Lars Korn

On the benefits of explaining herd immunity in vaccine advocacy

Most vaccines protect both the vaccinated individual and the community at large by building up herd immunity. Even though reaching disease-specific herd immunity thresholds is crucial for eliminating or eradicating certain diseases1,2, explanation of this concept remains rare in vaccine advocacy3. An awareness of this social benefit makes vaccination not only an individual but also a social decision. Although knowledge of herd immunity can induce prosocial vaccination in order to protect others, it can also invite free-riding, in which individuals profit from the protection provided by a well-vaccinated society without contributing to herd immunity themselves. This cross-cultural experiment assesses whether people will be more or less likely to be vaccinated when they know more about herd immunity. Results show that in cultures that focus on collective benefits, vaccination willingness is generally higher. Communicating the concept of herd immunity improved willingness to vaccinate, especially in cultures lacking this prosocial cultural background. Prosocial nudges can thus help to close these immunity gaps.

Improving Medical Decision Making and Health Promotion through Culture-Sensitive Health Communication An Agenda for Science and Practice

This review introduces the concept of culture-sensitive health communication. The basic premise is that congruency between the recipient’s cultural characteristics and the respective message will increase the communication’s effectiveness. Culture-sensitive health communication is therefore defined as the deliberate and evidence-informed adaptation of health communication to the recipients’ cultural background in order to increase knowledge and improve decision preparedness in medical decision making, and to enhance the persuasiveness of messages in health promotion. To achieve effective health communication in varying cultural contexts, an empirically and theoretically based understanding of culture will be indispensable. We therefore define culture, discuss which evolutionary and structural factors contribute to the development of cultural diversity, and how differences are conceptualized as scientific constructs in current models of cultural differences. Additionally, we will explicate the implications of cultural differences for psychological theorizing, because common constructs of health behavior theories and decision making, such as attitudes or risk perception, are subject to cultural variation. In terms of communication we will review both communication strategies as well as channels that are used to disseminate health messages, and discuss the implications of cultural differences for their effectiveness. Finally, we propose both an agenda for science as well as for practice to advance and apply the evidence base for culture-sensitive health communication. This calls for more interdisciplinary research: between science and practice, but also between scientific disciplines and between basic and applied research.This review introduces the concept of culture-sensitive health communication. The basic premise is that congruency between the recipient’s cultural characteristics and the respective message will increase the communication’s effectiveness. Culture-sensitive health communication is therefore defined as the deliberate and evidence-informed adaptation of health communication to the recipients’ cultural background in order to increase knowledge and improve preparation for medical decision making and to enhance the persuasiveness of messages in health promotion. To achieve effective health communication in varying cultural contexts, an empirically and theoretically based understanding of culture will be indispensable. We therefore define culture, discuss which evolutionary and structural factors contribute to the development of cultural diversity, and examine how differences are conceptualized as scientific constructs in current models of cultural differences. In addition, we will explicate the implications of cultural differences for psychological theorizing, because common constructs of health behavior theories and decision making, such as attitudes or risk perception, are subject to cultural variation. In terms of communication, we will review both communication strategies and channels that are used to disseminate health messages, and we will discuss the implications of cultural differences for their effectiveness. Finally, we propose an agenda both for science and for practice to advance and apply the evidence base for culture-sensitive health communication. This calls for more interdisciplinary research between science and practice but also between scientific disciplines and between basic and applied research.

Don’t try to convert the antivaccinators, instead target the fence-sitters

Developing effective communication strategies to increase vaccine uptake is crucial in times of increasing vaccine hesitancy and repeated outbreaks of vaccine-preventable diseases. Horne et al. (1) conclude from their study that a combination of warnings, an anecdote about a sick child, and pictures thereof are suitable to counter antivaccination attitudes; however, correcting vaccination myths proved unsuccessful. Yet, the study is somewhat fuzzy about what “antivaccination” actually means. It further summarizes different constructs in a single-attitude variable that we believe deserve separate attention. These two considerations led us to reanalyze the study’s data, resulting in the additional, important conclusions outlined below.

Exploring and Promoting Prosocial Vaccination: A Cross-Cultural Experiment on Vaccination of Health Care Personnel

Influenza vaccination for health care personnel (HCP) is recommended particularly because it indirectly protects patients from contracting the disease. Vaccinating can therefore be interpreted as a prosocial act. However, HCP vaccination rates are often far too low to prevent nosocomial infections. Effective interventions are needed to increase HCPs influenza vaccine uptake. Here we devise a novel tool to experimentally test interventions that aim at increasing prosocially motivated vaccine uptake under controlled conditions. We conducted a large-scale and cross-cultural experiment with participants from countries with either a collectivistic (South Korea) or an individualistic (USA) cultural background. Results showed that prosocially motivated vaccination was more likely in South Korea compared to the US, mediated by a greater perception of vaccination as a social act. However, changing the default of vaccination, such that participants had to opt out rather than to opt in, increased vaccine uptake in the US and therefore compensated for the lower level of prosocial vaccination. In sum, the present study provides both a novel method to investigate HCP influenza vaccination behavior and interventions to increase their vaccine uptake.

