Mobile app-assisted patient education in the public health: minimizing vaccine anxiety and managing long-term and post-COVID-19 effects
Mobile app-assisted education for minimizing vaccine anxiety and managing long-term and post-COVID-19 effects
Keywords:
anxiety, covid-19, long covid, patient education, post-covid syndrome, self-management, vaccine
Abstract
The challenge of vaccine hesitancy, especially towards COVID-19 vaccination, is raised by the widespread dissemination of misinformation, leading to increased anxiety among potential recipients. The primary objective is to assess the impact of a mobile app-based educational intervention on reducing anxiety associated with COVID-19 vaccination. Additionally, this study aims to establish the baseline prevalence of vaccine-related anxiety within the target population. A pre-test–post-test design was utilized for this study, conducted from March to August 2021 among residents of rural areas in the Special Region of Yogyakarta, Indonesia. A mobile app containing accurate and up-to-date vaccine-related information was developed for the educational intervention. Participants' levels of anxiety regarding COVID-19 vaccination were measured before and after the intervention using a standardized questionnaire. The Wilcoxon signed-rank test was applied for statistical analysis to evaluate the effectiveness of the intervention. Initial findings indicated that 56.90% of participants (n=268) experienced "mild to moderate" anxiety levels towards the COVID-19 vaccine before the intervention. Following the educational intervention, there was a statistically significant reduction in anxiety levels, with only 36.30% (n=171) reporting "mild to moderate" anxiety and 27.39% (n=129) indicating "moderate to severe" anxiety levels. The educational intervention's impact was statistically significant, with a p-value of 0.001. This study confirms that a mobile app-based educational intervention can significantly lower anxiety levels among individuals in rural Yogyakarta, Indonesia, concerning COVID-19 vaccination. These results highlight the potential of such interventions to effectively combat vaccine hesitancy and improve vaccine acceptance in similar contexts. This strategy shows promise in aiding global efforts to address the COVID-19 pandemic and future vaccination initiatives.
References
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Ghozali, M. T., Mohany, M., Milošević, M., Satibi, & Kurniawan, M. (2023). Impact of a mobile-app assisted self-management educational intervention on the scores of asthma control test (ACT) questionnaire among young asthmatic patients. Research in Social and Administrative Pharmacy, 19(10), 1354–1359. https://doi.org/10.1016/j.sapharm.2023.06.001
Gisondi, M. A., Barber, R., Faust, J. S., Raja, A., Strehlow, M. C., Westafer, L. M., & Gottlieb, M. (2022). A Deadly Infodemic: Social Media and the Power of COVID-19 Misinformation. Journal of Medical Internet Research, 24(2), e35552. https://doi.org/10.2196/35552
Hao, F., Wang, B., Tan, W., Husain, S. F., McIntyre, R. S., Tang, X., Zhang, L., Han, X., Jiang, L., Chew, N. W. S., Tan, B. Y.-Q., Tran, B., Zhang, Z., Vu, G. L., Vu, G. T., Ho, R., Ho, C. S., & Sharma, V. K. (2021). Attitudes toward COVID-19 vaccination and willingness to pay: Comparison of people with and without mental disorders in China. BJPsych Open, 7(5), e146. https://doi.org/10.1192/bjo.2021.979
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Hornsey, M. J., Finlayson, M., Chatwood, G., & Begeny, C. T. (2020). Donald Trump and vaccination: The effect of political identity, conspiracist ideation and presidential tweets on vaccine hesitancy. Journal of Experimental Social Psychology, 88, 103947.
