Integrating health behavior theories to predict American's intention to receive a COVID-19 vaccine

The Theory of Planned Behavior during the COVID-19 pandemic: A comparison of health behaviors between Belgian and French residents

The COVID-19 pandemic presents a global crisis and authorities have encouraged the population to promote preventive health behaviors to slow the spread of the virus. While the literature on psychological factors influencing health behaviors during the COVID-19 is flourishing, there is a lack of cross-national research focusing on multiple health behaviors. The present study overcomes this limitation and affords a validation of the Theory of Planned Behavior (TPB) as a conceptual framework for explaining the adoption of handwashing and limitation of social contacts, two health behaviors that highly differ in their nature. Specifically, we compare TPB model on these two protective behaviors among people living in Belgium (N = 3744) and France (N = 1060) during the COVID-19 sanitary crisis. Data were collected from March 18 until April 19, 2020, which corresponds to the spring lockdown and the first peak of the pandemic in these countries. Results indicated that more positive attitudes, greater social norms, increased perceived control and higher intentions were related to higher adherence to handwashing and limitation of social contacts, for both Belgian and French residents. Ultimately, we argued that the TPB model tends to manifest similarly across countries in explaining health behaviors, when comparing handwashing and limitation of social contacts among individuals living in different national contexts.

Intention to get COVID-19 vaccines: Exploring the role of attitudes, subjective norms, perceived behavioral control, belief in COVID-19 misinformation, and vaccine confidence in Northern India

This study examines people's intention to get COVID-19 vaccines and some of the psychological factors, that can facilitate the vaccination process. Using the theory of planned behavior (TPB) as a theoretical framework, we hypothesized that the key constructs of TPB (attitudes, subjective norms and perceived behavioral control) would explain people's intention to get COVID-19 vaccines. Belief in COVID-19-related misinformation and vaccine confidence were added to the TPB framework in order to comprehensively assess the predictors of COVID-19 vaccine intentions. Data was collected from 400 Indian respondents electronically during Feb-March, 2021. Hierarchical regression analysis was used to analyze the data. The Three components of TPB collectively explained 41% of the variance in the intention to get COVID-19 vaccines. Belief in COVID-19-related misinformation and vaccine confidence, on the other hand, had no significant impact on the intention to get COVID-19 vaccines. We discuss the theoretical and practical implications of these results.

Hope as a predictor for COVID-19 vaccine uptake

The worldwide effort to recover from the COVID-19 crisis is now at its pinnacle with the putative vaccine against SARS-CoV-2. To reach herd immunity, it has become an urgent global need to understand the emotional factors that drive people's choice to get vaccinated. Therefore, this exploratory study examined emotional motivations as predictors of the decision to receive the vaccine. The sample (N = 627) included adult (18+) participants in Israel who were recruited by a snowball sampling. The participants filled out an online survey when the vaccines have become widely available in Israel. Within the entire sample, as well as among people who did not receive the vaccine yet, hope was the only factor that was associated with their willingness to be vaccinated; higher levels of hope were related to willingness to be vaccinated. The results of the study indicate that hope is an important factor related to motivation to receive the SARS-CoV-2 vaccine.

The intention to get a COVID-19 vaccine among the students of health science in Vietnam

This study determines factors related to the intention to vaccinate against COVID-19 for health science students in Ho Chi Minh City (HCMC), using both the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) model. A cross-sectional survey was considered in April 2021, using a self-administered questionnaire to all health sciences students of the University of Medicine and Pharmacy in Ho Chi Minh City (UMP), Vietnam. The multiple regression was performed to specify the predictable factors of willingness to get a future COVID-19 vaccination.A total of 854 students completed the survey, whose vaccination acceptance was 77.1%. Predictors of intention to receive a COVID-19 vaccination included year of education, knowledge, and the HBM and TPB variables including the perceived benefits, cues to action, perceived behavioral control, and positive attitudes toward the vaccine (all p < .05). The main reasons for hesitancy included being afraid of the side effects (73.0%), vaccine safety (65.3%), and the process of new vaccine development (53.6%). The study examined students' intention toward COVID-19 vaccine and related factors to notify university administrators and policymakers. The findings showed the acceptability of vaccines had differences within the education year of students, besides, knowledge, perception of benefits, cues to action, behavioral control, and attitudes toward the vaccine were positive predictive factors. These may be useful for developing health education messages to promoting vaccination acceptability for students who had hesitancy of a new vaccine and in broader groups.

