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Achieving high vaccination rates is important for overcoming an epidemic. This study investigates the association between religious faith and intentions to become vaccinated against COVID-19 in Israel and Japan. Most of Israel’s population is monotheistic, whereas most Japanese are unaffiliated with any religion. Therefore, our findings might be applicable to various countries that differ in their religions and levels of religiosity. We conducted almost identical large-scale surveys four times in Israel and five times in Japan from March to June 2020 to obtain panel data. We found that intentions of getting vaccinated depend on people’s level of religiosity in a non-linear way. Those who have strong religious beliefs are less likely to become vaccinated than those who say they are less religious. Two other factors that play a role in this relationship are religious denomination in Israel and identifying with a religion in Japan. Supplementary Information The online version contains supplementary material available at 10.1007/s10198-021-01389-8.

Background In January 2020, Israel launched a reform mandating Front-of-Package (FOP) labeling on food products. The current study examined the factors affecting consumers’ decision-making regarding the use of FOP labels a year after the reform was implemented. Methods The survey was conducted between December 2020 and January 2021 and included a sample of 507 participants age 21 and over. The questionnaire included Health Belief Model (HBM) constructs related to food labeling, nutrition habits, media exposure and extent of support for the reform, frequency of using FOP labels, intention to change purchasing and consumption habits in the coming year, and personal details. Results The study found that 58.5% reported using the FOP labels to some extent. In addition, 70% indicated willingness to change to healthier products in the coming year. The results of the analytical model confirm the validity of the HBM and the other behavioral constructs. In particular, the frequency of using FOP labels increases as the following factors increase: levels of perceived benefits and perceived importance of reading FOP labels, level of perceived importance of healthy nutrition, frequency of conforming to healthy nutrition, and support for the reform. Conclusions The study's findings are important for understanding the impact of the new reform and for guiding future complementary actions to increase people’s motivation to use FOP labels. More advertisement about the FOP labels in the media and also through the HMOs is needed to increase people’s awareness of the reform. In addition, information about the reform provided to the public should emphasize the benefits and health implications of using FOP labels.

For young women, mammography has limited effectiveness and entails exposure to radiation, discomfort, and additional expense. This study identifies factors associated with women's willingness to undergo mammography despite official guidelines to the contrary. Using the Health Belief Model, we surveyed Israeli women aged 40-51 who are not at high risk of breast cancer and who had or had never undergone mammography. The results show that sociodemographic characteristics, private insurance coverage, out-of-pocket payments to physicians, and three Health Belief Model categories - lower perceived barriers to mammography, higher expectations of benefits, and stronger health motivation - are associated with the decision to undergo mammography. In addition, higher levels of perceived susceptibility to illness and experience with mammography are significant predictors of intentions to undergo early mammography. Understanding the determinants of women's tendency to undergo mammography contrary to recommendations may help nurses and healthcare policymakers to create health promotion programs targeting this group of women. Preventing unnecessary mammograms may reduce costs to households and health maintenance organizations, mitigate ineffective use of medical facilities, and alleviate the burden on the healthcare system.

Objective: The current study uses the unique setting created by the coronavirus crisis in China during the peak period of the pandemic to examine the behavioral factors affecting the decision of the Chinese people to adopt the precautionary actions recommended by the government. Methods: Using the social app WeChat, we conducted a cross sectional study of the Chinese people in mid-February 2020. Results: Our results show that higher levels of dispositional optimism and support for the government's actions for managing the epidemic were positively correlated with the compliance level. In addition, women and married participants were more likely to comply with the recommendations. Conclusions: Optimism and support for government actions should be considered when promoting policies related to health behavior such as social distancing.

This study investigates how people in Japan perceived the severity of and probability of infection from coronavirus disease 2019 (COVID-19), and how their willingness to purchase a hypothetical vaccine depends on these perceptions and their risk attitudes. We conducted a large-scale panel survey three times between 13 March to 13 April 2020 in Japan. By analyzing the data, we found that the perception of COVID-19 became more serious. The estimation of the fixed effect model reveals that a person becomes more willing to pay for a vaccine as the person evaluates COVID-19 as a more severe disease, considers a higher probability of infection, and becomes more risk averse. Since the sensitivity of willingness to pay for the vaccine on risk aversion increased during the period, the change in risk attitude contributed to an increase in willingness through the sensitivity channel, while it decreased through the magnitude channel.