Hou, Z., Tong, Y., Du, F., Lu, L., Zhao, S., Yu, K., Piatek, S. J., Larson, H. J., & Lin, L. (2021). Assessing COVID-19 Vaccine Hesitancy, Confidence, and Public Engagement: A Global Social Listening Study. Journal of Medical Internet Research, 23(6), e27632. https://doi.org/10.2196/27632
Hwang, S. E., Kim, W.-H., & Heo, J. (2022). Socio-demographic, psychological, and experiential predictors of COVID-19 vaccine hesitancy in South Korea, October-December 2020. Human Vaccines & Immunotherapeutics, 18(1), 1–8. https://doi.org/10.1080/21645515.2021.1983389
Iftinan, G. N., Wathoni, N., & Lestari, K. (2021). Telepharmacy: A Potential Alternative Approach for Diabetic Patients During the COVID-19 Pandemic. Journal of Multidisciplinary Healthcare, 14, 2261–2273. https://doi.org/10.2147/JMDH.S325645
Islam, M. N., Islam, I., Munim, K. Md., & Islam, A. K. M. N. (2020). A Review on the Mobile Applications Developed for COVID-19: An Exploratory Analysis. IEEE Access, 8, 145601–145610. https://doi.org/10.1109/ACCESS.2020.3015102
Islam, M. N., Khan, S., Islam, N., Rownok, R., Zaman, R., & Zaman, S. (2021). A Mobile Application for Mental Health Care During COVID-19 Pandemic: Development and Usability Evaluation with System Usability Scale (pp. 33–42). https://doi.org/10.1007/978-3-030-68133-3_4
Jaffe, D. H., Lee, L., Huynh, S., & Haskell, T. P. (2020). Health inequalities in the use of telehealth in the United States in the lens of COVID-19. Population Health Management, 23(5), 368–377.
Jiao, J. (2020). Under the epidemic situation of COVID‐19, should special attention to pregnant women be given? Journal of Medical Virology, 92(9), 1371–1372. https://doi.org/10.1002/jmv.25771
Kerr, J. R., Freeman, A. L. J., Marteau, T. M., & van der Linden, S. (2021). Effect of Information about COVID-19 Vaccine Effectiveness and Side Effects on Behavioural Intentions: Two Online Experiments. Vaccines, 9(4), Article 4. https://doi.org/10.3390/vaccines9040379
Kondylakis, H., Katehakis, D. G., Kouroubali, A., Logothetidis, F., Triantafyllidis, A., Kalamaras, I., Votis, K., & Tzovaras, D. (2020). COVID-19 Mobile Apps: A Systematic Review of the Literature. Journal of Medical Internet Research, 22(12), e23170. https://doi.org/10.2196/23170
Li, L. C. (2021). Facts and Analysis: Canvassing COVID-19 Responses. City University of HK Press.
Lu, H., Stratton, C. W., & Tang, Y.-W. (2020). The Wuhan SARS-CoV-2—What’s next for China. Journal of Medical Virology, 92(6), 546.
Ngai, C. S. B., Singh, R. G., & Yao, L. (2022). Impact of COVID-19 Vaccine Misinformation on Social Media Virality: Content Analysis of Message Themes and Writing Strategies. Journal of Medical Internet Research, 24(7), e37806. https://doi.org/10.2196/37806
Nguyen, K. V. (2021). Problems associated with antiviral drugs and vaccines development for COVID-19: Approach to intervention using expression vectors via GPI anchor. Nucleosides, Nucleotides & Nucleic Acids, 40(6), 665–706. https://doi.org/10.1080/15257770.2021.1914851
Rajachandran, K., Varghese, G. S., & Kumar, J. V. (2023). The effectiveness of Tocilizumab in severe covid 19 pneumonia among critically ill patients. Research Journal of Pharmacy and Technology, 16(2), 763–768. https://doi.org/10.52711/0974-360X.2023.00130
Rogowska, A. M., Pavlova, I., Kuśnierz, C., Ochnik, D., Bodnar, I., & Petrytsa, P. (2020). Does physical activity matter for the mental health of university students during the COVID-19 pandemic? Journal of Clinical Medicine, 9(11), 3494.
