Sarah Eitze

Endometriosis is a chronic and often misunderstood condition that exposes affected individuals to public stigma. This qualitative interview study explored how experienced public stigma by healthcare experts shapes women’s self-stigma before and after diagnosis and if women change health behaviors after public stigma was experienced and/or self stigma developed. In-depth interviews were conducted with recently diagnosed participants, focusing on public and self-stigma and their impact on health behaviors. Findings show that early and repeated exposure to stigma eroded trust in medical professionals, led to withdrawal from care, and fostered hyper-independence. Receiving a diagnosis provided both validation and emotional strain—strengthening self-confidence for some, while reinforcing distress for others. The study underscores the need for improved awareness and stigma-sensitive communication in healthcare to foster patient-centered, empathetic support and better outcomes for individuals with endometriosis.

Objectives: Antimicrobial resistance (AMR) is an urgent public health threat. Antibiotic prescriptions in primary care, such as for uncomplicated urinary tract infections (UTIs) in females, contribute substantially to antibiotic overuse. We examined whether consequence‐based risk communication emphasizing either individual (gut microbiome disruption) or societal (AMR) consequences can reduce expectations to receive antibiotics and improve decision‐related outcomes. Design and Methods: Across three online experiments ( N = 3057), women in the United Kingdom were exposed to a hypothetical physician consultation for an uncomplicated UTI. Depending on the experimental condition, the physician explained individual consequences of antibiotic use, societal consequences or no such consequences. Outcomes included expectations to receive antibiotics, trust in the physician and decisional conflict. Results: An internal meta‐analysis showed that both societal and individual consequence messages significantly reduced patients' expectations to receive antibiotics. Neither message type undermined trust in the physician (in Studies 1 and 2), and both communication messages significantly reduced decisional conflict (in Study 3). Conclusions: These findings indicate that brief, targeted communication regarding consequences of antibiotic use can lower antibiotic expectations and support decision‐making without eroding physician trust. Such messages represent a useful tool that can be adapted to different clinical contexts for patient‐centred antibiotic stewardship in primary care.

Background: Respiratory syncytial virus (RSV) can cause severe illness, especially in older adults. Since the European Medicines Agency approved two RSV vaccines in 2024, it is important to assess the public’s knowledge of this virus. Aims: Exploring knowledge about RSV and identifying associations with vaccination antecedents and vaccination intention. Method: We collected data from 565 individuals over 60 years of age in Germany, assessing their awareness and knowledge about RSV using a novel, pre-tested RSV knowledge scale and RSV-specific 5C vaccination antecedents (confidence, constraints, collective responsibility, complacency, and calculation), as well as their RSV vaccination intentions. Results: Around 50% of the sampled individuals stated that they had never heard of RSV. The RSV-aware sample ( n = 289) showed an intermediate level of knowledge concerning RSV, M ( SD) = 0.58 (0.19). The 5C vaccination antecedents collective responsibility and complacency mediated the relationship between knowledge and intentions. Limitations: As the results are from a survey study, mediation analysis can only be interpreted as correlational evidence. Conclusion: Educational interventions on RSV and respective vaccines are needed, as awareness, particularly about its infectiousness in children and vaccine availability, is low in the target group.

Background: In central Europe, tick-borne encephalitis (TBE) virus poses a growing health risk, amplified by climate-related changes in tick distribution. However, the TBE vaccination rate in Germany remains low. This study uses the Protection Motivation Theory (PMT) to investigate factors influencing TBE vaccination intention in Germany and the effect of tailored information on TBE risk areas. Methods: Participants ( N = 309) aged between 18 and 61 living in Germany were included in an online survey with an additional experimental variation of tailored TBE risk messages. Three experimental groups were provided with (a) no tailored risk information, (b) semi-tailored information about risk areas on federal level or (c) full-tailored information on risk areas on county levels. Results: The PMT concepts showed that perceived susceptibility, severity, and response efficacy were positively related to the intention to be vaccinated against TBE. In exploratory analyses, perceived self-efficacy was a positive predictor of vaccination status. Permanent residence in risk areas was also associated with vaccination status, whereas planned or previous vacations in such areas were not. The effect of tailored information on vaccination intentions could not be confirmed. Conclusions: TBE vaccination intentions and uptake appear to be shaped by PMT factors and residence in risk areas. Public health interventions should therefore focus on communicating TBE risk, enhancing self-efficacy, and presenting clear evidence of vaccine efficacy to strengthen preventive measures against tick-borne diseases. Factors such as travel planning should also be considered in evidence-based health campaigns.

