Using the Theory of Planned behavior to identify correlates of HPV vaccination uptake among college students attending a rural university in Alabama
Humanpapillomavirus (HPV) has infected nearly 80 million people in the U.S., and is associated with most cervical cancer cases. Alabama ranks first in the country for cervical cancer mortality and third for incidence. Although the HPV vaccine can prevent HPV and reduce cancer rates, Alabama is well-...
Gespeichert in:
Veröffentlicht in: | Vaccine 2021-12, Vol.39 (51), p.7421-7428 |
---|---|
Hauptverfasser: | , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 7428 |
---|---|
container_issue | 51 |
container_start_page | 7421 |
container_title | Vaccine |
container_volume | 39 |
creator | Shah, Sayyed Fawad Ali Ginossar, Tamar Bentley, Joshua M Zimet, Gregory McGrail, J. Patrick |
description | Humanpapillomavirus (HPV) has infected nearly 80 million people in the U.S., and is associated with most cervical cancer cases. Alabama ranks first in the country for cervical cancer mortality and third for incidence. Although the HPV vaccine can prevent HPV and reduce cancer rates, Alabama is well-below the national average for HPV vaccination. Using the Theory of Planned Behavior (TPB), this Alabama-based study aimed to examine college students’ intentions to get the HPV vaccine; to examine the relationship between the relationship between religious beliefs and HPV vaccination uptake status among college students.
Students (n = 257) from a university in rural Alabama completed the survey. Multiple regression analysis, Mann-Whitney U tests, and moderation analysis were used to examine associations among the variables of interest.
Consistent with TPB, results showed that attitudes and subjective norms were significant predictors of intention to get vaccinated. Knowledge that both sexes can experience HPV-related health problems, that HPV can cause genital warts, and that the vaccine protects against HPV were each associated with higher attitude scores. The results indicated that the odds of getting at least one HPV shot were higher for females than for males for non-Caucasians than for Caucasians. Students who were not vaccinated were more likely to report that religion influenced their health beliefs. *Abstract.
TPB was helpful in understanding HPV-related intentions. Communication and education efforts are needed to increase understanding of HPV illnesses and HPV vaccination benefits among peers, parents, and other loved ones of students. in the rural areas of Alabama. |
doi_str_mv | 10.1016/j.vaccine.2021.10.082 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2597500639</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0264410X21014316</els_id><sourcerecordid>2608445930</sourcerecordid><originalsourceid>FETCH-LOGICAL-c440t-e36fcfab546c45901ae117f74017f067526b6497e83f1c29fc0ff32933d601e33</originalsourceid><addsrcrecordid>eNqFkc2KFDEUhYMoTjv6CErAjZtqb37qbyXDoI4w4CxmxF1IpW6m01YnbZJq6PfwgU3RrQs3bhK4fOecmxxCXjNYM2DN--36oI1xHtccOCuzNXT8CVmxrhUVr1n3lKyAN7KSDL5fkBcpbQGgFqx_Ti6EbFteS7kivx6S8480b5DebzDEIw2W3k3aexzpgBt9cCHSHKgb0Wdnj9SEGHHSGdOC3tx9o6dFdHbB03mf9Q-keheKqwnThI9IU54XdaI6Z_TjEqhpnKOe6OzdAWNy-Uidp1eTHvROvyTPrJ4Svjrfl-Th08f765vq9uvnL9dXt5WREnKForHG6qGWjZF1D0wjY61tJZQTmrbmzdDIvsVOWGZ4bw1YK3gvxNgAQyEuybuT7z6GnzOmrHYuGZzK8zHMSfG6b2uARvQFffsPug1z9GU7xRvoZMkXUKj6RJkYUopo1T66nY5HxUAttamtOtemltqWcamt6N6c3edhh-Nf1Z-eCvDhBGD5joPDqJJx6A2OLqLJagzuPxG_Ad0QrOQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2608445930</pqid></control><display><type>article</type><title>Using the Theory of Planned behavior to identify correlates of HPV vaccination uptake among college students attending a rural university in Alabama</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><source>ProQuest Central UK/Ireland</source><creator>Shah, Sayyed Fawad Ali ; Ginossar, Tamar ; Bentley, Joshua M ; Zimet, Gregory ; McGrail, J. Patrick</creator><creatorcontrib>Shah, Sayyed Fawad Ali ; Ginossar, Tamar ; Bentley, Joshua M ; Zimet, Gregory ; McGrail, J. Patrick</creatorcontrib><description>Humanpapillomavirus (HPV) has infected nearly 80 million people in the U.S., and is associated with most cervical cancer cases. Alabama ranks first in the country for cervical cancer mortality and third for incidence. Although the HPV vaccine can prevent HPV and reduce cancer rates, Alabama is well-below the national average for HPV vaccination. Using the Theory of Planned Behavior (TPB), this Alabama-based study aimed to examine college students’ intentions to get the HPV vaccine; to examine the relationship between the relationship between religious beliefs and HPV vaccination uptake status among college students.
