An exploration of unorthodox worldviews that predict vaccine scepticism and use of complementary and alternative medicine

There are many people who choose alternative or unorthodox healthcare options that are not based on the best available evidence for efficacy and effectiveness. There has been a rejection of vaccination by sections of the population leading to suboptimal rates of vaccination, and increased rates of infectious diseases such as measles. Complementary and alternative medicines (CAMs) are also increasingly popular, despite the scarcity of clinical evidence for the efficacy and safety of many of these therapies. The goal of this thesis is to explore unorthodox worldviews that predict vaccine scepticism and use of CAM in order to inform the future development of persuasive strategies to encourage participation in vaccination programs, and evidence-based healthcare. In this thesis the underpinnings of vaccine scepticism and CAM use have been explored through the different traditions of individual differences (inclusive of personality, attitudes, and beliefs), socio-demographics, and emotional reactions. Four studies were undertaken to achieve this goal including (1) the development of a standardised measure of CAM utilisation using data from an archived population survey of Australian adults; (2) an investigation of explanatory factors, including personality (openness to experience), cognitive style, and a range of unorthodox beliefs, for the relationship between CAM use and vaccination scepticism, using an archived population survey of Australian adults; (3) an examination of associations between geographic or area-level socio-demographic factors and uptake of vaccination among 5-year old children throughout Australia, using a public health focused ecological methodology, and (4) conducting an online priming experiment, to assess whether increasing the salience of concepts of contamination and purity will produce changes in reactions to a range of health interventions, including vaccination and CAM. Following are the key findings. The first study developed a brief, summative questionnaire measure of CAM utilisation called the R-I-CAM-Q, to address a gap in previous research which was lacking a psychometrically sound, and quantitative measure of CAM utilisation. The main findings of the second study, a cross-sectional survey, were that positive attitudes to CAMs, rather than use of CAMs, best predict vaccination attitudes; and that negative attitudes to vaccination and positive attitudes to CAMs both correlate with the presumed antecedents of magical beliefs about health. The geographic/area-based study revealed that communities with lower rates of vaccination had relatively less disadvantage, and had relatively greater education and occupational status, suggesting that privilege puts people at risk. The priming experiment showed no experimental effect of priming for contamination or purity/naturalness. Nevertheless, higher levels of sensitivity to disgust were associated with lower ratings of the effectiveness of MMR vaccination, tetanus injection, antibiotics, and surgery. These studies identify the psychological, social, cultural, and emotional characteristics of those who have unorthodox health beliefs and behaviours. Knowledge that can directly inform the future development of tailored and persuasive health promotion strategies and campaigns which encourage evidence-based healthcare choices, particularly uptake of vaccination.