Objective: Older adults may fail to demand vaccinations because they lack knowledge about the benefits of vaccination or underestimate disease risks. This study evaluated an extended knowledge intervention that provided information on lesser-known risks of influenza—including pneumococcal disease and sepsis—and the benefits of vaccination. Methods: The intervention was implemented in a model region in Germany during two influenza seasons. Two quota-sampled telephone surveys targeting adults 60+ were conducted to assess the impact of the intervention (N = 700 each). Quasi-experimental groups (intervention-exposed vs. non-exposed) were defined based on self-reported intervention exposure. Primary outcomes included knowledge (influenza, pneumococci, sepsis), the 5C antecedents of vaccination, and vaccination intention and behavior. Results: Intervention exposure had small positive effects on knowledge about influenza (η² = .009), pneumococci (η² = .012), and sepsis (η² = .004). It was also associated with higher risk–benefit calculation regarding influenza vaccination (η² = .003) and increased confidence in the safety of pneumococcal vaccination (η² = .020). Vaccination intentions for both diseases did not differ between groups. Although the intervention did not directly influence behavior, vaccination uptake increased over time due to external factors (influenza: OR = 1.880; pneumococci: OR = 2.080). Conclusions: Information alone can enable informed decisions and can help to change underestimated risks, but does not shift behavior. Embedding knowledge gains within multi-component strategies (e.g., provider endorsement, reminders, easy access) is the most plausible path to increased coverage. Targeting other factors is also important.

Endometriosis is a chronic gynecological condition often characterized by severe menstrual pain. It takes 7 years on average to diagnose endometriosis, with menstrual stigma being an estimated factor for this delay. In this preregistered study, both the Theory of Planned Behavior and Stigma Theory are included in an online survey to understand conversation intentions about menstrual symptoms and the impact of menstrual stigma in daily life. With a partial least squares structural equation model including 776 participants, the research investigates the facilitators and barriers influencing participants' intentions to seek advice for severe menstrual discomfort across different social contexts, including conversations with friends, medical experts, and coworkers. The results highlight that the perceived public stigma surrounding menstruation is associated with higher self-stigmatization, decreased attitudes, and decreased perceived behavioral control, which in turn significantly decreases conversation intentions. The study's results inform targeted interventions to promote open dialogue about menstrual health and reduce stigma. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Endometriosis is a chronic condition that is often misunderstood and stigmatized. This study explores the impact of public stigma on women* with endometriosis, focusing on its effects before and after diagnosis. Using a qualitative approach, we conducted in-depth interviews with women* who received an endometriosis diagnosis within the past three years. Participants shared their experiences with public stigma, self-stigma, and its influence on health behaviors and disease coping.The findings reveal that greater and earlier exposure to public stigma led to decreased trust in medical professionals, withdrawal from the healthcare system, and the development of hyper-independence. Receiving a diagnosis came with benefits and risks for the affected women*. While some women develop greater self-confidence through the validation of their symptoms, others experience negative emotional effects. This study highlights the need to raise awareness of endometriosis in the medical field and to develop strategies for reducing patients' experiences of stigma in order to ensure access to empathetic and patient-centered care. It underscores the need for healthcare professionals to be better trained in recognizing and avoiding stigmatizing behaviors during the diagnostic process and in patients coping with the disease. Such efforts could mitigate the negative consequences of stigma and improve patient outcomes.

During a pandemic, knowledge, risk perceptions, trust in institutions and attitudes towards public health measures influence protective behaviours and mental health. The COVID-19 Snapshot Monitoring (COSMO) project collected psychosocial data on pandemic-related attitudes, feelings and behaviours from representative samples in Germany. In sixty-nine cross-sectional online surveys conducted between 03.03.2020 and 29.11.2022, N = 69,013 individuals were assessed. Our 332 variables show how COVID-19 was perceived (e.g., symptoms, risk perceptions), which behaviours were exhibited (e.g., mask wearing, keeping distance, being vaccinated, meeting other people), what attitudes and beliefs people held (e.g., towards vaccination, conspiracy beliefs, pandemic fatigue), which information sources they used and trusted, how their mental health was affected (e.g., worries, wellbeing, resilience) and what consequences the pandemic had for people (e.g., financial losses, alcohol consumption). Variables are available for at least five waves (i.e., roughly 5,000 participants), some variables are available for all waves. The data allow tracing population-level changes in pandemic perceptions and actions, assess the relationships between determinants and behaviours, and help prepare for future crises.