Students (n = 257) from a university in rural Alabama completed the survey. Multiple regression analysis, Mann-Whitney U tests, and moderation analysis were used to examine associations among the variables of interest.
Consistent with TPB, results showed that attitudes and subjective norms were significant predictors of intention to get vaccinated. Knowledge that both sexes can experience HPV-related health problems, that HPV can cause genital warts, and that the vaccine protects against HPV were each associated with higher attitude scores. The results indicated that the odds of getting at least one HPV shot were higher for females than for males for non-Caucasians than for Caucasians. Students who were not vaccinated were more likely to report that religion influenced their health beliefs. *Abstract.
TPB was helpful in understanding HPV-related intentions. Communication and education efforts are needed to increase understanding of HPV illnesses and HPV vaccination benefits among peers, parents, and other loved ones of students. in the rural areas of Alabama.</description><identifier>ISSN: 0264-410X</identifier><identifier>EISSN: 1873-2518</identifier><identifier>DOI: 10.1016/j.vaccine.2021.10.082</identifier><identifier>PMID: 34772544</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Alabama ; Attitudes ; Cancer ; Cervical cancer ; Cervix ; College students ; Colleges & universities ; Condyloma acuminatum ; Decision making ; Female ; Health Knowledge, Attitudes, Practice ; Health problems ; HPV vaccine ; Human papillomavirus ; Humans ; Immunization ; Male ; Multiple regression analysis ; Norms ; Papillomavirus Infections - prevention & control ; Papillomavirus Vaccines ; Patient Acceptance of Health Care ; Rural areas ; Students ; Surveys and Questionnaires ; Theory of Planned Behavior ; Universities ; Vaccination ; Vaccine acceptance ; Vaccine hesitancy ; Vaccines ; Warts</subject><ispartof>Vaccine, 2021-12, Vol.39 (51), p.7421-7428</ispartof><rights>2021 Elsevier Ltd</rights><rights>Copyright © 2021 Elsevier Ltd. All rights reserved.</rights><rights>2021. Elsevier Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-e36fcfab546c45901ae117f74017f067526b6497e83f1c29fc0ff32933d601e33</citedby><cites>FETCH-LOGICAL-c440t-e36fcfab546c45901ae117f74017f067526b6497e83f1c29fc0ff32933d601e33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2608445930?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34772544$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shah, Sayyed Fawad Ali</creatorcontrib><creatorcontrib>Ginossar, Tamar</creatorcontrib><creatorcontrib>Bentley, Joshua M</creatorcontrib><creatorcontrib>Zimet, Gregory</creatorcontrib><creatorcontrib>McGrail, J. Patrick</creatorcontrib><title>Using the Theory of Planned behavior to identify correlates of HPV vaccination uptake among college students attending a rural university in Alabama</title><title>Vaccine</title><addtitle>Vaccine</addtitle><description>Humanpapillomavirus (HPV) has infected nearly 80 million people in the U.S., and is associated with most cervical cancer cases. Alabama ranks first in the country for cervical cancer mortality and third for incidence. Although the HPV vaccine can prevent HPV and reduce cancer rates, Alabama is well-below the national average for HPV vaccination. Using the Theory of Planned Behavior (TPB), this Alabama-based study aimed to examine college students’ intentions to get the HPV vaccine; to examine the relationship between the relationship between religious beliefs and HPV vaccination uptake status among college students.
Students (n = 257) from a university in rural Alabama completed the survey. Multiple regression analysis, Mann-Whitney U tests, and moderation analysis were used to examine associations among the variables of interest.
Consistent with TPB, results showed that attitudes and subjective norms were significant predictors of intention to get vaccinated. Knowledge that both sexes can experience HPV-related health problems, that HPV can cause genital warts, and that the vaccine protects against HPV were each associated with higher attitude scores. The results indicated that the odds of getting at least one HPV shot were higher for females than for males for non-Caucasians than for Caucasians. Students who were not vaccinated were more likely to report that religion influenced their health beliefs. *Abstract.
