Predicting college students' COVID-19 vaccination behavior: an application of the extended parallel process model

Efficacy-focused and autonomy-supportive messaging in social media vaccine campaigns: insights from a Facebook split test

BACKGROUND

In the context of social media vaccine campaigns, understanding the impact of message framing on audience engagement is crucial. This study examines the efficacy of messages centered on efficacy versus autonomy, informed by theoretical frameworks: the Extended Parallel Process Model (EPPM) and Self Determination Theory (SDT).

METHODS

Utilizing the Facebook A/B Split Test (FBST) feature, an online experiment was conducted to compare the response to two different messages: one emphasizing vaccine efficacy (EPPM-informed) and the other focusing on individual autonomy in making vaccine decisions (SDT-informed). The primary measure of interest was the number of clicks on a link directing to a pro-vaccine website.

RESULTS

The findings indicated that the autonomy-centered (SDT-informed) message resulted in a significantly higher click-through rate to the pro-vaccine website, particularly among users aged 65 and above. Furthermore, analysis of comments from Facebook users identified factors potentially contributing to vaccine hesitancy, with mistrust being the most dominant.

CONCLUSIONS

The study underscores the importance of tailoring social media vaccine campaigns to address the autonomy needs of the target audience while considering trust-related issues to mitigate vaccine hesitancy. Emphasizing individual autonomy in vaccine decision-making processes can enhance engagement with pro-vaccine content, especially in older demographics.

Longitudinal study of theory-based predictors of COVID-19 vaccination

Efforts to mitigate the impact of COVID-19 now focus primarily on encouraging vaccination. These efforts have been hampered, however, by vaccine hesitancy. A better understanding of the factors associated with vaccination may help identify those most likely to experience hesitancy and inform the content of public health outreach efforts. The aims of this study were to evaluate whether two theory-based factors (perceived vaccine efficacy and vaccination intention) and political party affiliation were associated with vaccination in the United States (US) and to provide descriptive analysis of factors shaping vaccination decisions. A longitudinal online survey was conducted with 108 adults in the US. Participants completed surveys in July 2020 (Time 1) and October 2021 (Time 2). As hypothesized, greater vaccination intention and perceived vaccine efficacy were significant predictors of vaccine uptake. The second hypothesis was also supported as political party affiliation was associated with vaccination (i.e. Democrats were more likely to vaccinate than Republicans). Descriptive data indicated that vaccinated participants (including those reluctant to vaccinate at Time 1) had been motivated by a desire to protect themselves and others from COVID-19. Participants who had chosen not to vaccinate were influenced by a variety of factors including concerns about vaccine safety and efficacy. Understanding the predictors of vaccination is critical to identifying those unlikely to vaccinate and creating effective interventions to encourage the uptake of this essential public health strategy. Messaging should emphasize the efficacy of COVID-19 vaccines and be delivered by those seen as trustworthy in communities prone to vaccine hesitancy.

A Survey of Fear for Others, Fear for Self, and Pandemic Anxiety Predicting Intention to Take the First Booster Vaccine to Combat COVID-19

This study examined the impact of fear and anxiety on the intent to take the first COVID-19 booster vaccine. The objective of this study is to provide guidance for messaging campaigns of public health practitioners. A survey approach provided insights about individuals' emotions of fear and anxiety related to adopting the first booster vaccine for the Coronavirus disease 2019 (COVID-19).

METHODS

Three independent variables were considered in their ability to predict the intent to take the first COVID-19 booster vaccine (BINT): Fear for Others (FOTH), Fear for SELF (FSELF), and COVID-19 Anxiety (CANX).

RESULTS

The confirmatory factor analysis supported an underlying three-factor solution for three central emotions in this study. A path analysis indicated significant direct effects for FOTH and FSELF in the prediction of BINT. The interdependent nature of these variables on the intent to get the first booster vaccine also was indicated by significant indirect effects.

DISCUSSION

Fear should be more precisely refined to include the fear for others (FOTH) beyond consideration of the fear for self (FSELF) from the impact of COVID-19.

CONCLUSIONS

FOTH and FSELF were demonstrated to be direct predictors of BINT. CANX was only found to be significant as part of indirect effects impacting BINT. Future investigation should be given to the mediating role of anxiety with FOTH and FSELF as the context changes.

Determinants of COVID-19 preventive health behaviors in Iranian adults based on extended parallel process model

Performing preventive behaviors by individuals has been recognized as one of the important strategies for the prevention and control of Coronavirus Disease 2019 (COVID-19). This study aimed to assess the determinants of adopting preventive behaviors of COVID-19 in a sample of Iranian adults based on Extended Parallel Process Model (EPPM) variables. In this cross-sectional study, 300 adults from Tehran, Iran were selected using cluster sampling method from five areas of the city: north, south, west, east, and center. The participants completed a study instrument developed to assess demographic information and EPPM variables. Finally, the data were analyzed using SPSS software. The mean age of the participants was 40.11 (± 15.158) years. The results showed that 88.3% (n = 265) of the participants were in the process of danger control. Perceived self-efficacy, attitude, response efficiency, behavioral intention, and the number of hours of activity outside home were determinants of performing COVID-19 preventive behaviors among the participants. These predictors might be used to develop theory-based educational efforts based on EPPM variables due to encouraging people to adopt COVID-19 preventive behaviors. Our results suggest that because many participants were engaged in danger control, health professionals should focus on increasing perceived efficacy.

