Brief digital intervention to increase COVID-19 vaccination among individuals with anxiety or depression

项目摘要 尽管COVID-19感染、严重并发症、住院治疗和死亡的风险增加， 心理健康障碍报告的疫苗犹豫更大，COVID疫苗接种水平低于 一般人口。患有精神健康障碍的人更有可能支持COVID-19 疫苗错误信息，可能介导心理健康和疫苗之间的关系 犹豫能够减轻疫苗犹豫、错误/虚假信息的影响的干预措施， 未接种疫苗的精神疾病患者的后勤障碍是一个紧迫的优先事项。 态度接种是一个简短的，可扩展的战略，以解决错误/虚假信息。在一次准实验性试验中， 我们的团队发现，专门针对COVID-19疫苗的简短在线态度接种干预 错误/虚假信息显著降低了对COVID-19疫苗的犹豫，并增加了对疫苗的耐药性 未接种疫苗的美国成年人的错误信息。然而，它在精神病患者中的有效性 健康状况不明。根据接种理论，态度接种利用了 叙事，价值观和情感，以加强抵抗错误信息，减少犹豫，是很好的- 适合低信息受众和意识形态两极分化或阴谋集团。拟议 研究项目将利用国家追逐COVID队列的基础设施，这是一个大型的， 地理上多样化的社区为基础的美国队列，量身定制和测试的有效性，一个简短的数字 采取态度接种干预措施，增加有焦虑或抑郁症状的成年人的接种。 目的1：描述焦虑和抑郁症状与疫苗/加强剂之间的关系 接种率和疫苗接种的其他相关决定因素（包括对COVID-19错误信息的认可 和疫苗犹豫）在有和没有焦虑/抑郁症的人中 目标2：调整和试点基于证据的态度接种干预措施，以增加COVID-19疫苗接种 并在有焦虑或抑郁症状的成年人中得到提高。 目的3：确定两种简单的数字态度接种干预策略的有效性 通过传统的公共卫生宣传，增加未接种疫苗/接种不足和未加强接种的人的疫苗接种率 成年人了 这项研究直接涉及国家精神卫生研究所和PAR的优先事项：COVID-19 心理健康研究（PAR-22-112）进行“干预有效性研究，以解决疫苗 心理健康人群中的犹豫，吸收和实施。这项研究将迅速 提供证据，为制定和实施提高疫苗接种率的战略提供信息 并减轻COVID-19对精神健康人群的影响。除了COVID大流行之外， 研究可直接应用于未来的流行病和常规疫苗接种运动。

PROJECT SUMMARY Despite increased risk of COVID-19 infection, severe complications, hospitalizations, and death, people with mental health disorders report greater vaccine hesitancy and have lower COVID vaccination levels than the general population. Individuals with mental health disorders are much more likely to endorse COVID-19 vaccine misinformation, which may mediate the relationship between mental health and vaccine hesitancy. Interventions capable of mitigating the impact of vaccine hesitancy, mis/disinformation, and logistical barriers among unvaccinated people with mental health disorders are an urgent priority. Attitudinal inoculation is a brief, scalable strategy to address mis/disinformation. In a quasi-experimental trial, our team found that a brief online attitudinal inoculation intervention specifically addressing COVID-19 vaccine mis/disinformation significantly decreased COVID-19 vaccine hesitancy and increased resistance to vaccine misinformation among unvaccinated US adults. However, its effectiveness among individuals with mental health disorders is unknown. Informed by inoculation theory, attitudinal inoculation leverages the power of narrative, values, and emotion to strengthen resistance to misinformation and reduce hesitancy and is well- suited for low-information audiences and ideologically polarized or conspiratorial groups. The proposed research project will leverage the infrastructure of the national CHASING COVID Cohort, a large and geographically diverse community-based US cohort, to tailor and test the effectiveness of a brief digital attitudinal inoculation intervention to increase vaccination among adults with anxiety or depression symptoms. Aim 1: Characterize the relationship between symptoms of anxiety and depression and vaccine/booster uptake, and other related determinants of vaccine uptake (including endorsement of COVID-19 misinformation and vaccine hesitancy) among those with and without anxiety/depression Aim 2: Adapt and pilot an evidence-based attitudinal inoculation intervention to increase COVID-19 vaccination and boosting among adults with symptoms of anxiety or depression. Aim 3: Determine the effectiveness of two brief digital attitudinal inoculation intervention strategies compared with conventional public health messaging for increasing vaccine uptake in un/undervaccinated and unboosted adults. This study directly addresses the priorities of the National Institute of Mental Health and the PAR: COVID-19 Mental Health Research (PAR-22-112) to conduct “intervention effectiveness research to address vaccine hesitancy, uptake, and implementation among mental health populations.” This research will rapidly generate evidence to inform the development and implementation of strategies to increase vaccination uptake and mitigate the impact of COVID-19 among mental health populations. Beyond the COVID pandemic, this research has direct applicability to future pandemics and routine vaccination campaigns.