Being mentally flexible can influence our attitudes towards vaccination, study shows

Making decisions about our health is a complex and sometimes difficult process.

In addition to our own attitudes, experiences, and perspectives, we are inundated with information from other people (friends, family, health professionals) and external sources (news or social media) about what it means to be healthy.

Sometimes this information is consistent with what we think about our own health. At other times, it may contradict our own beliefs. And to complicate matters further, sometimes this information is deliberate misinformation.

How do we make sense of all this when making decisions about our health? What determines whether we stick to our attitudes or change our minds?

Most of us can probably relate to this. During the COVID-19 pandemic, we had to change many of our behaviors to slow the spread of the virus. This meant working from home, wearing a mask, staying in our “bubbles” and finally getting the shot.

While the decision to get vaccinated was obvious for many people, for others it was not so simple. Research from the period immediately before the COVID vaccine was available in New Zealand showed a significant minority were either unsure or unlikely to be vaccinated.

These people were more likely to be young, female, and less educated, and were primarily concerned about unknown future side effects. Our new research suggests that cognitive (mental) flexibility may also have something to do with attitudes toward vaccination.

A flexible mind

Previous research suggests that mental flexibility plays an important role in our decision making. Imagine changing the way you do something at work, arguing with someone who has a different opinion, or being told that you should make healthier choices (like exercising more).

Some people navigate these situations with ease. Others find it harder to adapt. Mental flexibility describes this ability to adapt our attitudes, thoughts or behaviors in the face of new or changing information.

Studies show that mental flexibility influences how extreme our opinions are, how likely we are to believe misinformation or “fake news,” whether we make pro-environmental choices or engage in health-promoting behaviors (sunscreen or physical exercise, for example).

To increase vaccination coverage, governments often use educational campaigns that emphasize the safety, effectiveness, and importance of vaccination. However, these campaigns do not always succeed in reducing feelings of uncertainty about vaccination.

We wanted to know why, and thought that mental flexibility might play a role. To test this, we surveyed 601 New Zealanders about their opinions and experiences of vaccination.

Some questions asked about external factors, such as how easy they thought it was to access or pay for vaccines. Other questions asked about internal factors, such as personal beliefs about vaccination, perceptions of their own health, and how important or safe they thought vaccines were.

Overall, our participants reported few external barriers to vaccination, with 97% saying they found vaccines accessible or affordable. These percentages are promising and may reflect the government’s continued efforts to make it easier to get a vaccine.

In comparison, internal factors played a larger role in vaccine uncertainty or hesitancy. In particular, nearly a quarter (22%) of participants reported concerns about the health risks of vaccines. And 12% said they did not trust the processes or people who developed vaccines.

Adaptive Behavior Test

We also asked our participants to play a game designed to measure mental flexibility.

This involved matching cards based on a rule, for example matching cards with the same number of objects. The rule would change randomly during the game, meaning that participants had to adapt their behavior as the game progressed.

Interestingly, people who found it more difficult to adapt to rule changes (ie, who had lower levels of mental flexibility) also reported more internal barriers to vaccination.

For example, when we divided the participants into two groups based on their mental flexibility, the low flexibility group was 18% more likely to say that vaccination was inconsistent with their beliefs. They were also 14% more likely to say they did not trust vaccines and 11% more likely to report negative side effects of vaccines.

This was not the case for external factors. Mental flexibility did not predict whether people thought vaccines were accessible or affordable.

Information is sometimes not enough

These results suggest that making decisions about our health, including whether or not to vaccinate, depends on more than receiving the “correct” information.

Simply telling them the importance of vaccination may not be enough to change attitudes or behaviour. It also depends on each person’s unique cognitive style—the way they perceive and process information.

Declining vaccination rates have been a concern around the world, including in New Zealand, since long before the pandemic. Our results suggest that health education campaigns may be more effective if they consider the role of cognitive flexibility.

One technique is to change the way information is framed. For example, rather than simply presenting facts about the safety or importance of vaccination, educational campaigns could encourage us to question our own perspectives or imagine alternative realities by asking “what if?” questions

Research shows that this kind of framing can engage our deliberative thought processes (those that help us think deeply and critically), increase mental flexibility, and ultimately make us more receptive to change.

This article is republished from The Conversation under a Creative Commons license. Read the original article.