences vaccine acceptance. The findings established that the message-consistent effects of media frames manifesting fear (e.g., consequence and uncertainty) and action cues made receivers more supportive of vaccination. The present study findings theoretically address the calls for a more inclusive “community-health reporting model”, besides offering new evidence on the media framing strategies to deliver more targeted, meaningful, and effective campaigns to raise public acceptance for COVID-19 vaccines.     

社会力量参与公立互联网医院建设激励与约束机制研究

社会力量具备相应的经济基础和技术条件,对于公立互联网医院体系建设具有积极的促进作用。但是实践中仍然存在商业模式不完善、监管制度不健全等问题。基于经济学契约理论要义,提出在坚持激励与约束机制并举、平衡公私益关系的前提下,通过完善医保政策、构建互联网医疗服务价格分类管理机制来促进社会力量向医疗服务公益性目标回归,并通过构建完善的监督体制来约束部分社会力量的盲目逐利性行为。     

Vaccination against HPV: boosting coverage and tackling misinformation

The availability of human papillomavirus (HPV) vaccines and screening tests has raised the possibility of globally eliminating cervical cancer, which is caused by HPV. Cervical cancer is a very common malignancy worldwide, especially among deprived women. High vaccination coverage is key to the containment and eventual elimination of the infection. Public HPV vaccination programmes in Italy and Denmark were swiftly established and are among the most successful worldwide. Still, in both countries, it has been challenging to achieve and maintain the recommended coverage of > 80% in girls. In a well‐studied Italian region, vaccination coverage in girls at age 15 years (World Health Organization''s gold standard) reached 76% in 2015 but decreased to 69% in 2018, likely due to work overload in public immunization centres. In Denmark, doubts about safety and efficacy of the HPV vaccine generated a decline in coverage among girls age 12–17, from 80% in 2013 down to 37% in 2015, when remedial actions made it rise again. Insights from these two countries are shared to illustrate the importance of monitoring coverage in a digital vaccine registry and promptly reacting to misinformation about vaccination.

Abbreviations

CC

cervical cancer

FVG

Friuli Venezia Giulia

HICs

high‐income countries

HPV

human papillomavirus

LMICs

middle‐income countries

WHO

World Health Organization

     

Swedish neonatal nurses’ experiences of enhancing attachment to children born prematurely

The purpose of this study was to illuminate pediatric neonatal nurses' (PNNs') experiences of enhancing early attachment for the premature children in neonatal intensive care (NIC). An interview study with 8 PNNs in NIC in southeastern Sweden was conducted, and analyzed by content analysis. Result, illustrated three categories: Enabling closeness between the child and the parents, Supporting parents’ sense of parenthood, and Obstacles to enhancing attachment. Discussion, PNNs have a great role to supporting parents, but several barriers need to be addressed to make it easier for the PNN in NIC to enhance attachment for the child.