Information Framing Effect on Public's Intention to Receive the COVID-19 Vaccination in China

The aims of the study were (1) to explore information framing effect on the public's intention to receive the COVID-19 vaccination and (2) to understand the key factors influencing the intention of COVID-19 vaccinations in China. An online questionnaire survey was conducted to explore the influence of demographic characteristics, individual awareness, social relationship, risk disclosure, perceived vaccine efficacy, and protection duration under the assumptions of information framing. The results showed that (1) the persuasion effect under loss frame was higher than that under gain frame (B = 0.616 vs. 0.552); (2) there was no significant difference between sex, age, income, occupation, educational background and residence for the participants' intention to be vaccinated; whether family members/friends were vaccinated had a strong correlation with their vaccination intention under the gain frame; (3) the higher the understanding of COVID-19 and the compliance with government COVID-19 prevention and control measures were, the higher the vaccination intention was; (4) risk disclosure had the greatest impact on people's COVID-19 vaccination intention; (5) perceived vaccine effectiveness and duration of protection had little effect on people's intention to receive vaccination. The influence of information framing on the intention of COVID-19 vaccination is different. The publicity of relevant health information should pay attention to the influence of information framing and contents on the behavior of public vaccination, so as to enhance public health awareness and promote the vaccination of the whole population.

Light at the end of the tunnel: Influence of vaccine availability and vaccination intention on people's consideration of the COVID-19 vaccine

Rationale

Countries worldwide rely on the COVID-19 vaccine to contain the spread of the pandemic. However, because of the inequality in distribution, people in many demographic groups and regions still do not have access to a safe and effective COVID-19 vaccine.

Objective

To aid vaccine promotion campaigns that target populations with different access to the COVID-19 vaccine, this study examined how vaccine availability and vaccination intention influence people's consideration of the COVID-19 vaccine.

Method

We conducted a two-wave longitudinal survey and choice-based conjoint experiment to examine the influence of vaccine availability and vaccination intention on perceived barriers of vaccination (e.g., safety and cost concern) and preference in different vaccine features (e.g., FDA approval status and number of doses administered).

Result

We found that low availability and intention increased attention to global behavioral barriers such as safety concern and high-level vaccine attributes such as efficacy. In contrast, high availability articulates practical considerations such as cost and logistics associated with vaccination.

Conclusion

Based on such findings, we conclude that health communicators need to strategically customize their messages based on audience access to the COVID-19 vaccine and their intention to get vaccinated. Highlighting the safety and effectiveness of the vaccine may be more effective in low-accessibility and low-intention groups, while emphasis on practical considerations such as vaccine cost and logistics may be more effective in high-accessibility and high-intention groups.

COVID-19 Vaccine Hesitancy-A Scoping Review of Literature in High-Income Countries

Vaccine hesitancy forms a critical barrier to the uptake of COVID-19 vaccine in high-income countries or regions. This review aims to summarize rates of COVID-19 hesitancy and its determinants in high-income countries or regions. A scoping review was conducted in Medline®, Embase®, CINAHL®, and Scopus® and was reported in accordance with the PRISMA-SCr checklist. The search was current as of March 2021. Studies which evaluated COVID-19 vaccine hesitancy and its determinants in high-income countries (US$12,536 or more GNI per capita in 2019) were included. Studies conducted in low, lower-middle, and upper-middle income countries or regions were excluded. Factors associated with vaccine hesitancy were grouped into four themes (vaccine specific, individual, group, or contextual related factors). Of 2237 articles retrieved, 97 articles were included in this review. Most studies were conducted in U.S. (n = 39) and Italy (n = 9). The rates of vaccine hesitancy across high-income countries or regions ranged from 7-77.9%. 46 studies (47.4%) had rates of 30% and more. Younger age, females, not being of white ethnicity and lower education were common contextual factors associated with increased vaccine hesitancy. Lack of recent history of influenza vaccination, lower self-perceived risk of contracting COVID-19, lesser fear of COVID-19, believing that COVID-19 is not severe and not having chronic medical conditions were most frequently studied individual/group factors associated with increased vaccine hesitancy. Common vaccine-specific factors associated with increased vaccine hesitancy included beliefs that vaccine are not safe/effective and increased concerns about rapid development of COVID-19 vaccines. Given the heterogeneity in vaccine hesitancy definitions used across studies, there is a need for standardization in its assessment. This review has summarized COVID-19 vaccine hesitancy determinants that national policymakers can use when formulating health policies related to COVID-19 vaccination.