Shear, M. K., Vander Bilt, J., Rucci, P., Endicott, J., Lydiard, B., Otto, M. W., Pollack, M. H., Chandler, L., Williams, J., Ali, A., & Frank, D. M. (2001). Reliability and validity of a structured interview guide for the Hamilton Anxiety Rating Scale (SIGH-A). Depression and Anxiety, 13(4), 166–178. https://doi.org/10.1002/da.1033
Theng, L. Y., Han, L. Y., Er, L. J., Joy, L. C., Karthikeyan, P., Kumaresan, R., Rao, S. M., & Selvaraj, S. (2023a). Assessment of Fear and Anxiety towards Covid 19 among Dental Students in Malaysian Private University. Research Journal of Pharmacy and Technology, 16(6), 2699–2704. https://doi.org/10.52711/0974-360X.2023.00443
Theng, L. Y., Han, L. Y., Er, L. J., Joy, L. C., Karthikeyan, P., Kumaresan, R., Rao, S. M., & Selvaraj, S. (2023b). Assessment of Fear and Anxiety towards Covid 19 among Dental Students in Malaysian Private University. Research Journal of Pharmacy and Technology, 16(6), 2699–2704. https://doi.org/10.52711/0974-360X.2023.00443
Visacri, M. B., Figueiredo, I. V., & de Mendonça Lima, T. (2021). Role of pharmacist during the COVID-19 pandemic: A scoping review. Research in Social and Administrative Pharmacy, 17(1), 1799–1806.
Yang, Z. (2021). Hamilton Anxiety Rating Scale. In D. Gu & M. E. Dupre (Eds.), Encyclopedia of Gerontology and Population Aging (pp. 2243–2246). Springer International Publishing. https://doi.org/10.1007/978-3-030-22009-9_825
Zimand-Sheiner, D., Kol, O., Frydman, S., & Levy, S. (2021). To Be (Vaccinated) or Not to Be: The Effect of Media Exposure, Institutional Trust, and Incentives on Attitudes toward COVID-19 Vaccination. International Journal of Environmental Research and Public Health, 18(24), 12894. https://doi.org/10.3390/ijerph182412894
Zimmerman, T., Shiroma, K., Fleischmann, K. R., Xie, B., Jia, C., Verma, N., & Lee, M. K. (2023). Misinformation and COVID-19 vaccine hesitancy. Vaccine, 41(1), 136–144. https://doi.org/10.1016/j.vaccine.2022.11.014
Agley, J., & Xiao, Y. (2021). Misinformation about COVID-19: Evidence for differential latent profiles and a strong association with trust in science. BMC Public Health, 21(1), 89. https://doi.org/10.1186/s12889-020-10103-x
Aguilera-Hermida, A. P. (2020). College students’ use and acceptance of emergency online learning due to COVID-19. International Journal of Educational Research Open, 1, 100011.
Akarsu, B., Canbay Özdemir, D., Ayhan Baser, D., Aksoy, H., Fidancı, İ., & Cankurtaran, M. (2021). While studies on COVID-19 vaccine is ongoing, the public’s thoughts and attitudes to the future COVID-19 vaccine. International Journal of Clinical Practice, 75(4), e13891.
Atehortua, N. A., & Patino, S. (2020). COVID-19, a tale of two pandemics: Novel coronavirus and fake news messaging. Health Promotion International, daaa140. https://doi.org/10.1093/heapro/daaa140
Bhat, S. A., Singh, G., Bhat, W. F., Borole, K., & Khan, A. A. (2021). Coronavirus disease-2019 and its current scenario–A review. Clinical eHealth, 4, 67–73.
Chen, C., Zhou, Y., & Wang, D. W. (2020). SARS-CoV-2: A potential novel etiology of fulminant myocarditis. Herz, 45, 230–232.
Chintalapudi, N., Battineni, G., & Amenta, F. (2020). COVID-19 virus outbreak forecasting of registered and recovered cases after sixty day lockdown in Italy: A data driven model approach. Journal of Microbiology, Immunology and Infection, 53(3), 396–403.
