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Background: Perceptions of the US healthcare system can impact individuals' healthcare utilization, including vaccination intentions. This study examined the association between perceived racial-ethnic inequities in COVID-19 healthcare and willingness to receive the COVID-19 vaccine. Methods: This study used data from REACH-US, a nationally representative online survey of a large, diverse sample of U.S. adults (N=5145 January 26, 2021-March 3, 2021). Confirmatory factor and regression analyses examined a latent factor of perceived racial-ethnic inequities in COVID-19 healthcare, whether the factor was associated with willingness to receive the COVID-19 vaccine, and whether associations varied across racial-ethnic groups reported as probit estimates (B) and 95% confidence intervals (CIs). Results: Perceived racial-ethnic inequities in COVID-19 healthcare were highest among Black/African American adults (mean latent factor score: 0.65 ± 0.43) and lowest among White adults (mean latent factor score: 0.04 ± 0.67). Black/African American (B = -0.08; 95% CI = -0.19, 0.03) and Native Hawaiian/Pacific Islander (B = -0.08; 95% CI = -0.23, 0.07) adults who perceived greater racial-ethnic inequities in COVID-19 healthcare were less willing than participants who perceived lower inequities. In contrast, American Indian/Alaska Native (B = 0.15; 95% CI = -0.01, 0.30), Asian (B = 0.20; 95% CI = 0.08, 0.31), Hispanic/Latino (English language preference) (B = 0.22; 95% CI = 0.01, 0.43), Multiracial (B = 0.23; 95% CI = 0.09, 0.36), and White (B = 0.31; 95% CI = 0.19, 0.43) adults who perceived greater racial-ethnic inequities in COVID-19 healthcare were more willing to receive the COVID-19 vaccine than participants perceiving higher inequities. Conclusions: Greater perceived racial-ethnic inequities in COVID-19 healthcare were associated with less willingness to receive the COVID-19 vaccine among Black/African American and Native Hawaiian/Pacific Islander adults. © 2024 Lippincott Williams and Wilkins. All rights reserved.
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Drug waste poses a real threat to human health and the environment. Therefore, recycling and sustainability scholars have recently sought practical solutions to the drug waste problem. Furthermore, several governments have made significant efforts to reduce the negative effects of waste, such as establishing programs to take back unwanted drugs (expired and unused) for recycling (i.e., drug reuse or drug redispersing). However, many of these programs have failed to achieve their goals. In this context, it is expected that creating green start-ups to collect unwanted drugs will contribute to solving this problem. Accordingly, this study aims to investigate the antecedents of intentions to create green start-ups for collecting unwanted drugs. To this end, the authors integrate start-up self-efficacy and drug waste collection-related knowledge constructs into the theory of planned behavior (TPB). Using a self-administered paper questionnaire and relying on a convenience sample, data were collected from 328 students in six Algerian universities. A hierarchical multiple regression was conducted to test the proposed study model. Theresults revealed that perceived behavioral control (PBC) (β = 0.187, p < 0.001), attitudes (β = 0.182, p = 0.002), start-up self-efficacy (β = 0.169, p = 0.001), drug waste collection-related knowledge (β = 0.161, p < 0.001), and subjective norms (β = 0.088, p < 0.05) have a positive significant effect on the intention to create a start-up to collect unwanted drugs. In conclusion, this paper contributes to reducing drug waste by investigating the drivers of intention to create green start-ups for collecting unwanted drugs. Therefore, our study is expected to provide valuable insights for hospitals, pharmacies, pharmaceutical manufacturers, environmental protection associations, and stakeholders interested in reverse logistics. © 2024 by the authors.