Motivations for (non)participation in population-based health studies among the elderly - comparison of participants and nonparticipants of a prospective study on influenza vaccination.
Identifieur interne : 000060 ( Main/Corpus ); précédent : 000059; suivant : 000061Motivations for (non)participation in population-based health studies among the elderly - comparison of participants and nonparticipants of a prospective study on influenza vaccination.
Auteurs : Manas K. Akmatov ; Leonhard Jentsch ; Peggy Riese ; Marcus May ; Malik W. Ahmed ; Damaris Werner ; Anja Rösel ; Jana Prokein ; Inga Bernemann ; Norman Klopp ; Blair Prochnow ; Thomas Illig ; Christoph Schindler ; Carlos A. Guzman ; Frank PesslerSource :
- BMC medical research methodology [ 1471-2288 ] ; 2017.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Influenza Vaccines.
- prevention & control : Influenza, Human.
- psychology : Patient Compliance, Refusal to Participate.
- statistics & numerical data : Vaccination.
- Aged, Female, Germany, Health Surveys, Humans, Male, Motivation, Prospective Studies.
Abstract
BACKGROUND
Participation in epidemiological studies has strongly declined in recent years. We examined the reasons for (non)participation in population-based health studies among participants and nonparticipants of a prospective study on influenza vaccination among the elderly.
METHODS
Males and females between 65 and 80 years of age (N = 5582) were randomly selected from the residents' registration office in Hannover, Germany, and were invited to participate in a study featuring vaccination with a seasonal adjuvanted influenza vaccine (Fluad™, Novartis) including five follow-up visits (day 0, 1/3, 7, 21, 70 with respect to vaccination). A 24-item nonresponder questionnaire, including 10 items on reasons for participating in a hypothetical health study, was mailed to 1500 randomly selected nonparticipants. The same 10 items were included in the end-of-study questionnaire administered to the participants in the vaccination study (n = 200). Logistic regression analysis with backward elimination was used to identify the reasons most strongly associated with nonparticipation.
RESULTS
Five hundred thirty-one (35%) nonparticipants and 200 participants (100%) returned the respective questionnaires. Nonparticipation was associated with a lower interest in obtaining personal health information (OR = 3.32) and a preference for less invasive (OR = 3.01) and less time-demanding (OR = 2.19) studies. Responses to other items, e.g. regarding altruistic motives, monetary compensation, general interest of the study, or study approval through ethics committee and data security authority, did not differ between participants and nonparticipants.
CONCLUSIONS
Participation rates in health studies among elderly individuals could potentially be improved by reducing interventions and time demand, for instance by implementing methods of self-sampling and remote data collection.
TRIAL REGISTRATION
No. 1100359 (ClinicalTrials.gov, date of registration: 09.02.2015).
DOI: 10.1186/s12874-017-0302-z
PubMed: 28148221
Links to Exploration step
pubmed:28148221Le document en format XML
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Akmatov</name><affiliation><nlm:affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany. manas.akmatov@twincore.de.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Helmholtz Centre for Infection Research, Braunschweig, Germany. manas.akmatov@twincore.de.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Individualized Infection Medicine, Hannover, Germany. manas.akmatov@twincore.de.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Research Group "Biomarkers for Infectious Diseases", TWINCORE, Centre for Experimental and Clinical Infection Research, Feodor-Lynen-Str. 7, Hannover, 30625, Germany. manas.akmatov@twincore.de.</nlm:affiliation></affiliation></author><author><name sortKey="Jentsch, Leonhard" sort="Jentsch, Leonhard" uniqKey="Jentsch L" first="Leonhard" last="Jentsch">Leonhard Jentsch</name><affiliation><nlm:affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Riese, Peggy" sort="Riese, Peggy" uniqKey="Riese P" first="Peggy" last="Riese">Peggy Riese</name><affiliation><nlm:affiliation>Helmholtz Centre for Infection Research, Braunschweig, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="May, Marcus" sort="May, Marcus" uniqKey="May M" first="Marcus" last="May">Marcus May</name><affiliation><nlm:affiliation>MHH CRC Core Facility, Hannover Medical School, Hannover, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Ahmed, Malik W" sort="Ahmed, Malik W" uniqKey="Ahmed M" first="Malik W" last="Ahmed">Malik W. 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Guzman</name><affiliation><nlm:affiliation>Helmholtz Centre for Infection Research, Braunschweig, Germany.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Individualized Infection Medicine, Hannover, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Pessler, Frank" sort="Pessler, Frank" uniqKey="Pessler F" first="Frank" last="Pessler">Frank Pessler</name><affiliation><nlm:affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Helmholtz Centre for Infection Research, Braunschweig, Germany.