Pharmacists and COVID-19 vaccination - Considering mobile phone caller tunes as a novel approach to promote vaccine uptake in low- and middle-income countries

As several low- and middle-income countries roll out their COVID-19 vaccination programmes, COVID-19 vaccines hesitancy could threaten the success of such programmes. But pharmacists can play a leading role in addressing COVID-19 vaccine hesitancy by using a critical mobile phone-based technology. This technology, known as caller tunes or ringback tones, is flourishing in low- and middle-income countries such as those in Africa and Asia where it is used to promote popular songs and religious messages. With this technology, callers to mobile phones hear a message or a song instead of the typical ringing sound. There is a need for pharmacists associations to collaborate with the creative arts industry and telecommunication companies to have caller tunes on COVID-19 vaccines. As pharmacists and others download COVID-19 vaccine caller tunes onto their mobile phones, their callers will hear COVID-19 vaccines messages or songs. This could help combat disinformation and hesitancy, and promote widespread vaccination as availability increases.

Investigating the Links Between Vaccination Against COVID-19 and Public Attitudes Toward Protective Countermeasures: Implications for Public Health

The COVID-19 pandemic caused by the novel coronavirus, SARS-CoV-2, is spreading globally at an unprecedented rate. To protect the world against this devastating catastrophe, vaccines for SARS-CoV-2 have been produced following consistent clinical trials. However, the durability of a protective immune response due to vaccination has not been confirmed. Moreover, COVID-19 vaccination against SARS-CoV-2 is not 100% guaranteed, as new variants arise due to mutations. Consequently, health officials are pleading with the public to take extra precautions against the virus and continue wearing masks, wash hands, and observe physical distancing even after vaccination. The current research collected data from 4,540 participants (1,825 vaccinated and 2,715 not vaccinated) in China to analyze this phenomenon empirically. The propensity score matching (PSM) model is employed to analyze the impact of vaccination against COVID-19 on participants' attitudes toward protective countermeasures. The findings showed that gender, age, education level, occupation risk, individual health risk perception, public health risk perception, social responsibility, peer effect, and government supervision are the main drivers for participants to be vaccinated with COVID-19's vaccines. The results further show that vaccination lessened participants' frequency of hand washing by 1.75 times and their compliance frequency intensity of observing physical distancing by 1.24 times. However, the rate of mask-wearing did not reduce significantly, implying that China's main countermeasure of effective mask-wearing effectively controls COVID-19. Moreover, the findings indicate that a reduction in the frequency of hand washing and observing physical distance could cause a resurgence of COVID-19. In conclusion, factors leading to the eradication of SARS-CoV-2 from the world are complex to be achieved, so the exploration of COVID-19 vaccination and people's attitude toward protective countermeasures may provide insights for policymakers to encourage vaccinated people to follow protective health measures and help in completely defeating the COVID-19 from the globe.

