Everlien de Graaf, Merel van Klinken, Danielle Zweers, Saskia Teunissen
From concept to practice, is multidimensional care the leading principle in hospice care? An exploratory mixed method study
BMJ supportive & palliative care
introduction evidence exists individuallevel sociodemographic factors contribute vaccine hesitancy unknown communitylevel factors affect covid19 booster dose hesitancy current study aims fill knowledge gap comparing data nationwide survey covid19 vaccine hesitancy communitylevel indicator ie distressed communities index dci methods attitudes toward vaccinations vaccine literacy covid19 vaccine confidence index trust measured using 48item psychometrically valid reliable survey tool study 2138 survey participants residing united states divided quintiles varying community distress levels based zip codes using dci data analyzed chisquare oneway anova post hoc analysis tukeys test results significantly higher proportion participants distressed communities lower trust prosperous counterparts 266 vs 376 p 0001 contrary participants prosperous communities significantly higher vaccine confidence index scores distressed communities 222 113 vs 170 101 p 0001 conclusions findings affirm importance developing communitylevel interventions promote trust covid19 vaccinations increase booster dose uptake results future studies examine efficacy various communitylevel interventions