Elharake, J. A., Akbar, F., Malik, A. A., Gilliam, W., & Omer, S. B. (2023). Mental Health Impact of COVID-19 among Children and College Students: A Systematic Review. Child Psychiatry & Human Development, 54(3), 913–925. https://doi.org/10.1007/s10578-021-01297-1
Fawcett, E. J., Power, H., & Fawcett, J. M. (2020). Women are at greater risk of OCD than men: A meta-analytic review of OCD prevalence worldwide. The Journal of Clinical Psychiatry, 81(4), 13075.
Ferreira Caceres, M. M., Sosa, J. P., Lawrence, J. A., Sestacovschi, C., Tidd-Johnson, A., Rasool, M. H. U., Gadamidi, V. K., Ozair, S., Pandav, K., Cuevas-Lou, C., Parrish, M., Rodriguez, I., & Fernandez, J. P. (2022). The impact of misinformation on the COVID-19 pandemic. AIMS Public Health, 9(2), 262–277. https://doi.org/10.3934/publichealth.2022018
Ferreira, L. N., Pereira, L. N., da Fé Brás, M., & Ilchuk, K. (2021). Quality of life under the COVID-19 quarantine. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 30(5), 1389–1405. https://doi.org/10.1007/s11136-020-02724-x
Gaikwad, P. P., Nakade, M., Kamble, S., Shiralkar, M., Chaudhari, V., & Udmale, M. (2023). Protocol for a Systematic review and Network meta-analysis of Randomized controlled trials examining the effectiveness of Ayurveda Interventions in management of Covid 19 positive patients. Research Journal of Pharmacy and Technology, 16(2), 936–940. https://doi.org/10.52711/0974-360X.2023.00157
Gamsakhurdashvili, D., Antov, M. I., & Stockhorst, U. (2021). Facial Emotion Recognition and Emotional Memory From the Ovarian-Hormone Perspective: A Systematic Review. Frontiers in Psychology, 12. https://www.frontiersin.org/articles/10.3389/fpsyg.2021.641250
Ghozali, M. T. (2022). Mobile app for COVID-19 patient education – Development process using the analysis, design, development, implementation, and evaluation models. Nonlinear Engineering, 11(1), 549–557. https://doi.org/10.1515/nleng-2022-0241
Ghozali, M. T. (2023). Is integrating video into tech-based patient education effective for improving medication adherence? – A review. Paladyn, Journal of Behavioral Robotics, 14(1). https://doi.org/10.1515/pjbr-2022-0109
Ghozali, M. T., Amalia Islamy, I. D., & Hidayaturrohim, B. (2022). Effectiveness of an educational mobile-app intervention in improving the knowledge of COVID-19 preventive measures. Informatics in Medicine Unlocked, 34, 101112. https://doi.org/10.1016/j.imu.2022.101112
Ghozali, M. T., Mohany, M., Milošević, M., Satibi, & Kurniawan, M. (2023). Impact of a mobile-app assisted self-management educational intervention on the scores of asthma control test (ACT) questionnaire among young asthmatic patients. Research in Social and Administrative Pharmacy, 19(10), 1354–1359. https://doi.org/10.1016/j.sapharm.2023.06.001
Gisondi, M. A., Barber, R., Faust, J. S., Raja, A., Strehlow, M. C., Westafer, L. M., & Gottlieb, M. (2022). A Deadly Infodemic: Social Media and the Power of COVID-19 Misinformation. Journal of Medical Internet Research, 24(2), e35552. https://doi.org/10.2196/35552
Hao, F., Wang, B., Tan, W., Husain, S. F., McIntyre, R. S., Tang, X., Zhang, L., Han, X., Jiang, L., Chew, N. W. S., Tan, B. Y.-Q., Tran, B., Zhang, Z., Vu, G. L., Vu, G. T., Ho, R., Ho, C. S., & Sharma, V. K. (2021). Attitudes toward COVID-19 vaccination and willingness to pay: Comparison of people with and without mental disorders in China. BJPsych Open, 7(5), e146. https://doi.org/10.1192/bjo.2021.979
Harapan, H., Wagner, A. L., Yufika, A., Winardi, W., Anwar, S., Gan, A. K., Setiawan, A. M., Rajamoorthy, Y., Sofyan, H., & Mudatsir, M. (2020). Acceptance of a COVID-19 Vaccine in Southeast Asia: A Cross-Sectional Study in Indonesia. Frontiers in Public Health, 8.