TPB was helpful in understanding HPV-related intentions. Communication and education efforts are needed to increase understanding of HPV illnesses and HPV vaccination benefits among peers, parents, and other loved ones of students. in the rural areas of Alabama.</description><subject>Alabama</subject><subject>Attitudes</subject><subject>Cancer</subject><subject>Cervical cancer</subject><subject>Cervix</subject><subject>College students</subject><subject>Colleges & universities</subject><subject>Condyloma acuminatum</subject><subject>Decision making</subject><subject>Female</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Health problems</subject><subject>HPV vaccine</subject><subject>Human papillomavirus</subject><subject>Humans</subject><subject>Immunization</subject><subject>Male</subject><subject>Multiple regression analysis</subject><subject>Norms</subject><subject>Papillomavirus Infections - prevention & control</subject><subject>Papillomavirus Vaccines</subject><subject>Patient Acceptance of Health Care</subject><subject>Rural areas</subject><subject>Students</subject><subject>Surveys and Questionnaires</subject><subject>Theory of Planned Behavior</subject><subject>Universities</subject><subject>Vaccination</subject><subject>Vaccine acceptance</subject><subject>Vaccine hesitancy</subject><subject>Vaccines</subject><subject>Warts</subject><issn>0264-410X</issn><issn>1873-2518</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc2KFDEUhYMoTjv6CErAjZtqb37qbyXDoI4w4CxmxF1IpW6m01YnbZJq6PfwgU3RrQs3bhK4fOecmxxCXjNYM2DN--36oI1xHtccOCuzNXT8CVmxrhUVr1n3lKyAN7KSDL5fkBcpbQGgFqx_Ti6EbFteS7kivx6S8480b5DebzDEIw2W3k3aexzpgBt9cCHSHKgb0Wdnj9SEGHHSGdOC3tx9o6dFdHbB03mf9Q-keheKqwnThI9IU54XdaI6Z_TjEqhpnKOe6OzdAWNy-Uidp1eTHvROvyTPrJ4Svjrfl-Th08f765vq9uvnL9dXt5WREnKForHG6qGWjZF1D0wjY61tJZQTmrbmzdDIvsVOWGZ4bw1YK3gvxNgAQyEuybuT7z6GnzOmrHYuGZzK8zHMSfG6b2uARvQFffsPug1z9GU7xRvoZMkXUKj6RJkYUopo1T66nY5HxUAttamtOtemltqWcamt6N6c3edhh-Nf1Z-eCvDhBGD5joPDqJJx6A2OLqLJagzuPxG_Ad0QrOQ</recordid><startdate>20211217</startdate><enddate>20211217</enddate><creator>Shah, Sayyed Fawad Ali</creator><creator>Ginossar, Tamar</creator><creator>Bentley, Joshua M</creator><creator>Zimet, Gregory</creator><creator>McGrail, J. Patrick</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T2</scope><scope>7T5</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20211217</creationdate><title>Using the Theory of Planned behavior to identify correlates of HPV vaccination uptake among college students attending a rural university in Alabama</title><author>Shah, Sayyed Fawad Ali ; Ginossar, Tamar ; Bentley, Joshua M ; Zimet, Gregory ; McGrail, J. Patrick</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-e36fcfab546c45901ae117f74017f067526b6497e83f1c29fc0ff32933d601e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Alabama</topic><topic>Attitudes</topic><topic>Cancer</topic><topic>Cervical cancer</topic><topic>Cervix</topic><topic>College students</topic><topic>Colleges & universities</topic><topic>Condyloma acuminatum</topic><topic>Decision making</topic><topic>Female</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Health problems</topic><topic>HPV vaccine</topic><topic>Human papillomavirus</topic><topic>Humans</topic><topic>Immunization</topic><topic>Male</topic><topic>Multiple regression analysis</topic><topic>Norms</topic><topic>Papillomavirus Infections - prevention & control</topic><topic>Papillomavirus Vaccines</topic><topic>Patient Acceptance of Health Care</topic><topic>Rural areas</topic><topic>Students</topic><topic>Surveys and Questionnaires</topic><topic>Theory of Planned Behavior</topic><topic>Universities</topic><topic>Vaccination</topic><topic>Vaccine acceptance</topic><topic>Vaccine hesitancy</topic><topic>Vaccines</topic><topic>Warts</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shah, Sayyed Fawad Ali</creatorcontrib><creatorcontrib>Ginossar, Tamar</creatorcontrib><creatorcontrib>Bentley, Joshua M</creatorcontrib><creatorcontrib>Zimet, Gregory</creatorcontrib><creatorcontrib>McGrail, J. Patrick</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Vaccine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shah, Sayyed