Trust in societal factors and vaccine hesitancy in Western Balkans

Abstract Background Countries in the Western Balkans are facing vaccine hesitancy, trying to bring vaccine acceptance and ways to improve it into the focus. Trust in science and institutions, namely political trust, plays an important role and can significantly affects vaccine acceptance. Methods Cross-sectional research was carried out from July to September 2021 in five countries of the Western Balkans (Albania, Bosnia and Herzegovina, North Macedonia, Montenegro and Serbia) and included adult population aged 18 and older (1605 individuals). Convenience sampling was applied using anonymised online questionnaires and Likert scales, shared through online social media, and asking, among others, for trust in societal factors. Results In all countries people had more confidence in health authorities than in political officials. There are no gender differences found in showing trust in societal factors, except in Serbia where women compared to men showed greater trust in health authorities (50.6% vs. 34.4%), as well as in political officials (42.8% vs. 28.2%). The lowest trust in pharmaceutical companies was found in Albania where 34,9% respondents believe that vaccination against COVID-19 is largely promoted by pharmaceutical companies due to financial profits. People who put more trust in societal factors were vaccinated to a greater extent. In Serbia and Albania, the older respondents in general put more trust in societal factors. People who assessed themselves as more religious in Serbia and North Macedonia demonstrated less trust towards societal factors. Conclusions The study demonstrated moderate trust in societal factors in all countries, with greatest trust in health authorities. This implies that health authorities should have a pivotal role, together with physicians in primary health, in promoting vaccination and educating the general public in the Western Balkans. Key messages Vaccine hesitancy is identified as one of the crucial contributors to the decline in vaccine coverage in the Western Balkans. Vaccine hesitancy is associated with the global crisis of trust in science and institutions.

Identifying predictors of e-cigarette use initiation is important for preventing young persons from becoming smokers. Because of the addictiveness, harmful effects but on the other hand attractiveness and fashion for e-cigarettes among young people, teen use of tobacco related products is a significant public health concern. This study evaluated the determinants of susceptibility to e-cigarette use to both ecigarettes use and traditional cigarettes in secondary school students in Poland. This study examined a sample of Polish youths aged 13-19 (n = 19241) attending 192 schools, 12 on average in each voivodship. Logistic regression and multivariable logistic regression models were used to calculate crude and adjusted odds ratios. The profile of susceptibility to ecigarettes use among never e-cigarette users included: pocket money available per month (more than 150 PLN) (OR = 1.7; p = 0.001), 16-17 years old (OR = 1.9; p = 0.001), parental tobacco smoking and e-cigarette usage (OR = 2.0; p = 0.01 and OR = 1.7; p = 0.001 respectively), maternal secondary education (OR = 1.1; p = 0.04) and living in big cities >500 thou. inhabitants (OR = 1.4; p = 0.04). E-cigarette susceptible persons among ever users were similar to never cigarette users in their opinion that e-cigarettes use are less harmful than conventional smoking (OR = 1.6; p = 0.0012) and living with both parents smoking cigarettes (OR = 1.3; p = 0.02). Additionally, the determinants were: female gender (OR = 1.5; p = 0.009) in the age group less than 15 years of age (OR = 1.3; p = 0.007). The results revealed that such basic predictors as: parental smoking and opinion of lower harmfulness of e-cigarettes use are the most important determinants of smoking susceptibility among never or ever e-cigarette users. The intervention should be focused on educating the young people and their parents on the addictiveness and harmful effects of e-cigarette use and smoking. Key messages: Such basic predictors as: parental smoking and opinion of lower harmfulness of e-cigarettes use are the most important determinants of smoking susceptibility among never or ever e-cigarette users.
The intervention should be focused on educating the young people and their parents on the addictiveness and harmful effects of e-cigarette use and smoking.