Background Routine dental examinations are important for early diagnosis and treatment of dental problems among older adults in order to improve their quality of life and avoid costly future treatments. In Israel, a significant percentage of adults do not seek dental care. Methods The study is based on a 2017 telephone survey conducted among people aged 50–75 from different population groups in Israel to examine their health beliefs and attitudes toward dental treatments. Results The results show that among older adults the decision to undergo routine dental checkups is affected by socio-demographic status and health beliefs regarding dental health. Lower age, higher income levels, and Jewish religion predicted higher chances of frequent checkups. In addition, those who saw the benefits of routine checkups, believed that dentists were readily available, and had higher levels of health motivation were more likely to seek out routine dental care. Conclusions According to the recent dental reform in Israel, people aged 75 and over are eligible for subsidized dental treatments. To enhance the frequency of dental checkups among older adults, it is recommended to provide this subsidized coverage for adults under age 75. In addition, planning dental health services for individuals in this age group should be based upon their accepted beliefs and values. Moreover, systematic health education through the media and health maintenance organizations should specifically target this population group to encourage them to undergo dental checkups more frequently.

The present study aimed to extend the original focus of the dual-hormone hypothesis on testosterone and cortisol involvement in risk-taking to other sex hormones: estrogen and progesterone. The study also examined two alternative models for the proposed relationship between cortisol and sex steroids and for their joint influence on risk-taking: interaction and ratio terms. In all, 40 women and 37 men were tested for circulating sex hormones and provided self-reports on risk-taking. The findings suggest that sex hormone–cortisol ratios differentially modulate risk-taking in men and women: In men, high ratios were associated with risk-taking, whereas in women the opposite pattern was found. The findings are discussed in light of evolutionary assumptions regarding sex differences in neuroendocrine mechanisms, suggesting sex differences in neural sensitivity to sex hormones in risk-taking.

Obstructive sleep apnea (OSA) disorder has a deleterious impact on health. Using the continuous positive airway pressure (CPAP) device effectively lessens OSA. The purpose of this study was to examine the factors affecting patients’ intention and actual decision to get treatment. Questionnaires were distributed at three sleep laboratories in Israel among 633 participants suspected of having OSA. Six months later, 194 OSA patients were contacted to verify whether they had purchased a CPAP device. Factors affecting intention to use the device included Health Belief Model variables, income level, and sleep laboratory location. The decision to get treatment was positively affected by the intention to use CPAP, the number of CPAP trial days, age, and number of years in the country. Patients’ attitudes and health beliefs prior to diagnosis may predict their intention to be treated for OSA, and in turn, affect their actual decision to get treatment. Awareness of behavioral intention can enable decision makers developing targeted interventions to promote treatment.

This study examines the impact of past experience with influenza and the influenza vaccine on four categories of the Health Belief Model: beliefs about susceptibility to contracting influenza, severity of illness, perceived benefits of the vaccine in preventing influenza, and perceived barriers to getting vaccinated. The study population comprised employees at different workplaces in Israel. The results indicate that individuals who took flu shots in the past perceived higher levels of benefits from the vaccine and lower barriers to getting the vaccine than those who had not been vaccinated. In addition, those who had influenza over the last 2 years exhibited higher levels of perceived susceptibility and lower levels of perceived benefits from the vaccine. These results imply that an individual’s health beliefs regarding the flu vaccine can be changed as a result of accumulated experience with the illness and the vaccine. Therefore, recommendations for first-time vaccination may have implications on decisions to be vaccinated over the long run.

The objective of this study was to identify factors that influence the decision whether or not to get the influenza (flu) vaccine among nurses in Israel by using the health belief model (HBM). A questionnaire distributed among 299 nurses in Israel in winter 2005/2006 included (1) socio-demographic information; (2) variables based on the HBM, including susceptibility, seriousness, benefits, barriers and cues to action; and (3) knowledge about influenza and the vaccine, and health motivation. A probit model was used to analyze the data. In Israel, the significant HBM categories affecting nurses' decision to get a flu shot are the perceived benefits from vaccination and cues to action. In addition, nurses who are vaccinated have higher levels of (1) knowledge regarding the vaccine and influenza, (2) perceived seriousness of the illness, (3) perceived susceptibility, and (4) health motivation than do those who do not get the vaccine. Immunization of healthcare workers may reduce the risk of flu outbreaks in all types of healthcare facilities and reduce morbidity and mortality among high-risk patients. In order to increase vaccination rates among nurses, efforts should be made to educate them regarding the benefits of vaccination and the potential health consequences of influenza for their patients, and themselves.

