{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:06:33Z","timestamp":1780329993982,"version":"3.54.1"},"reference-count":50,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Japanese encephalitis (JE) is a mosquito-borne disease with low infection risk but high consequences. Low uptake of JE vaccines among travelers persists despite effective vaccines. Tools that improve decision quality may help address this gap.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate whether a web-based JE vaccine decision aid (JEVaDA) improves decision-making and vaccine uptake among Australian travelers compared with an online government JE resource.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This parallel-group, single-blind randomized clinical trial was conducted online across Australia from November 6, 2024, to July 14, 2025. Adults (aged \u226518 years) planning travel to a JE-endemic country within 6 months were recruited via a research panel.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Participants were randomized 1:1 to the JEVaDA intervention, developed to International Patient Decision Aid Standards, or an online government JE resource (the active comparator).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was postintervention decisional conflict, measured using the Decisional Conflict Scale (DCS) (scores range from 0 to 100, with higher scores indicating greater conflict). Secondary outcomes included change in JE knowledge, intention to vaccinate, and self-reported vaccine uptake. Analyses used regression models adjusted for baseline values, age, and gender.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of the 1879 individuals screened, 814 were randomized and 769 completed preintervention and postintervention assessments (modified intention-to-treat population: 373 in the intervention group and 396 in the comparator group). Their mean (SD) age was 44.7 (15.2) years; 394 (51.2%) identified as women. The intervention and comparator groups showed significant reductions in decisional conflict (mean DCS score change, \u221210.94 [95% CI, \u221212.81 to \u22129.07] vs \u221211.58 [\u221213.24 to \u22129.91] points, respectively; both\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), with no between-group difference (\u03b2, \u22120.87 [95% CI, \u22122.93 to 1.19];\n P<\/jats:italic>\n \u2009=\u2009.41). JE knowledge improved in both groups (intervention vs comparator: 2.27 [95% CI, 2.00-2.54] vs 2.63 [95% CI, 2.36-2.91] correct responses;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), with no between-group difference (incidence rate ratio [IRR], 0.95 [95% CI, 0.90-1.00];\n P<\/jats:italic>\n \u2009=\u2009.07). Positive change in intention to vaccinate occurred in 72 participants (19.3% [95% CI, 1.53%-2.33%]) in the intervention group vs 66 (16.7% [95% CI, 1.30%-2.04%]) in the comparator group (adjusted odds ratio [AOR], 1.19 [95% CI, 0.80-1.76];\n P<\/jats:italic>\n \u2009=\u2009.40). Among the 348 travelers completing follow-up after travel to JE risk areas, vaccine uptake was 35.1% overall (n\u2009=\u2009122) and was significantly higher in the intervention group than in the comparator group (69 of 161 [42.9%] vs 53 of 187 [28.3%]; AOR, 2.22 [95% CI, 1.36-3.61];\n P<\/jats:italic>\n \u2009=\u2009.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this randomized clinical trial, the web-based JEVaDA was not associated with a further reduction in decisional conflict compared with an active comparator but was associated with higher vaccine uptake. These findings suggest that decision aids can support informed, values-congruent choices in complex, preference-sensitive health decisions such as travel vaccination and beyond.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n anzctr.org.au Identifier:\n ACTRN12624001176550<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.15190","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T15:30:38Z","timestamp":1780327838000},"page":"e2615190","source":"Crossref","is-referenced-by-count":0,"title":["Japanese Encephalitis Vaccine Decision Aid for Travelers"],"prefix":"10.1001","volume":"9","author":[{"given":"Sarah L.","family":"McGuinness","sequence":"first","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen","family":"Eades","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Morris","sequence":"additional","affiliation":[{"name":"Independent Consumer Advisor, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Seale","sequence":"additional","affiliation":[{"name":"School of Population Health, Faculty of Medicine and Health, University of New South Wales, Kensington, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen C.","family":"Cheng","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"Monash Infectious Diseases Service, Clayton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Leder","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"Victorian Infectious Diseases Service, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"zoi260436r1","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.51027","article-title":"Estimates of the global burden of Japanese encephalitis and the impact of vaccination from 2000-2015.","volume":"9","author":"Quan","year":"2020","journal-title":"Elife"},{"issue":"1","key":"zoi260436r2","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s40794-017-0057-x","article-title":"The changing epidemiology of Japanese 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