Haryanto, B., Nurlambang, T., & Dewi, S. R. (2021). COVID-19 in Indonesia: Geo-Ecology and People’s Behaviour. In R. Akhtar (Ed.), Coronavirus (COVID-19) Outbreaks, Environment and Human Behaviour (pp. 97–114). Springer International Publishing. https://doi.org/10.1007/978-3-030-68120-3_7
Hornsey, M. J., Finlayson, M., Chatwood, G., & Begeny, C. T. (2020). Donald Trump and vaccination: The effect of political identity, conspiracist ideation and presidential tweets on vaccine hesitancy. Journal of Experimental Social Psychology, 88, 103947.
Hou, Z., Tong, Y., Du, F., Lu, L., Zhao, S., Yu, K., Piatek, S. J., Larson, H. J., & Lin, L. (2021). Assessing COVID-19 Vaccine Hesitancy, Confidence, and Public Engagement: A Global Social Listening Study. Journal of Medical Internet Research, 23(6), e27632. https://doi.org/10.2196/27632
Hwang, S. E., Kim, W.-H., & Heo, J. (2022). Socio-demographic, psychological, and experiential predictors of COVID-19 vaccine hesitancy in South Korea, October-December 2020. Human Vaccines & Immunotherapeutics, 18(1), 1–8. https://doi.org/10.1080/21645515.2021.1983389
Iftinan, G. N., Wathoni, N., & Lestari, K. (2021). Telepharmacy: A Potential Alternative Approach for Diabetic Patients During the COVID-19 Pandemic. Journal of Multidisciplinary Healthcare, 14, 2261–2273. https://doi.org/10.2147/JMDH.S325645
Islam, M. N., Islam, I., Munim, K. Md., & Islam, A. K. M. N. (2020). A Review on the Mobile Applications Developed for COVID-19: An Exploratory Analysis. IEEE Access, 8, 145601–145610. https://doi.org/10.1109/ACCESS.2020.3015102
Islam, M. N., Khan, S., Islam, N., Rownok, R., Zaman, R., & Zaman, S. (2021). A Mobile Application for Mental Health Care During COVID-19 Pandemic: Development and Usability Evaluation with System Usability Scale (pp. 33–42). https://doi.org/10.1007/978-3-030-68133-3_4
Jaffe, D. H., Lee, L., Huynh, S., & Haskell, T. P. (2020). Health inequalities in the use of telehealth in the United States in the lens of COVID-19. Population Health Management, 23(5), 368–377.
Jiao, J. (2020). Under the epidemic situation of COVID‐19, should special attention to pregnant women be given? Journal of Medical Virology, 92(9), 1371–1372. https://doi.org/10.1002/jmv.25771
Kerr, J. R., Freeman, A. L. J., Marteau, T. M., & van der Linden, S. (2021). Effect of Information about COVID-19 Vaccine Effectiveness and Side Effects on Behavioural Intentions: Two Online Experiments. Vaccines, 9(4), Article 4. https://doi.org/10.3390/vaccines9040379
Kondylakis, H., Katehakis, D. G., Kouroubali, A., Logothetidis, F., Triantafyllidis, A., Kalamaras, I., Votis, K., & Tzovaras, D. (2020). COVID-19 Mobile Apps: A Systematic Review of the Literature. Journal of Medical Internet Research, 22(12), e23170. https://doi.org/10.2196/23170
Li, L. C. (2021). Facts and Analysis: Canvassing COVID-19 Responses. City University of HK Press.
Lu, H., Stratton, C. W., & Tang, Y.-W. (2020). The Wuhan SARS-CoV-2—What’s next for China. Journal of Medical Virology, 92(6), 546.
