Urszula Zwierczyk

Background/Objectives: Vaccine hesitancy arises from multiple determinants, including individual beliefs, cognitive style, social norms, political identity and the information environment. In this context, health literacy, e-health literacy, susceptibility to health misinformation, conspiracy beliefs and trust in science may be relevant in mediatized societies. Aim: The aim of the study was to examine how susceptibility to health misinformation relates to vaccine hesitancy in Poland and how this association is influenced by health literacy, e-health literacy, trust in scientists and sociodemographic factors. Methods: Data came from a web-based survey conducted in December 2024 among 2200 adults aged 18–75 years. The questionnaire included validated scales of vaccine hesitancy, health literacy, e-health literacy, vaccine conspiracy beliefs and trust in scientists. The susceptibility to health misinformation was measured with ad hoc instrument based on the statement from fact-checking services. Items assessing digital media use, political sympathies, religious practices and sociodemographics were also applied. Multivariable linear regression was applied with continuous vaccine hesitancy as the dependent variable. Results: The model explained 57.8% of the variance in vaccine hesitancy. Susceptibility to misinformation (B = 0.11, 95% CI: 0.08–0.15) and vaccine conspiracy beliefs (B = 0.44, 95% CI: 0.41–0.46) were positive predictors, whereas trust in scientists (B = −0.20, 95% CI: −0.23–−0.17) and e-health literacy (B = −0.07, 95% CI: −0.11–−0.02) were protective. Older age was associated with lower hesitancy (B = −0.02, 95% CI: −0.03–0.00). Secondary education (B = −0.58) and a master’s degree (B = −0.77) predicted lower hesitancy. Health literacy categories were not significantly related to vaccine hesitancy. Conclusions: Susceptibility to health misinformation and vaccine conspiracy beliefs were key predictors of vaccine hesitancy, outweighing the effects of health literacy and the protective impact of trust in scientists and e-health literacy, and indicating a need for interventions that combine prebunking and literacy-focused strategies with efforts to strengthen confidence in health institutions.

Artykuł prezentuje wyniki badania jakościowego dotyczącego powiązań pomiędzy postawami negacjonistycznymi a zaufaniem do instytucji ochrony zdrowia. 13 pogłębionych wywiadów indywidualnych z osobami prezentującymi postawy negacjonistyczne zostało poddanych jakościowej analizie treści z wykorzystaniem programu MaxQda. W wyniku analizy uzyskano podział narracji występujących w wywiadach na podgrupy: sceptyczne zagubione, sceptyczne zdrworozsądkowe, sceptyzczne indywidualistyczne i negacjonistyczne. Występujące w wypowiedziach pokazują istnienie relacji pomiędzy poglądami negacjonistycznymi, zaufaniem do instytucji medycznych i ich przedstawicieli oraz procesami kulturowymi charakterystycznymi dla okresu nowoczesności refleksyjnej.

The term “planetary diet” proposed by the EAT-Lancet Commission (the EAT-Lancet Commission on Food, Planet, Health) emphasises the reduction in the consumption of animal-based foods, especially red meat. Such nutritional model leads to positive health effects, especially in relation to the prevention of cardiovascular diseases, obesity and type II diabetes. Adhering to the principles of a planetary diet may help reduce the production of greenhouse gases and may also positively contribute towards restoring biodiversity and increasing the resources of natural ecosystems. Without firm actions, especially in terms of the strategies in the food industry, destructive climate changes will accelerate. Both in Poland and over the world, the movements emphasising protection of the environment are gaining more power. However, Polish society still adheres to unbalanced dietary habits that exert harmful effect on health. Nutrition education and promotion of the principles of a planetary diet, which can protect against the development of lifestyle diseases and can also have a positive impact on the environment, seem to be the appropriate action to take.