Predictors of Intention to Vaccinate against COVID-19 in the General Public in Hong Kong: Findings from a Population-Based, Cross-Sectional Survey

Vaccination is one of the most effective ways to stop the spread of COVID-19. Understanding factors associated with intention to receive COVID-19 vaccines is the key to a successful vaccination programme. This cross-sectional study explored the rate of vaccination intention and identified its predictors using the health belief model (HBM) in the general population in Hong Kong during the pandemic. Data were collected between December 2020 and January 2021 via telephone surveys. Hierarchical logistic regression analysis was used to identify factors associated with intention to receive COVID-19 vaccines. A total of 1255 adults (>18 years, 53% female) completed the telephone survey. Overall, 42% indicated an intention to vaccinate, 31.5% showed vaccine hesitancy, and 26.5% reported refusal to receive any COVID-19 vaccines. Individuals who were men, older in age, working, with past experiences of other pandemics, less concerned with the vaccine safety, with poorer knowledge about COVID-19, and having greater levels of perceived susceptibility, self-efficacy, cues to action, and acceptance of governmental preventive measures related to COVID-19 were significantly more likely to report an intention to vaccinate. The low intention among the Hong Kong population reflects the importance of developing effective vaccination promotion campaigns with the predictors identified in this study.

Using structural equation modeling to predict Indian people's attitudes and intentions towards COVID-19 vaccination

BACKGROUND AND AIM

Understanding people's attitudes towards Covid-19 vaccination is crucial to the successful implementation of a vaccination program. Hence this research study seeks to identify critical factors influencing Indian people's attitudes and intentions to take up Covid-19 vaccinations.

METHODS

An online questionnaire was administered to a sample (n = 254) drawn from Indian population, to assess the impact of perceived benefits, risk perceptions, social media exposure, social norms, and trust associated with Covid-19 vaccines on people's attitudes towards Covid-19 vaccines and their intentions to take up the Covid-19 vaccinations.

RESULTS

The findings showed that the perceived benefits, social norms, and trust correlated significantly with people's attitudes towards Covid-19 vaccinations. In contrast, risk perceptions and social media exposure showed an insignificant influence on people's attitudes towards Covid-19 vaccinations. Social norms, trust, and people's attitudes towards the Covid-19 vaccinations are significantly correlated with their intentions to take up Covid-19 vaccinations. On the contrary, social media exposure was found to have an insignificant influence on people's intentions to take up Covid-19 vaccinations.

CONCLUSION

Participants' intentions to take up Covid-19 vaccinations was influenced mainly by their attitudes and perceptions of Covid-19 vaccines in general, which strongly confirms the importance of various dimensions (perceived benefits, trust, social norms) of Covid-19 vaccines in cultivating Covid-19 vaccination acceptance among participants'.

Perceptions and predictors of intention to receive the COVID-19 vaccine

Background

The control of the Coronavirus Disease 2019 (COVID-19) pandemic may be dependent on widespread receipt of an effective vaccine. It is important to understand patient health-related behaviors and perceptions to guide public health vaccination strategies.

Objectives

To examine perceptions of COVID-19 and vaccination beliefs, and identify predictors of intention to receive the COVID-19 vaccine in the US.

Methods

A cross-sectional, web-based survey guided by the Health Belief Model was conducted using a web-based Qualtrics survey panel of US adults. The main outcome was the intention to receive the COVID-19 vaccine if offered. Additional measures included: demographics, perceptions of COVID-19 severity, risk and susceptibility, views of a potential COVID-19 vaccine, virus and vaccine information sources, vaccine beliefs and behaviors, and seasonal flu vaccine history.

Results

A total of 1047 complete responses were included. Females had lower odds of intending to receive the COVID-19 vaccine than males (AOR = 0.54, 95% CI: 0.36–0.80). Those with a two-year degree/some college had lower odds of intending to receive the COVID-19 vaccine compared to those with a high school degree/GED (AOR = 0.59, 95% CI: 0.36–0.97). Respondents who perceived the severity of the virus to be higher, perceived a greater COVID-19 vaccine benefit, and perceived greater general vaccine benefits had higher odds of intending to receive a COVID-19 vaccine (AOR = 1.44, 95% CI: 1.09–1.91; AOR = 2.82, 95% CI: 2.24–3.56; AOR = 1.77, 95% CI 1.41–2.21, respectively).

Conclusions

In this study, intention to receive the COVID-19 vaccine varied across demographics, perceived virus severity, COVID-19 vaccine and general vaccine beliefs. Successful implementation of a COVID-19 immunization strategy by healthcare providers and public health officials will need to incorporate diverse COVID-19 vaccination education strategies tailored to patients' health beliefs.