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Individualized Infection Medicine, Hannover, Germany.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:28148221</idno><idno type="pmid">28148221</idno><idno type="doi">10.1186/s12874-017-0302-z</idno><idno type="wicri:Area/Main/Corpus">000060</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000060</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Motivations for (non)participation in population-based health studies among the elderly - comparison of participants and nonparticipants of a prospective study on influenza vaccination.</title><author><name sortKey="Akmatov, Manas K" sort="Akmatov, Manas K" uniqKey="Akmatov M" first="Manas K" last="Akmatov">Manas K. Akmatov</name><affiliation><nlm:affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany. manas.akmatov@twincore.de.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Helmholtz Centre for Infection Research, Braunschweig, Germany. manas.akmatov@twincore.de.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Individualized Infection Medicine, Hannover, Germany. manas.akmatov@twincore.de.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Research Group "Biomarkers for Infectious Diseases", TWINCORE, Centre for Experimental and Clinical Infection Research, Feodor-Lynen-Str. 7, Hannover, 30625, Germany. manas.akmatov@twincore.de.</nlm:affiliation></affiliation></author><author><name sortKey="Jentsch, Leonhard" sort="Jentsch, Leonhard" uniqKey="Jentsch L" first="Leonhard" last="Jentsch">Leonhard Jentsch</name><affiliation><nlm:affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Riese, Peggy" sort="Riese, Peggy" uniqKey="Riese P" first="Peggy" last="Riese">Peggy Riese</name><affiliation><nlm:affiliation>Helmholtz Centre for Infection Research, Braunschweig, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="May, Marcus" sort="May, Marcus" uniqKey="May M" first="Marcus" last="May">Marcus May</name><affiliation><nlm:affiliation>MHH CRC Core Facility, Hannover Medical School, Hannover, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Ahmed, Malik W" sort="Ahmed, Malik W" uniqKey="Ahmed M" first="Malik W" last="Ahmed">Malik W. Ahmed</name><affiliation><nlm:affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Werner, Damaris" sort="Werner, Damaris" uniqKey="Werner D" first="Damaris" last="Werner">Damaris Werner</name><affiliation><nlm:affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Rosel, Anja" sort="Rosel, Anja" uniqKey="Rosel A" first="Anja" last="Rösel">Anja Rösel</name><affiliation><nlm:affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Prokein, Jana" sort="Prokein, Jana" uniqKey="Prokein J" first="Jana" last="Prokein">Jana Prokein</name><affiliation><nlm:affiliation>Hannover Unified Biobank, Hannover Medical School, Hannover, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Bernemann, Inga" sort="Bernemann, Inga" uniqKey="Bernemann I" first="Inga" last="Bernemann">Inga Bernemann</name><affiliation><nlm:affiliation>Hannover Unified Biobank, Hannover Medical School, Hannover, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Klopp, Norman" sort="Klopp, Norman" uniqKey="Klopp N" first="Norman" last="Klopp">Norman Klopp</name><affiliation><nlm:affiliation>Hannover Unified Biobank, Hannover Medical School, Hannover, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Prochnow, Blair" sort="Prochnow, Blair" uniqKey="Prochnow B" first="Blair" last="Prochnow">Blair Prochnow</name><affiliation><nlm:affiliation>Helmholtz Centre for Infection Research, Braunschweig, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Illig, Thomas" sort="Illig, Thomas" uniqKey="Illig T" first="Thomas" last="Illig">Thomas Illig</name><affiliation><nlm:affiliation>Hannover Unified Biobank, Hannover Medical School, Hannover, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Schindler, Christoph" sort="Schindler, Christoph" uniqKey="Schindler C" first="Christoph" last="Schindler">Christoph Schindler</name><affiliation><nlm:affiliation>MHH CRC Core Facility, Hannover Medical School, Hannover, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Guzman, Carlos A" sort="Guzman, Carlos A" uniqKey="Guzman C" first="Carlos A" last="Guzman">Carlos A. Guzman</name><affiliation><nlm:affiliation>Helmholtz Centre for Infection Research, Braunschweig, Germany.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Individualized Infection Medicine, Hannover, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Pessler, Frank" sort="Pessler, Frank" uniqKey="Pessler F" first="Frank" last="Pessler">Frank Pessler</name><affiliation><nlm:affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Helmholtz Centre for Infection Research, Braunschweig, Germany.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Individualized Infection Medicine, Hannover, Germany.