Science denialism is characterized by the refusal to accept existing consensus and available evidence. Typical strategies denialists employ include spreading conspiracies, selective use of information, relying on fake experts, or general fallacies in logic. A flood of misinformation, fake news, and conspiracy theories accompanied the COVID-19 pandemic. Simultaneously, it was a subject of many denialistic opinions, from denying the existence of the epidemic challenge to claims that questioned the safety and effectiveness of the COVID-19 vaccines. This study’s main aim was to assess the manifestations of denialism in attitudes toward the preventive measures recommended during the pandemic, with a special focus on vaccination. In-depth interviews were conducted with fifty representatives of the general population, demonstrating diversified opinions about COVID-19 vaccines and other preventive behaviors. The interviews were performed face to face in participants’ houses or at other places they identified as convenient. Some of the interviewees preferred to do the interview via teleconference. The interviews were carried out from November 2022 to March 2023. The interviewees were recruited initially by convenience, and in further stages, the snowball technique was used. The interviewees were residents of four main administrative districts in Poland. Out of 50 participants, 26 were males, 29 were between 18–40, 16 were inhabitants of rural areas, and 28 had a university level of education. The interviews were based on a semi-structured guide that addressed, in addition to views about the origin of the new coronavirus, respondents’ attitudes toward vaccination and sanitary recommendation, the health status of interviewees, their use of healthcare services, and their health behaviors. The interviews were transcribed and analyzed with MAXQDA Analytics Pro 2022 software (Release 22.7.0). Thematic analysis (TA) was applied to the content generated from the interviews. Based on the uptake of the COVID-19 vaccine, the participants were divided into three groups: unvaccinated, hesitant, and vaccinated (18, 4, and 28 interviewees, respectively). The main themes were established based on the TA of the interviews: attitudes toward COVID-19 vaccination, perception of sources of information, and the origin of the new coronavirus. The first theme decidedly drew the greatest attention of the interviewees. There was also a clear relationship between vaccination status and the presence of denialist thinking among interviewees. Interestingly, the role of experts as a key source of information about the pandemic was underlined by study participants. However, the criteria for being an expert differed. The subject of the origin of a new coronavirus was not interesting to interviewees. The analysis of the adherence to preventive measures revealed an interplay of diversified attitudes and motivations. Individuals presenting denialist views most frequently abstained from COVID-19 vaccination. However, such views were also present among those who hesitated or even among those who had been vaccinated. Furthermore, denialism was only one of the determinants of adherence to preventive measures.

The negative consequences of commercial determinants of health (CDoH) have become a major challenge for public health systems, especially in terms of non-communicable diseases (NCDs). CDoH are defined as profit-driven factors that influence health. In this study, we assessed the awareness of CDoH and the attitudes toward potential restrictions on advertising, as well as fiscal interventions targeting food products with harmful effects on health in Polish society. Our analysis is based on data from a computer-based web interviewing (CAWI) survey performed in May 2022 among 2008 adult internet users from Poland. Multivariable logistic regression models were developed for variables derived from three items exploring the respondents’ understanding of the relationship between CDoH and NCDs, as well as three items asking about their acceptance of a prohibition of advertising unhealthy products during sports events, a general ban on unhealthy food advertising, and their attitudes toward sugar-sweetened beverages (SSBs). Food (FL) and e-health literacy (eHL) levels were consistently positive predictors of both awareness of CDoH and acceptance of the proposed actions. Both higher FL and eHL were significantly associated with the opinion that advertising unhealthy food is associated with the prevalence of NCDs (OR, 95% CI: 1.03, 1.02–1.05, and 1.04, 1.02–1.06, respectively). Health literacy was less frequently a significant predictor of the dependent variables. Among sociodemographic factors, a respondent’s level of education and age showed a significant relationship with their awareness and acceptance of countermeasures against CDoH. Respondents with a university master’s level of education were more likely to agree with the statement on the relationship between big industry profits and harm to society’s health (OR, 95% CI: 1.96, 1.42–2.69) and to support a ban on advertising unhealthy food similar to that for tobacco products (OR, 95% CI: 1.66, 1.21–2.27). Respondents suffering from chronic diseases were also consistently more likely to show a greater understanding of the harmful impact of CDoH and support proposed restrictions. For example, they were more likely to agree with restrictions on advertising harmful products during sports events (OR, 95% CI: 1.23, 1.02–1.50) and the introduction of a sugar tax (OR, 95% CI: 1.26, 1.03–1.54). Our study revealed that more than 50% of the Polish population is conscious of the problem of the harmful effects of big industries producing and selling processed food, sugar-sweetened beverages, and alcoholic beverages. Interestingly, slightly more than half of the respondents supported the introduction of restrictions on advertising such products. Still, only approximately 30% of them accepted a sugar tax to counter the obesity epidemic. The results of our study indicate that Polish society is open to the introduction of regulations aimed at limiting the impact of commercial determinants of health. To our knowledge, this is one of the first studies to assess the awareness of CDoH and the acceptance of restrictions to limit their impact.

Background and Objective: The last decade faced the re-discovery of commercial determinants of health (CDoH). Significant research is currently conducted on the corporate aspects of CDoH. This study aimed to assess society’s readiness to adopt restrictive measures against unhealthy food...

