School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Front Public Health. 2022 Sep 28;10:1016372. doi: 10.3389/fpubh.2022.1016372. eCollection 2022.
Since the mass vaccination against SARS-CoV-2 was launched in Israel, the Arab ethnicity minority had lower vaccine uptake. The syndemics theory suggests a closely interrelated complex of health and social crises among vulnerable societies results in an increased disease burden or in more adverse health conditions. Syndemics may explain the health disparities between different people or communities. Likewise, acculturation was found to be associated with different health outcomes among minority populations. The purpose of the study is to explore the association between syndemic construct, acculturation style, and adherence to recommended COVID-19 vaccination among the Arab ethnicity in Israel.
A cross-sectional study among 305 participants who completed a self-report questionnaire. Syndemic construct (syndemics score and syndemics severity) was calculated from the participants' health behavior index, self-rated health status, and adherence to flu vaccination. Four acculturation strategies were defined according to Barry's acculturation model: assimilation, integration, separation, and marginalization style. Linear regression (stepwise method) was conducted to determine the explanatory factors for COVID-19 vaccine adherence.
Assimilation and separation acculturation styles and syndemics severity were significantly associated with higher adherence to the recommended COVID-19 vaccination ( = 1.12, 95%CI = 0.34-1.98; = 0.45, 95%CI = 0.10-0.80; B = 0.18, 95%CI = 0.09-0.28; respectively). The explained variance of the model ( ) was 19.9%.
Syndemics severity, assimilation and separation acculturation styles were associated with higher adherence to recommended COVID-19 vaccination in the Israeli Arab minority population. Syndemics score was not associated with recommended COVID-19 vaccination. To encourage COVID-19 vaccination among minority communities, campaigns should be tailored to the social determinants in a sensitive and individualized manner.
自以色列启动针对 SARS-CoV-2 的大规模疫苗接种以来，阿拉伯少数民族的疫苗接种率较低。综合征理论表明，弱势社会中密切相关的健康和社会危机的综合导致疾病负担增加或健康状况恶化。综合征可能解释不同人群或社区之间的健康差距。同样，文化适应被发现与少数民族群体的不同健康结果有关。本研究旨在探讨综合征结构、文化适应方式与以色列阿拉伯少数民族对推荐的 COVID-19 疫苗接种的依从性之间的关系。
对 305 名完成自我报告问卷的参与者进行横断面研究。综合征结构（综合征评分和综合征严重程度）是根据参与者的健康行为指数、自我评估的健康状况和流感疫苗接种的依从性计算得出的。根据 Barry 的文化适应模型，定义了四种文化适应策略：同化、整合、分离和边缘化。采用线性回归（逐步法）确定 COVID-19 疫苗接种依从性的解释因素。
同化和分离文化适应方式以及综合征严重程度与更高的推荐 COVID-19 疫苗接种依从性显著相关（ = 1.12，95%CI = 0.34-1.98； = 0.45，95%CI = 0.10-0.80；B = 0.18，95%CI = 0.09-0.28；分别）。模型的解释方差（ ）为 19.9%。
综合征严重程度、同化和分离文化适应方式与以色列阿拉伯少数民族中更高的推荐 COVID-19 疫苗接种依从性相关。综合征评分与推荐的 COVID-19 疫苗接种无关。为了鼓励少数民族社区接种 COVID-19 疫苗，宣传活动应根据社会决定因素以敏感和个性化的方式量身定制。
