Observational studyVaccine2023
The mediating effect of health literacy on COVID-19 vaccine confidence among a diverse sample of urban adults in Boston and Chicago.
Observational study in Vaccine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03584490 (Reducing Assessment Barriers for Patients With Low Health Literacy), which is not on this map. Cited by 13 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Reducing Assessment Barriers for Patients With Low Health Literacy
Who cites it
13 citing papers in PubMed, 23 citations in OpenAlex.
- Mitigating Vaccine Disparities Through Faith-Based Intervention: A Pre-Post Analysis of Recombinant Zoster Vaccine Knowledge and Acceptance in Socially Vulnerable Racial and Ethnic Minoritized Communities.Infectious diseases and therapy · 2026Article
- Flattening the curve: Factors associated with engagement in health protective behaviors at the onset of the COVID-19 pandemic among Black individuals from predominantly low-income backgrounds.Journal of health psychology · 2026Article
- Socioeconomic disparities in childhood vaccine hesitancy among parents in China: The mediating role of social support and health literacy.Human vaccines & immunotherapeutics · 2025Article
- Article
- Supporting Primary Care Communication on Vaccination in Multilingual and Culturally Diverse Settings: Lessons from South Tyrol, Italy.Epidemiologia (Basel, Switzerland) · 2025Review
- The still unexplored mediating role of vaccine literacy.Human vaccines & immunotherapeutics · 2024Article
- Health literacy and COVID-19 pandemic impacts among adults in rural northern Arizona.Rural and remote health · 2024Article
- Review
- COVID-19 Vaccine Confidence Mediates the Relationship between Health Literacy and Vaccination in a Diverse Sample of Urban Adults.Vaccines · 2023Article
- Pervasive Parental Hesitancy and Resistance towards Measles Rubella Vaccination in Jordan.Vaccines · 2023Article
- Information Consumption, Trust Dynamics and COVID-19 Vaccine Hesitancy among Older Adults: Implications for Health Messaging.Vaccines · 2023Article
- Article
- Investigation of the relationship of general and digital health literacy with various health-related outcomes.Frontiers in public health · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundA high rate of COVID-19 vaccination is critical to reduce morbidity and mortality related to infection and to control the COVID-19 pandemic. Understanding the factors that influence vaccine confidence can inform policies and programs aimed at vaccine promotion. We examined the impact of health literacy on COVID-19 vaccine confidence among a diverse sample of adults living in two major metropolitan areas.
methodsQuestionnaire data from adults participating in an observational study conducted in Boston and Chicago from September 2018 through March 2021 were examined using path analyses to determine whether health literacy mediates the relationship between demographic variables and vaccine confidence, as measured by an adapted Vaccine Confidence Index (aVCI).
resultsParticipants (N = 273) were on average 49 years old, 63 % female, 4 % non-Hispanic Asian, 25 % Hispanic, 30 % non-Hispanic white, and 40 % non-Hispanic Black. Using non-Hispanic white and other race as the reference category, Black race and Hispanic ethnicity were associated with lower aVCI (-0.76, 95 % CI -1.00 to -0.50; -0.52, 95 % CI -0.80 to -0.27, total effects from a model excluding other covariates). Lower education was also associated with lower aVCI (using college or more as the reference, -0.73 for 12th grade or less, 95 % CI -0.93 to -0.47; -0.73 for some college/associate's/technical degree, 95 % CI -1.05 to -0.39). Health literacy partially mediated these effects for Black and Hispanic participants and those with lower education (indirect effects -0.19 and -0.19 for Black race and Hispanic ethnicity; 0.27 for 12th grade or less; -0.15 for some college/associate's/technical degree).
conclusionsLower levels of education, Black race, and Hispanic ethnicity were associated with lower scores on health literacy, which in turn were associated with lower vaccine confidence. Our findings suggest that efforts to improve health literacy may improve vaccine confidence, which in turn may improve vaccination rates and vaccine equity. CLINICAL TRIALS NUMBER: NCT03584490.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.