Vaccine hesitancy has become a pivotal consideration in assessing society’s readiness to accept recommended vaccination programs. The role of vaccination as a preventive measure during great epidemic challenges cannot be overestimated. On the other hand, the overwhelming flow of misinformation and attitudes resulting from denialism may have a profoundly harmful effect on the acceptance of preventive interventions. The adult Vaccine Hesitancy Scale (aVHS) is a result of efforts to develop a tool that will be relevant to the views about vaccination in the general adult population. It was derived from the Vaccine Hesitancy Scale (VHS), initially developed by researchers attempting to assess the opinions and attitudes of parents. This study’s main aim was to determine the reliability and validity of the Polish version of aVHS (PL-aVHS). We have also analyzed whether the scale can feasibly predict the COVID-19 vaccination status of respondents. The analysis was performed on data originating from a computer-based web-interviewing (CAWI) survey of 2008 adult Internet users. It included the analysis of internal consistency, test-retest reliability, and hypotheses testing. Exploratory (EFA) and confirmatory factor analyses (CFA) were performed on the subsets generated by randomly splitting the initial survey data. We have found that the scale has excellent internal consistency (Cronbach α = 0.935), acceptable levels of inter-item bivariate correlations, and good test–retest reliability (interclass correlation coefficient, ICC = 0.843). The EFA revealed that the tool has a two-factor latent structure; however, similar loadings of item 10 to both factors spoke for its exclusion from the model. Two extracted factors were responsible for 68.90% of the variance after rotation based on the maximum likelihood method. The CFA showed that the best fit of the model to measurement data was obtained for the two-factor model after excluding item 10. All seven fit indexes calculated in the analysis suggested at least an acceptable fit. In conclusion, the assessment of the PL-aVHS revealed good reliability and validity of the instrument. Furthermore, we have obtained similar EFA results as reported for the English version of the tool. Finally, to our knowledge, it is one of a few tools available in Polish for the measurement of vaccine-related attitudes.

Food choices are determined by intrinsic and extrinsic product characteristics, biological and physiological features, psychological factors, and situational and socio-cultural factors. Self-determination theory offers the explanation of health behavior change identifying motivations located along a continuum of autonomy. Another approach to the motivations guiding health behaviors, including food choices, relies on distinguishing thematic categories. Health motivations seem to be an obvious determinant of health behaviors, but final decisions regarding health are also the effect of other types of motivations such as economic, cultural, or emotional. The role of marketing pressure in modern society is perceived to be an important source of motivation for purchasing food and other products. The Motivation–Opportunity–Ability (MOA) framework was initially proposed in order to explain the processing of brand information from advertisements and was later expanded to other areas, including health and nutritional behaviors. The aim of this study was the analysis of determinants of food choices. We have developed a common regression model including six categories of motivations addressed by the Eating Motivations Scale and three health literacy types corresponding with element of ability from the MOA framework, adjusted for socio-demographic factors, health status, and the use of the Internet and TV. The analysis was performed on data from a computer-assisted web-based interviewing (CAWI) survey among 2008 adult Internet users completed in May 2022. The uni- and multivariate linear regression models were developed with the Index of Unhealthy Food Choices (IUFC), calculated based on the responses to items asking about the frequency of the consumption of twelve food categories. Univariate modeling revealed that IUFC is significantly associated with health, food, and e-health literacies and with five out of six eating motivations. However, the multivariate regression model yielded significant associations only for eating motivations but not for the three literacy scores. Health motivation was negatively associated with IUFC (B, standard error (SE): 0.83, 0.07; 95% confidence interval (95% CI): 0.98–0.69), but positively with emotional (B, SE: 0.22, 0.04; 95% CI: 0.14–0.3), economic (B, SE: 0.41, 0.08; 95% CI: 0.25–0.56), and marketing (B, SE: 0.62, 0.08; 95% CI: 0.47–0.78) motivations. Our findings suggest that motivations guiding food choices may prevail over the element of ‘ability’ distinguished in the frameworks and models that explain people’s behaviors, including behaviors relating to health. Thus, it is essential to emphasize development of appropriate motivations and not only to provide knowledge and skills. Furthermore, one should also remember motivations other than health motivations when searching for the determinants of health behaviors.

Analogous to health literacy, food literacy can be defined as a set of cognitive and social skills associated with the ability to acquire and understand information about food and nutrition to make appropriate nutritional decisions. In the literature, several terms such as food, nutrition, or nutritional literacy are used in parallel, differing in some aspects of their meaning. Food literacy is an important measure of the effectiveness of nutritional education interventions and appropriate instruments for its measurement should be available in every society. The aim of this study was the assessment of the validity and testing of a proposed model of the Short Food Literacy Questionnaire (SFLQ) culturally adapted into Polish. The analysis was performed on data from an online survey in a representative sample of 1286 adult internet users. Exploratory (EFA) and confirmatory factor (CFA) analyses were performed on two different subsets obtained through random splitting of the initial dataset. The Polish version of the SFLQ had good internal consistency (Cronbach’s α 0.841; Guttman split-half coefficient was 0.812). The EFA revealed that the tool had a three-factor latent structure. The distinguished dimensions were ‘information accessing’, ‘knowledge’, and ‘information appraisal’. The subscales also showed acceptable internal consistency based on the values of the Cronbach’s α coefficients (ranging from 0.768 to 0.845). The CFA confirmed a good fit of the three-factor model with at least five indexes achieving acceptable levels (CFI = 0.972, GFI = 0.963, AGFI = 0.940, NFI = 0.959, and RMSEA = 0.059). The validation of the Polish version of the SFLQ revealed, contrary to earlier reports, not a single but a three-factor structure of the instrument. The SFLQ will be an important tool for the assessment of the effectiveness of educational interventions and population studies analyzing the determinants of food literacy in Poland.