Effectiveness Of Evidence-Based Educational Intervention On Covid-19 Vaccine Acceptability Among Healthcare Students Of Rural India: A Randomized Controlled Trial

Abstract

Purpose:

To fight against the COVID-19 epidemic, improving COVID-19 vaccine acceptance amongst the future healthcare workforce (healthcare students) is crucial since, being front liners, they are in authority for endorsing vaccination to their future patients. High and ongoing vaccine acceptance also relies on persons' knowledge, attitudes, and perceptions toward the vaccine. With the advent of misinformation and myths about vaccines, lower acceptance rates are observed in rural areas of India that demand evidence-based education to train future healthcare professionals in the first place. Considering this background, this study aimed to evaluate the impact of an education-based intervention to improve COVID-19 vaccine acceptance among healthcare students in rural parts of India.

Method: To achieve this purpose, a randomized controlled trial was performed to measure the effect of an evidenced-based educational intervention (The COVID-19 vaccination 100 Questions Resource Booklet) among healthcare students in rural India. A total of 165 sample size participants in each of the two study arms was planned to detect a significant difference of at least 20% in vaccine acceptability among arms. All participants completed an anonymized questionnaire survey collecting data on socio-demographics, COVID-19 vaccine knowledge, attitude, perception, willingness to accept the vaccine, vaccine hesitancy, and its associated factors after completing their randomization assignments. The efficacy of the evidence-based intervention was tested by evaluating the outcomes between the control and intervention groups. Multivariable logistic regression, ANOVA test, and Descriptive statistics were performed to analyze the correlation level among study variables and to assess the associated outcomes between co-variates and intervention.

Result: Analysis of the questionnaires demonstrated that participants in the Interventional group who read an educational interventional COVID-19 vaccination booklet were likelier to report (p-value <.0.05) acceptance toward the COVID-19 vaccine than the control group. Multivariate analysis exhibited overall improved "excellent" knowledge scores, and the mean value of students' perception and attitude regarding the COVID-19 vaccine were also improved in the intervention group.

Conclusion:

The experimental study demonstrated the significance of healthcare students' knowledge, attitudes, and perceptions by incorporating educational intervention initially in their degree curricula to enhance the vaccine acceptance rate. These encouraging results may help future similar studies to promote vaccines among the general population in their future careers. However, further research studies in more extensive settings and different populations are needed to determine whether this intervention also increases vaccine acceptance rates as booster vaccination programs continue across the globe.

Background:

SARSCoV-2, identified in January 2020, soon announced "The Corona Virus Disease 2019" pandemic by WHO [1] spread significantly faster over 200 countries, resulting in significant mortality and morbidity while hitting the economy and the national healthcare system. India, the country with the 2nd highest population (1.34 billion), has a current healthcare structure distribution system that has already been encountering challenges of affordability and accessibility and deserves greater attention amid the COVID-19 pandemic, specific rural parts of states like Madhya Pradesh, Rajasthan, etc. which has reported more than 250k cases and more than 4000 deaths till March 2021 [2]. By August 2020, it was noted that approx.3000 healthcare workers were infected with COVID-19, the deaths of doctors were 200, and healthcare personnel were 16 in every 1 lakh COVID-19 patients in India [3]. No specific antiviral medications are available for COVID-19, so healthcare personnel follow WHO and national guidelines in prevention, like wearing face masks, social distancing, washing hands, early diagnosis, etc. [4]. However, humans cannot use face masks and social distancing for a long time. Thus, the best approach to prevent the pandemic is immunization. [5]. Subsequently, at the beginning of 2021, India permitted the COVID-19 vaccine for emergency use against COVID-19, aiming for successful vaccination [6].