The role of perceived threat and self-efficacy in the use of Insecticide Treated Bednets (ITNs) to prevent malaria among pregnant women in Tororo District, Uganda

BACKGROUND

Despite increased coverage of Insecticide Treated Nets (ITNs) due to free distribution programs, ITN use in Uganda remains sub optimal among pregnant women. This study explored the relationship between constructs of a theoretical framework and Net use.

OBJECTIVE

The study examined the role of constructs from the Extended Parallel Process Model (EPPM) in determining ITN use amongst pregnant women 15-49 years in Tororo district, Uganda.

METHODS

A cross-sectional study using a systematic sample was conducted among 230 pregnant women attending antenatal care. The questionnaire was administered by trained research assistants. Analysis was conducted to establish the relationship between ITN use and perceived susceptibility, severity, self-efficacy and response efficacy.

RESULTS

Over three-quarters (78.6%) reported using ITNs the night before the study while 49.78% reported consistent Net use. High self-efficacy (AOR 9.48 95%CI 3.34-26.91) was associated with ITN use the previous night and consistent use. High perceived threat was associated with consistent ITN use (AOR 2.78, 95%CI 1.16-6.67) but not with Net use the previous night.

CONCLUSION

Self-efficacy was an important predictor of ITN use, as well as high levels of fear, as measured through perceived threat, which was associated with consistent ITN use, but not ITN use the previous night. Social and behavior change communication interventions should focus on improving self-efficacy to use ITNs.

Risk-efficacy framework - a new perspective on threat and efficacy appraisal and the role of disparity

The current study aims to provide a more nuanced understanding of threat and efficacy appraisal and account for the influence of disparity in the accessibility to risk prevention resources in predicting attitudes and behaviors. We propose a Risk-Efficacy Framework by integrating theories, including the extended parallel process model, health belief model, social cognitive theory, and construal level theory of psychological distance to achieve such a goal. An online survey targeting the U.S. population was conducted to empirically test the model (N = 729). The survey measured people's threat and efficacy appraisals related to COVID-19 and its vaccines and their attitudes and behavioral intention. The results of the survey supported the model's propositions. Specifically, perceived susceptibility moderated perceived severity's effects on attitudes and behaviors, such that perceived severity's influence attenuated as perceived susceptibility increased. Perceived accessibility to risk prevention resources moderated the influence of self and response efficacy. The former's effects on attitudes and behaviors increased, and the latter's effects decreased when perceived accessibility was high. The proposed framework provides a new perspective to examine the psychological determinants of prevention adoption and contributes to designing and implementing campaigns distributing prevention to underserved populations. The framework offers insights for risk managers such as public health authorities by articulating the dynamic nature of risks. When communicating early-stage lesser-known risks to the public, campaigns should highlight their severity and the response efficacy of risk solutions. Differently, more resources should be devoted to cultivating self-efficacy for widespread risks with more mitigation resources.

Broad perspectives in understanding vaccine hesitancy and vaccine confidence: an introduction to the special issue

The World Health Organization has designated vaccine hesitancy and vaccine confidence among the most pressing issues in global health. The COVID-19 pandemic has made vaccine hesitancy and vaccine confidence particularly salient and urgent. The purpose of this special issue is to highlight a broad range of perspectives on these critical issues. We have included a total of 30 papers that address issues related to vaccine hesitancy and vaccine confidence across multiple levels of the Socio-Ecological Model. We have organized the empirical papers into the following sections: individual-level beliefs, minority health and health disparities, social media and conspiracy beliefs, and interventions. In addition to the empirical papers, three commentaries are included in this special issue.

'COVID Is Coming, and I'm Bloody Scared': How Adults with Co-Morbidities' Threat Perceptions of COVID-19 Shape Their Vaccination Decisions

Adults with comorbidities have faced a high risk from COVID-19 infection. However, Western Australia experienced relatively few infections and deaths from 2020 until early 2022 compared with other OECD countries, as hard border policies allowed for wide-scale vaccination before mass infections began. This research investigated the thoughts, feelings, risk perceptions, and practices of Western Australian adults with comorbidities aged 18-60 years in regard to COVID-19 disease and COVID-19 vaccines. We conducted 14 in-depth qualitative interviews between January and April 2022, just as the disease was starting to circulate. We coded results inductively and deductively, combining the Extended Parallel Process Model (EPPM) and vaccine belief models. Non-hesitant participants believed COVID-19 vaccines were safe and effective at mitigating COVID-19's threat and subsequently got vaccinated. Vaccine hesitant participants were less convinced the disease was severe or that they were susceptible to it; they also did not consider the vaccines to be sufficiently safe. Yet, for some hesitant participants, the exogenous force of mandates prompted vaccination. This work is important to understand how people's thoughts and feelings about their comorbidities and risks from COVID-19 influence vaccine uptake and how mandatory policies can affect uptake in this cohort.