</nlm:affiliation></affiliation></author></analytic><series><title level="j">BMC medical research methodology</title><idno type="eISSN">1471-2288</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Female</term><term>Germany</term><term>Health Surveys</term><term>Humans</term><term>Influenza Vaccines (therapeutic use)</term><term>Influenza, Human (prevention & control)</term><term>Male</term><term>Motivation</term><term>Patient Compliance (psychology)</term><term>Prospective Studies</term><term>Refusal to Participate (psychology)</term><term>Vaccination (statistics & numerical data)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Patient Compliance</term><term>Refusal to Participate</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Vaccination</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Germany</term><term>Health Surveys</term><term>Humans</term><term>Male</term><term>Motivation</term><term>Prospective Studies</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Participation in epidemiological studies has strongly declined in recent years. We examined the reasons for (non)participation in population-based health studies among participants and nonparticipants of a prospective study on influenza vaccination among the elderly.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Males and females between 65 and 80 years of age (N = 5582) were randomly selected from the residents' registration office in Hannover, Germany, and were invited to participate in a study featuring vaccination with a seasonal adjuvanted influenza vaccine (Fluad™, Novartis) including five follow-up visits (day 0, 1/3, 7, 21, 70 with respect to vaccination). A 24-item nonresponder questionnaire, including 10 items on reasons for participating in a hypothetical health study, was mailed to 1500 randomly selected nonparticipants. The same 10 items were included in the end-of-study questionnaire administered to the participants in the vaccination study (n = 200). Logistic regression analysis with backward elimination was used to identify the reasons most strongly associated with nonparticipation.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Five hundred thirty-one (35%) nonparticipants and 200 participants (100%) returned the respective questionnaires. Nonparticipation was associated with a lower interest in obtaining personal health information (OR = 3.32) and a preference for less invasive (OR = 3.01) and less time-demanding (OR = 2.19) studies. Responses to other items, e.g. regarding altruistic motives, monetary compensation, general interest of the study, or study approval through ethics committee and data security authority, did not differ between participants and nonparticipants.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Participation rates in health studies among elderly individuals could potentially be improved by reducing interventions and time demand, for instance by implementing methods of self-sampling and remote data collection.</p></div><div type="abstract" xml:lang="en"><p><b>TRIAL REGISTRATION</b></p><p>No. 1100359 (ClinicalTrials.gov, date of registration: 09.02.2015).</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28148221</PMID><DateCompleted><Year>2017</Year><Month>10</Month><Day>31</Day></DateCompleted><DateRevised><Year>2019</Year><Month>01</Month><Day>09</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2288</ISSN><JournalIssue CitedMedium="Internet"><Volume>17</Volume><Issue>1</Issue><PubDate><Year>2017</Year><Month>02</Month><Day>02</Day></PubDate></JournalIssue><Title>BMC medical research methodology</Title><ISOAbbreviation>BMC Med Res Methodol</ISOAbbreviation></Journal><ArticleTitle>Motivations for (non)participation in population-based health studies among the elderly - comparison of participants and nonparticipants of a prospective study on influenza vaccination.</ArticleTitle><Pagination><MedlinePgn>18</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12874-017-0302-z</ELocationID><Abstract><AbstractText Label="BACKGROUND">Participation in epidemiological studies has strongly declined in recent years. We examined the reasons for (non)participation in population-based health studies among participants and nonparticipants of a prospective study on influenza vaccination among the elderly.</AbstractText><AbstractText Label="METHODS">Males and females between 65 and 80 years of age (N = 5582) were randomly selected from the residents' registration office in Hannover, Germany, and were invited to participate in a study featuring vaccination with a seasonal adjuvanted influenza vaccine (Fluad™, Novartis) including five follow-up visits (day 0, 1/3, 7, 21, 70 with respect to vaccination). A 24-item nonresponder questionnaire, including 10 items on reasons for participating in a hypothetical health study, was mailed to 1500 randomly selected nonparticipants. The same 10 items were included in the end-of-study questionnaire administered to the participants in the vaccination study (n = 200). Logistic regression analysis with backward elimination was used to identify the reasons most strongly associated with nonparticipation.