2_SAGE_Appendicies_Background_final

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condoms featured prominently. Many interventions sought to address contextual issues such asgender norms (often aimed at men) and the influence of individual/social group determinants,especially beliefs and attitudes about reproductive health. Most interventions, particularly in lowincome regions, adopted a dialogue-based (57%) approach; the primary target populations werehealthcare workers, and religious and influential leaders, who as part of the strategy, wereencouraged to involve local community members to bring about change.Which interventions have been most successful?The interventions with the largest effect estimates on uptake of RHT focused on leaders havingdialogue with their communities. Leaders included those from government, religious institutions,and the local community (both male and female). These interventions centred on the interpretationof local religious and cultural norms, particularly around the understanding and perceptions of men,and sought to create an environment to support pro-RHT decision-making. At a broader contextuallevel, group sessions with journalists and mass media campaigns were also used to positive effect tosupport message consistency. As found for vaccine hesitancy, multicomponent interventions provedmost effective.Which interventions have been least successful?There are not as many examples to draw more general statements from for RHT however, theinterventions that were less successful were those that did not engage closely with the individual.Specifically, the use of field workers instead of local opinion leaders was not as effective asemploying both in community group discussions. Familiarity and trust with the messenger seems tobe a key feature in these instances.Objective 3. Evaluation of relevant evaluated strategies relating to vaccine hesitancy.Of 129 studies available to potentially address the questions set out by <strong>SAGE</strong>, only 13 studies wererelevant (reporting on Outcome 1) and eligible (usable data) for inclusion in this section. Overall, ofthe fifteen original PICO questions, only ten were able to be addressed, and often each had only onestudy from which to draw evidence.Thirteen studies met the inclusion criteria for evaluation using GRADE; three were clusterrandomised; three were individually randomised; four were single group cohorts and three were twogroup cohorts. The process of delivering the interventions varied as did the outcomes reported.Consequently only one outcome (two studies) for a single vaccine was pooled; meta-analysis was notfeasible for any of the other outcomes. Summary of relative risk ratios (RR) and evidence quality(GRADE) for each question are presented in Table 2.63
Table 2. PICO questions proposed by <strong>SAGE</strong> working group, RR (95% CI), and evidence quality(GRADE)Theme PICO# QuestionDialoguebased12345678Does the involvement of a religious leader increaseuptake of all vaccines included in primary routineimmunisation in populations with low baselinevaccination coverage (≤50%) compared to a controlgroup/no intervention?Does the involvement of a religious leader increaseuptake of all vaccines included in primary routineimmunisation in populations with high baselinevaccination coverage (≥80%) compared to a controlgroup/no intervention?Does the involvement of a traditional leader increaseuptake of all vaccines included in primary routineimmunisation in populations with low baselinevaccination coverage (≤50%) compared to a controlgroup/no intervention?Does the involvement of a traditional leader increaseuptake of all vaccines included in primary routineimmunisation in populations with high baselinevaccination coverage (≥80%) compared to a controlgroup/no intervention?Does social mobilisation increase uptake of allvaccines included in primary routine immunisation byparents in low income settings compared to a controlgroup/no intervention?Do social media interventions increase uptake of allvaccines included in primary routine immunisationsby parents in high income settings compared to acontrol group/no intervention?Do awareness raising/information provision usingmass media interventions increase uptake of allvaccines included in primary routine immunisation byparents in high income settings compared to a controlgroup/no intervention?Does communication tool-based health care worker(HCW) training increase uptake of all vaccinesincluded in primary routine immunisation by(rostered) patients compared to a control group/nointervention?EvidenceavailableYesRR & 95%CIRR 4.12(3.99, 4.26)EvidenceQuality(GRADE)Very lowNo - -YesRR 4.12(3.99, 4.26)Very lowNo - -YesYesYesYesRange offindings; RR1.54 (1.1,2.15) to RR1050.00(147.96,7451.4)Range offindings; RR2.01 (1.39,2.93) to RR2.38 (1.23,4.6)RR 1.57(1.4, 1.75)Range offindings; RR1.54 (1.33,1.79) to RR3.09 (2.19,4.36)Range:Very lowtoModerateRange:Very lowto LowModerateRange:Low toModerate64
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APPENDICES TO THEREPORT OF THE SAGE
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vaccine hesitancy in low income cou
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INDIVIDUAL andGROUPINFLUENCESInflue
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Another model reviewed by the Worki
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Appendix for Section 4Appendix A4.1
Page 13 and 14: epresented mostly low and middle in
Page 15 and 16: was more hesitant than the younger
Page 17 and 18: a variable or to a lack of understa
Page 19 and 20: References[1] World Health Organiza
Page 21 and 22: Country FVaccine hesitancy is not a
Page 23 and 24: Figure 1. IMs’ opinions regarding
Page 25 and 26: DefinitionVaccination confidence is
Page 27 and 28: Of all participating countries, 19%
Page 29 and 30: Countries from all 3 regions provid
Page 31 and 32: Table 5: Income level of countries
Page 33 and 34: variety of determinants of vaccine
Page 35 and 36: Uruguay no no responseVenezuela no
Page 37 and 38: RussianFederationyesQuestioning dur
Page 39 and 40: Question 2:Was this % measured or e
Page 41 and 42: Of those countries which submitted
Page 43 and 44: Indicator 2:Indicator 2 was modifie
Page 45 and 46: Table 4. Top three reasons for vacc
Page 47 and 48: The overall response rate to both i
Page 49 and 50: Czech Republic No 1. The fear of si
Page 51 and 52: Kyrgyzstan Yes В 2013 году в
Page 53 and 54: Table A5.3 .1: Survey questions to
Page 55 and 56: Table A5.3.1: Survey questions to a
Page 57 and 58: Table A5.3.2: Survey questions to a
Page 59 and 60: Appendix A5.4 WHO EUR Tailoring Imm
Page 61 and 62: Objective 2 - Characteristics of ev
Page 63: Most interventions targeted parents
Page 67 and 68: Dialogue-based interventionsEleven
Page 69 and 70: The impact of information-based tra
Page 71 and 72: Conclusions and implicationsLiterat
Page 73 and 74: Appendix A6A.2 Strategies to addres
Page 75 and 76: change in attitudes).- Most studies
Page 77 and 78: Strategies to address vaccine hesit
Page 79 and 80: Table 1.Summary of published litera
Page 81 and 82: Title/ First author/year of publica
Page 91 and 92: References1. Williams, S.E., What a
Page 93 and 94: Appendix A6C.1 Vaccine Hesitancy La
Page 95 and 96: ii. Google (Hong Kong)• Used the
Page 97 and 98: Categories Key Actors Areas ofWork/
Page 101 and 102: Categories Key Actors Areas ofActio
Page 107 and 108: This landscape analysis, along with
Page 109 and 110: References for Vaccine Hesitancy La
Page 111: 67 Robert Wood Johnson Foundation.
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