Using Attachment and Relational Perspectives to Understand Adaptation and Resilience among Immigrant and Refugee Youth

Migration is a critical issue for child development in the 21st century. We expand on García Coll et al.’s (1996) integrative model of minority child development by drawing from principles of attachment theory and interpersonal relationships research to offer new insights into how youth manage and respond to migration experiences. Immigrant and refugee youth should experience better outcomes to the extent that they (a) maintain strong relationships with caregivers and peers who provide a sense of closeness, safety, and confidence during the process of adjusting to this life transition and (b) find ways to establish a sense of connection and belonging to the new people, places, communities, and social networks within which they now live. Strong bonds to people and connection to places (both familiar and new) can counter the social stratification consequences to minority youth development that are well articulated in García Coll et al.’s integrative model. The need for new and better strategies that promote the positive development of immigrant and refugee youth within their families, schools, workplaces, and communities is crucial, not only for individuals and families but for society as a whole.

Drawbacks of communicating refugee vaccination rates

364 www.thelancet.com/infection Vol 17 April 2017 See Online for appendix leading to discrimination against refugees. To prevent discrimination, the authors recommend debunking misconceptions about disease risks. Although we agree that measures to decrease discrimination are crucial, we argue that communicating refugees’ high vaccination uptake can have detrimental effects on the host population’s prevention behaviour. Most vaccinations provide, beyond individual protection of the vaccinated individual, a social benefit by reducing the transmission of pathogens and the risk of infection. From an individual perspective, the utility of vaccination thus decreases as vaccination uptake in society increases. Eventually, vaccination can even turn out to be irrational from a selfish-rational view point, when subjectively perceived vaccination risks surpass the perceived disease risks. However, from a societal perspective, vaccination is still required when uptake is already high to allow elimination of diseases. This conjecture led us to hypothesise that knowledge about high vaccine uptake in the refugee population can have detrimental effects on the host population’s vaccination behaviour. We tested this hypothesis using an interactive vaccination game (appendix). Participants, representing the host population, received information about a hypothetical influx of refugees and their vaccination uptake (clustered as low, medium, and high uptake, and no uptake information; figure). Participants subsequently indicated their vaccination decision for each situation (for statistical methods, see appendix). The figure shows that vaccination behaviour in the host population declined with increasing vaccine uptake in refugees. In host populations with high uptake in the previous rounds of the game, vaccination willingness decreased more strongly than in populations with low previous uptake. In uncertainty (ie, no information), vaccination behaviour Drawbacks of communicating refugee vaccination rates

Social nudging: The effect of social feedback interventions on vaccine uptake.

Objective: Most vaccines provide indirect community protection by preventing the transmission of the disease. Paradoxically, this effect can also motivate omission of vaccination because increasing vaccination rates reduce the risk of infection and, therefore, the individual benefit of vaccination. Consequently, vaccination becomes a social dilemma where individuals’ interests conflict with group interests. The current study investigated two social nudge interventions aiming to increasing individuals’ motivation to act in the group’s interest. Rewarding the attainment of the goal (disease elimination) is hypothesized to increase goal-directed behavior (vaccination). Further, it is assumed that comparisons with another group increase cooperative vaccination within one’s own group. Method: In a laboratory experiment, the interactive vaccination (I-Vax) game was used to model the direct and indirect effects of vaccinations. The game was played by 288 participants over 20 rounds. The experimental setup varied the feedback information after each round to implement a 2 (rewarding goal-attainment: present vs. absent) × 2 (intergroup comparison: present vs. absent) between-subjects design. Results: Analyses revealed the expected positive effect of rewarding goal-attainment, which was particularly strong at the beginning and weakened over the course of repeated decisions. The effect of intergroup comparisons was also positive but did not reach conventional criteria of statistical significance. Conclusions: The current experiment shows that communicating and rewarding “small wins” may increase individuals’ willingness to act in the group’s interest. Intergroup processes deserve further attention and investigation as potential strategies for improving vaccine communication and advocacy.