</AbstractText><AbstractText Label="RESULTS">Five hundred thirty-one (35%) nonparticipants and 200 participants (100%) returned the respective questionnaires. Nonparticipation was associated with a lower interest in obtaining personal health information (OR = 3.32) and a preference for less invasive (OR = 3.01) and less time-demanding (OR = 2.19) studies. Responses to other items, e.g. regarding altruistic motives, monetary compensation, general interest of the study, or study approval through ethics committee and data security authority, did not differ between participants and nonparticipants.</AbstractText><AbstractText Label="CONCLUSIONS">Participation rates in health studies among elderly individuals could potentially be improved by reducing interventions and time demand, for instance by implementing methods of self-sampling and remote data collection.</AbstractText><AbstractText Label="TRIAL REGISTRATION">No. 1100359 (ClinicalTrials.gov, date of registration: 09.02.2015).</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Akmatov</LastName><ForeName>Manas K</ForeName><Initials>MK</Initials><AffiliationInfo><Affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany. manas.akmatov@twincore.de.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Helmholtz Centre for Infection Research, Braunschweig, Germany. manas.akmatov@twincore.de.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Individualized Infection Medicine, Hannover, Germany. manas.akmatov@twincore.de.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Research Group "Biomarkers for Infectious Diseases", TWINCORE, Centre for Experimental and Clinical Infection Research, Feodor-Lynen-Str. 7, Hannover, 30625, Germany. manas.akmatov@twincore.de.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jentsch</LastName><ForeName>Leonhard</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Riese</LastName><ForeName>Peggy</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Helmholtz Centre for Infection Research, Braunschweig, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>May</LastName><ForeName>Marcus</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>MHH CRC Core Facility, Hannover Medical School, Hannover, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ahmed</LastName><ForeName>Malik W</ForeName><Initials>MW</Initials><AffiliationInfo><Affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Werner</LastName><ForeName>Damaris</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rösel</LastName><ForeName>Anja</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Prokein</LastName><ForeName>Jana</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Hannover Unified Biobank, Hannover Medical School, Hannover, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bernemann</LastName><ForeName>Inga</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Hannover Unified Biobank, Hannover Medical School, Hannover, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Klopp</LastName><ForeName>Norman</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Hannover Unified Biobank, Hannover Medical School, Hannover, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Prochnow</LastName><ForeName>Blair</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Helmholtz Centre for Infection Research, Braunschweig, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Illig</LastName><ForeName>Thomas</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Hannover Unified Biobank, Hannover Medical School, Hannover, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schindler</LastName><ForeName>Christoph</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>MHH CRC Core Facility, Hannover Medical School, Hannover, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Guzman</LastName><ForeName>Carlos A</ForeName><Initials>CA</Initials><AffiliationInfo><Affiliation>Helmholtz Centre for Infection Research, Braunschweig, Germany.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Individualized Infection Medicine, Hannover, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pessler</LastName><ForeName>Frank</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Helmholtz Centre for Infection Research, Braunschweig, Germany.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Individualized Infection Medicine, Hannover, Germany.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><DataBankList CompleteYN="Y"><DataBank><DataBankName>ClinicalTrials.gov</DataBankName><AccessionNumberList><AccessionNumber>NCT02362919</AccessionNumber></AccessionNumberList></DataBank></DataBankList><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>02</Month><Day>02</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Med Res 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use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009042" MajorTopicYN="N">Motivation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010349" MajorTopicYN="N">Patient Compliance</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D045808" MajorTopicYN="N">Refusal to Participate</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014611" MajorTopicYN="N">Vaccination</DescriptorName><QualifierName UI="Q000706" 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