Routine dental examinations for children are important for early diagnosis and treatment of dental problems. The level of dental morbidity among Israeli children is higher than the global average. A July 2010 reform of Israel's National Health Insurance Law gradually offers free dental services for children up to age 12. The study examines the use of dental services for children and the factors affecting mothers' decision to take their children for routine checkups. In addition, the study examines the impact of the reform on dental checkups for children in various populations groups. A national representative sample comprising 618 mothers of children aged 5-18 was surveyed by telephone. The survey integrated the principles of the health beliefs model and socio-demographic characteristics. The results show that mothers' decision to take their children for dental checkups is affected by their socio-demographic status and by their health beliefs with respect to dental health. After the reform, the frequency of children's dental checkups significantly increased among vulnerable populations. Therefore, the reform has helped reduce gaps in Israeli society regarding children's dental health. Raising families' awareness of the reform and of the importance of dental health care together with expanding national distribution of approved dental clinics can increase the frequency of dental checkups among children in Israel.

Obstructive sleep apnea syndrome (OSAS) is a sleep-related breathing disorder characterized by excessive daytime sleepiness, accidents and high medical expenses. The first line of treatment for OSAS is continuous positive airway pressure (CPAP).To examine attitudes and beliefs as well as physiological and sociodemographic factors affecting OSA patients' decision whether or not to purchase a CPAP device.The study was divided into two stages; in the first, 83 subjects completed self-administered questionnaires prior to sleep examination (polysomnography, PSG). The questionnaires related to sleep habits, sleep disorders, questions organized around health belief model (HBM) concepts, sociodemographic information, health status and PSG examination. In the second stage, 3 months later, 50 OSAS patients were interviewed by telephone, which included questions about their reasons for purchasing/not purchasing the CPAP device.Only 48% of the OSAS patients purchased the CPAP device. The significant factors positively affecting the decision included higher levels of physiological factors such as body mass index (coefficient 0.36, P0.05) and respiratory disturbance index (coefficient 0.16, P0.05), higher income levels (coefficient 3.26, P0.05), and higher levels of knowledge about OSAS (coefficient -2.98, P0.1).Individuals who are more aware of their own health condition, are better informed about OSAS and have higher incomes are more likely to purchase the device. We suggest reducing the level of co-payment and providing patients with more information about the severe effects of OSAS.

The study examined the factors affecting the decision to be vaccinated against influenza among employees in Israel. The research, conducted in 2007/2008, included 616 employees aged 18−65 at various workplaces in Israel, among them companies that offered their employees influenza vaccination. The research questionnaire included socio-demographic characteristics, and the Health Belief Model principles. The results show that the significant factors affecting vaccination compliance include a vaccination program at workplaces, vaccinations in the past, higher levels of vaccine's perceived benefits, and lower levels of barriers to getting the vaccine. We conclude that vaccine compliance is larger at companies with workplace vaccination programs providing easier accessibility to vaccination.

The aims of this study were to identify the predictors of people's willingness to be vaccinated against influenza and to determine how to improve the inoculation rate. The study was based upon the results of our original large-scale survey conducted in the USA in 2005. A model of bounded rationality can explain vaccination behavior fairly well: (a) people evaluate the costs and benefits of vaccination by applying risk aversion and time preference; (b) the ‘status quo bias’ of those who were vaccinated in the past affects their decision to be vaccinated in the future; and (c) overconfidence indirectly affects the decision through the moderation of perceived variables. Policy implications include: (a) dissemination of information about the vaccine is especially important among people who are inexperienced with the vaccine since they undervalue the effectiveness of vaccination; (b) lowering the total cost of vaccination, including time costs (for example, by offering the vaccine at workplaces) may raise the inoculation rate, especially among those inexperienced with the vaccine, since those who have experience with the vaccine tend to take it on a regular basis.

Anti-influenza vaccination has proven cost-effective for society. In Israel, however, vaccination rates remain relatively low in comparison to other countries.To analyze the socioeconomic and health status factors affecting the decision to be vaccinated against flu and to compare these factors to results from other countries in order to determine which segments of the adult population should be targeted for increased coverage in influenza vaccination programs.Our source was the 1999/2000 Health Survey of the Central Bureau of Statistics for the group aged 25 and above, comprising 16,033 individuals. We used statistical methods such as the Probit regression model to estimate the effects of socioeconomic and health status variables on the decision to get a flu shot. The variables included gender, age, marital status, education, ethnic origin, religious affiliation and housing density, as well as chronic illnesses, smoking, hospitalizations, membership in health management organizations and kibbutz membership.Our findings indicate that being a post-1990 immigrant from the former Soviet Union, living in a densely populated house, being unmarried and smoking heavily are important factors in predicting the decision not to be vaccinated. In contrast, chronic illness, previous hospitalizations, older age, and kibbutz membership positively affected the decision to take the vaccine.It is necessary to identify the socioeconomic and health variables marking population sectors that are less likely to be vaccinated in order to design a suitable policy to encourage vaccination.