Improving medical decision making through culture-sensitive health communication – An agenda for science and practice

This review introduces the concept of culture-sensitive health communication. The basic premise is that congruency between the recipient’s cultural characteristics and the respective message will increase the communication’s effectiveness. Culture-sensitive health communication is therefore defined as the deliberate and evidence-informed adaptation of health communication to the recipients’ cultural background in order to increase knowledge and improve decision preparedness in medical decision making, and to enhance the persuasiveness of messages in health promotion. To achieve effective health communication in varying cultural contexts, an empirically and theoretically based understanding of culture will be indispensable. We therefore define culture, discuss which evolutionary and structural factors contribute to the development of cultural diversity, and how differences are conceptualized as scientific constructs in current models of cultural differences. Additionally, we will explicate the implications of cultural differences for psychological theorizing, because common constructs of health behavior theories and decision making, such as attitudes or risk perception, are subject to cultural variation. In terms of communication we will review both communication strategies as well as channels that are used to disseminate health messages, and discuss the implications of cultural differences for their effectiveness. Finally, we propose both an agenda for science as well as for practice to advance and apply the evidence base for culture-sensitive health communication. This calls for more interdisciplinary research: between science and practice, but also between scientific disciplines and between basic and applied research.This review introduces the concept of culture-sensitive health communication. The basic premise is that congruency between the recipient’s cultural characteristics and the respective message will increase the communication’s effectiveness. Culture-sensitive health communication is therefore defined as the deliberate and evidence-informed adaptation of health communication to the recipients’ cultural background in order to increase knowledge and improve preparation for medical decision making and to enhance the persuasiveness of messages in health promotion. To achieve effective health communication in varying cultural contexts, an empirically and theoretically based understanding of culture will be indispensable. We therefore define culture, discuss which evolutionary and structural factors contribute to the development of cultural diversity, and examine how differences are conceptualized as scientific constructs in current models of cultural differences. In addition, we will explicate the implications of cultural differences for psychological theorizing, because common constructs of health behavior theories and decision making, such as attitudes or risk perception, are subject to cultural variation. In terms of communication, we will review both communication strategies and channels that are used to disseminate health messages, and we will discuss the implications of cultural differences for their effectiveness. Finally, we propose an agenda both for science and for practice to advance and apply the evidence base for culture-sensitive health communication. This calls for more interdisciplinary research between science and practice but also between scientific disciplines and between basic and applied research.

Improving Medical Decision Making and Health Promotion through Culture-Sensitive Health Communication

This review introduces the concept of culture-sensitive health communication. The basic premise is that congruency between the recipient’s cultural characteristics and the respective message will increase the communication’s effectiveness. Culture-sensitive health communication is therefore defined as the deliberate and evidence-informed adaptation of health communication to the recipients’ cultural background in order to increase knowledge and improve decision preparedness in medical decision making, and to enhance the persuasiveness of messages in health promotion. To achieve effective health communication in varying cultural contexts, an empirically and theoretically based understanding of culture will be indispensable. We therefore define culture, discuss which evolutionary and structural factors contribute to the development of cultural diversity, and how differences are conceptualized as scientific constructs in current models of cultural differences. Additionally, we will explicate the implications of cultural differences for psychological theorizing, because common constructs of health behavior theories and decision making, such as attitudes or risk perception, are subject to cultural variation. In terms of communication we will review both communication strategies as well as channels that are used to disseminate health messages, and discuss the implications of cultural differences for their effectiveness. Finally, we propose both an agenda for science as well as for practice to advance and apply the evidence base for culture-sensitive health communication. This calls for more interdisciplinary research: between science and practice, but also between scientific disciplines and between basic and applied research.This review introduces the concept of culture-sensitive health communication. The basic premise is that congruency between the recipient’s cultural characteristics and the respective message will increase the communication’s effectiveness. Culture-sensitive health communication is therefore defined as the deliberate and evidence-informed adaptation of health communication to the recipients’ cultural background in order to increase knowledge and improve preparation for medical decision making and to enhance the persuasiveness of messages in health promotion. To achieve effective health communication in varying cultural contexts, an empirically and theoretically based understanding of culture will be indispensable. We therefore define culture, discuss which evolutionary and structural factors contribute to the development of cultural diversity, and examine how differences are conceptualized as scientific constructs in current models of cultural differences. In addition, we will explicate the implications of cultural differences for psychological theorizing, because common constructs of health behavior theories and decision making, such as attitudes or risk perception, are subject to cultural variation. In terms of communication, we will review both communication strategies and channels that are used to disseminate health messages, and we will discuss the implications of cultural differences for their effectiveness. Finally, we propose an agenda both for science and for practice to advance and apply the evidence base for culture-sensitive health communication. This calls for more interdisciplinary research between science and practice but also between scientific disciplines and between basic and applied research.