The Mediating Effect of Distrust of the Health System on the Relationship Between Health Literacy and Anti-Vaccination

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-06-23 DOI:10.1111/jep.70140

Şehriban Özdemir, Fatih Şantaş

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引用次数: 0

Abstract

Aim

This study aims to determine whether distrust of the health system has a mediating role in the effect of health literacy on anti-vaccination.

Methods

The universe of the study consists of people over the age of 18 who apply to the polyclinics of Yozgat Akdağmadeni Şehit Sinan Babacan Public Hospital in Turkey and the number of people reached in this study was 450.

Findings

According to the Process Macro analysis result, the total effect of health literacy on anti-vaccination (c = −0.115, p < 0.01) and its direct effect (c' = −0.073, p < 0.01) were negative and statistically significant. It was determined that health literacy negatively and significantly affected distrust of the health system (a = −0.098, p < 0.01) and distrust of the health system positively and significantly affected anti-vaccination (b = 0.432, p < 0.01). It was determined that distrust of the health system mediated the effect of health literacy on anti-vaccination in a statistically significant way [= −0.042 95% CI (−0.076; −0.012)]. Similar results were found in the structural equation modeling, but higher standardized and unstandardized loads and explained variance were obtained according to the Process Macro analysis result.

Conclusion

According to the research results, individuals' distrust of the health system and their anti-vaccination can be reduced by increasing their health literacy.

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卫生系统不信任对卫生素养与抗疫苗接种关系的中介作用

目的本研究旨在确定对卫生系统的不信任是否在卫生素养对抗疫苗接种的影响中起中介作用。方法本研究对象为在土耳其Yozgat Akdağmadeni Şehit Sinan Babacan公立医院综合诊所就诊的年龄在18岁以上的人群，研究对象为450人。结果Process Macro分析结果显示，健康素养对抗疫苗接种的总影响（c = - 0.115, p < 0.01）和直接影响（c' = - 0.073, p < 0.01）均为负，且具有统计学意义。结果表明，卫生素养对卫生系统不信任有显著负向影响（a = - 0.098, p < 0.01），对卫生系统不信任有显著正向影响（b = 0.432, p < 0.01）。结果表明，对卫生系统的不信任介导了卫生素养对抗疫苗接种的影响，其统计学意义显著[= - 0.042 95% CI (- 0.076；−0.012)]。结构方程模型得到了类似的结果，但根据过程宏观分析结果得到了更高的标准化和非标准化荷载和解释方差。结论根据研究结果，个人对卫生系统的不信任和反疫苗接种可以通过提高健康素养来减少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.