Ngai, C. S. B., Singh, R. G., & Yao, L. (2022). Impact of COVID-19 Vaccine Misinformation on Social Media Virality: Content Analysis of Message Themes and Writing Strategies. Journal of Medical Internet Research, 24(7), e37806. https://doi.org/10.2196/37806
Nguyen, K. V. (2021). Problems associated with antiviral drugs and vaccines development for COVID-19: Approach to intervention using expression vectors via GPI anchor. Nucleosides, Nucleotides & Nucleic Acids, 40(6), 665–706. https://doi.org/10.1080/15257770.2021.1914851
Rajachandran, K., Varghese, G. S., & Kumar, J. V. (2023). The effectiveness of Tocilizumab in severe covid 19 pneumonia among critically ill patients. Research Journal of Pharmacy and Technology, 16(2), 763–768. https://doi.org/10.52711/0974-360X.2023.00130
Rogowska, A. M., Pavlova, I., Kuśnierz, C., Ochnik, D., Bodnar, I., & Petrytsa, P. (2020). Does physical activity matter for the mental health of university students during the COVID-19 pandemic? Journal of Clinical Medicine, 9(11), 3494.
Shear, M. K., Vander Bilt, J., Rucci, P., Endicott, J., Lydiard, B., Otto, M. W., Pollack, M. H., Chandler, L., Williams, J., Ali, A., & Frank, D. M. (2001). Reliability and validity of a structured interview guide for the Hamilton Anxiety Rating Scale (SIGH-A). Depression and Anxiety, 13(4), 166–178. https://doi.org/10.1002/da.1033
Theng, L. Y., Han, L. Y., Er, L. J., Joy, L. C., Karthikeyan, P., Kumaresan, R., Rao, S. M., & Selvaraj, S. (2023a). Assessment of Fear and Anxiety towards Covid 19 among Dental Students in Malaysian Private University. Research Journal of Pharmacy and Technology, 16(6), 2699–2704. https://doi.org/10.52711/0974-360X.2023.00443
Theng, L. Y., Han, L. Y., Er, L. J., Joy, L. C., Karthikeyan, P., Kumaresan, R., Rao, S. M., & Selvaraj, S. (2023b). Assessment of Fear and Anxiety towards Covid 19 among Dental Students in Malaysian Private University. Research Journal of Pharmacy and Technology, 16(6), 2699–2704. https://doi.org/10.52711/0974-360X.2023.00443
Visacri, M. B., Figueiredo, I. V., & de Mendonça Lima, T. (2021). Role of pharmacist during the COVID-19 pandemic: A scoping review. Research in Social and Administrative Pharmacy, 17(1), 1799–1806.
Yang, Z. (2021). Hamilton Anxiety Rating Scale. In D. Gu & M. E. Dupre (Eds.), Encyclopedia of Gerontology and Population Aging (pp. 2243–2246). Springer International Publishing. https://doi.org/10.1007/978-3-030-22009-9_825
Zimand-Sheiner, D., Kol, O., Frydman, S., & Levy, S. (2021). To Be (Vaccinated) or Not to Be: The Effect of Media Exposure, Institutional Trust, and Incentives on Attitudes toward COVID-19 Vaccination. International Journal of Environmental Research and Public Health, 18(24), 12894. https://doi.org/10.3390/ijerph182412894
Zimmerman, T., Shiroma, K., Fleischmann, K. R., Xie, B., Jia, C., Verma, N., & Lee, M. K. (2023). Misinformation and COVID-19 vaccine hesitancy. Vaccine, 41(1), 136–144. https://doi.org/10.1016/j.vaccine.2022.11.014
Published
2025-03-27
How to Cite
Ghozali, M. (2025). Mobile app-assisted patient education in the public health: minimizing vaccine anxiety and managing long-term and post-COVID-19 effects. Indonesian Journal of Pharmacy. https://doi.org/10.22146/ijp.12230
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Research Article