Abstract citation ID: ckac130.156 Trust in societal factors and vaccine hesitancy in Western Balkans
Background: Countries in the Western Balkans are facing vaccine hesitancy, trying to bring vaccine acceptance and ways to improve it into the focus. Trust in science and institutions, namely political trust, plays an important role and can significantly affects vaccine acceptance.

Methods:
Cross-sectional research was carried out from July to September 2021 in five countries of the Western Balkans (Albania, Bosnia and Herzegovina, North Macedonia, Montenegro and Serbia) and included adult population aged 18 and older (1605 individuals). Convenience sampling was applied using anonymised online questionnaires and Likert scales, shared through online social media, and asking, among others, for trust in societal factors.

Results:
In all countries people had more confidence in health authorities than in political officials. There are no gender differences found in showing trust in societal factors, except in Serbia where women compared to men showed greater trust in health authorities (50.6% vs. 34.4%), as well as in political officials (42.8% vs. 28.2%). The lowest trust in pharmaceutical companies was found in Albania where 34,9% respondents believe that vaccination against COVID-19 is largely promoted by pharmaceutical companies due to financial profits. People who put more trust in societal factors were vaccinated to a greater extent. In Serbia and Albania, the older respondents in general put more trust in societal factors. People who assessed themselves as more religious in Serbia and North Macedonia demonstrated less trust towards societal factors.

Background:
Comprehensive sexuality education (CSE) is an integrated approach to sexual health and wellbeing promotion, especially effective when performed in school settings, but it is not included in Italian school curricula. This study describes the creation and early results of a pilot experience targeting students attending 20 lower secondary schools (LSS) in 4 Italian regions within EduForIST project, funded by the Ministry of Health.

Methods:
A literature review and a national survey were used to collect guidelines and best practices in the field of sexuality education (SE), along with focus groups and multisectorial expert consultations. The results informed the development of 4 modules of 2 hours each, addressing: changes in adolescence; emotions and relationships; sexual identities and diversity; sexual consent, pregnancy and sexually transmitted infection (STI) prevention, sexual health services. A final session was dedicated to evaluation.

Results:
The pre-test results referred to 14 classrooms of 5 schools within 2 Regions, for a total of 266 students. A high level of uncertainty was reported, regarding the topics of personal identity development (37,4%), experiencing intense emotions during adolescence (18,1%), the definitions of gender identity, sexual orientation and stereotype (42,1%), STI symptoms (58,7%) and prevention (43,4%). The post-test results were available for 153 students. Pre/post analysis showed an increase of correct answers (p<.05) for 12/15 items investigated. A total of 102 students responded to the satisfaction questionnaire, with positive results.

Conclusions:
Preliminary results revealed knowledge gaps and high levels of uncertainty among LSS students. Early pre/post evaluation suggested that the pilot activity was effective in enhancing knowledge and decreasing uncertainty in all domains. Evidence collected through this study will foster awareness among policy makers on the value and urgency of introducing CSE in Italian school curricula.

Key messages:
School-based CSE is the most effective way to positively impact on young people's behaviour and attitudes towards sexuality. However, it is not yet included in Italian school curricula.
EduForIST pilot activity represents a first step towards the implementation of an evidence-based approach to sexuality education, to be promoted and implemented equally across Italian schools.

Introduction:
Colorectal cancer (CRC) is one of the major causes of death worldwide. Previous research reported differences in screening adherence both by gender and socioeconomic determinants. However, little is known about the extent to which Health Literacy (HL) may affect gender differences in CRC screening rates. Here, we aimed to assess HL levels in both genders and their relations with CRC screening adherence.

Methods:
The study was performed within the

Conclusions:
Our findings suggest that adherence to CRC screening is associated with HL in females only, while it depends on financial status in males. Therefore, gender specific interventions, tailored on different factors, are needed to increase the CRC screening rates.

Key messages:
The association between Health Literacy and colorectal cancer screening adherence differs according to gender. Gender specific interventions are needed to increase the colorectal cancer screening rates.