Fawad Ali</au><au>Ginossar, Tamar</au><au>Bentley, Joshua M</au><au>Zimet, Gregory</au><au>McGrail, J. Patrick</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Using the Theory of Planned behavior to identify correlates of HPV vaccination uptake among college students attending a rural university in Alabama</atitle><jtitle>Vaccine</jtitle><addtitle>Vaccine</addtitle><date>2021-12-17</date><risdate>2021</risdate><volume>39</volume><issue>51</issue><spage>7421</spage><epage>7428</epage><pages>7421-7428</pages><issn>0264-410X</issn><eissn>1873-2518</eissn><abstract>Humanpapillomavirus (HPV) has infected nearly 80 million people in the U.S., and is associated with most cervical cancer cases. Alabama ranks first in the country for cervical cancer mortality and third for incidence. Although the HPV vaccine can prevent HPV and reduce cancer rates, Alabama is well-below the national average for HPV vaccination. Using the Theory of Planned Behavior (TPB), this Alabama-based study aimed to examine college students’ intentions to get the HPV vaccine; to examine the relationship between the relationship between religious beliefs and HPV vaccination uptake status among college students.
Students (n = 257) from a university in rural Alabama completed the survey. Multiple regression analysis, Mann-Whitney U tests, and moderation analysis were used to examine associations among the variables of interest.
Consistent with TPB, results showed that attitudes and subjective norms were significant predictors of intention to get vaccinated. Knowledge that both sexes can experience HPV-related health problems, that HPV can cause genital warts, and that the vaccine protects against HPV were each associated with higher attitude scores. The results indicated that the odds of getting at least one HPV shot were higher for females than for males for non-Caucasians than for Caucasians. Students who were not vaccinated were more likely to report that religion influenced their health beliefs. *Abstract.
TPB was helpful in understanding HPV-related intentions. Communication and education efforts are needed to increase understanding of HPV illnesses and HPV vaccination benefits among peers, parents, and other loved ones of students. in the rural areas of Alabama.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>34772544</pmid><doi>10.1016/j.vaccine.2021.10.082</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0264-410X |
ispartof | Vaccine, 2021-12, Vol.39 (51), p.7421-7428 |
issn | 0264-410X 1873-2518 |
language | eng |
recordid | cdi_proquest_miscellaneous_2597500639 |
source | MEDLINE; Elsevier ScienceDirect Journals Complete; ProQuest Central UK/Ireland |
subjects | Alabama Attitudes Cancer Cervical cancer Cervix College students Colleges & universities Condyloma acuminatum Decision making Female Health Knowledge, Attitudes, Practice Health problems HPV vaccine Human papillomavirus Humans Immunization Male Multiple regression analysis Norms Papillomavirus Infections - prevention & control Papillomavirus Vaccines Patient Acceptance of Health Care Rural areas Students Surveys and Questionnaires Theory of Planned Behavior Universities Vaccination Vaccine acceptance Vaccine hesitancy Vaccines Warts |
title | Using the Theory of Planned behavior to identify correlates of HPV vaccination uptake among college students attending a rural university in Alabama |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T10%3A54%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Using%20the%20Theory%20of%20Planned%20behavior%20to%20identify%20correlates%20of%20HPV%20vaccination%20uptake%20among%20college%20students%20attending%20a%20rural%20university%20in%20Alabama&rft.jtitle=Vaccine&rft.au=Shah,%20Sayyed%20Fawad%20Ali&rft.date=2021-12-17&rft.volume=39&rft.issue=51&rft.spage=7421&rft.epage=7428&rft.pages=7421-7428&rft.issn=0264-410X&rft.eissn=1873-2518&rft_id=info:doi/10.1016/j.vaccine.2021.10.082&rft_dat=%3Cproquest_cross%3E2608445930%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2608445930&rft_id=info:pmid/34772544&rft_els_id=S0264410X21014316&rfr_iscdi=true |