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Sun G, Zhang L, Qiu Y, Jia Y, Wang Y, Xu H, Zhang A, Hao L, Zhu W, Ye C. Changes of influenza vaccination rate and associated influencing factors after the COVID-19 pandemic in Shanghai, China. Hum Vaccin Immunother 2024; 20:2287294. [PMID: 38299510 PMCID: PMC10841022 DOI: 10.1080/21645515.2023.2287294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/21/2023] [Indexed: 02/02/2024] Open
Abstract
The vaccination rate for seasonal influenza remains low in most regions of China. It is essential to understand the factors that associated with the low influenza vaccination rate in various populations after the COVID-19 pandemic. A cross-sectional survey was conducted with residents in Pudong New Area, Shanghai, China. Respondents' vaccination condition during the 2021-2022 flu season and the reasons for receiving or not receiving influenza vaccine were investigated. Binary logistic regression was conducted to explore potential factors influencing vaccination uptake. 2,476 of 14,001 respondents received an influenza vaccine, with a total coverage of 17.68% (95% CI: 17.05%, 18.32%). Children had the highest vaccination coverage (35.68%; 95% CI: 34.02, 37.33), followed by adults (12.75%; 95% CI: 11.91%, 13.58%) and elderly individuals (11.70%, 95% CI: 10.78%, 12.62%). For children, lower household income was an significant promoting factor. For adults, factors significantly associated with vaccination were household income, sex, and education level. For elderly, factors significantly associated with vaccination were household income, education level, living state, and having underlying diseases. (P < .05)The main reason for vaccine hesitancy among children was worried about side effects (21.49%), for adults and elderly was self-rated good health (adults: 37.14%, elderly people: 30.66%). The overall influenza vaccination coverage rate in Shanghai, especially among elderly individuals, is lower than many developed countries. Appropriate strategies and programs targeting different populations need to be implemented to enhance influenza vaccine coverage.
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Affiliation(s)
- Geyang Sun
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Li Zhang
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Ye Qiu
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yilin Jia
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yuanping Wang
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Hongmei Xu
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Anran Zhang
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Lipeng Hao
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Weiping Zhu
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Chuchu Ye
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
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Dionne M, Rochette L, Hamel D, Dube È. Change in intention and hesitancy regarding COVID-19 vaccines in a cohort of adults in Quebec during the pandemic. Hum Vaccin Immunother 2024; 20:2309006. [PMID: 38347660 PMCID: PMC10865925 DOI: 10.1080/21645515.2024.2309006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/19/2024] [Indexed: 02/15/2024] Open
Abstract
Although COVID-19 vaccine uptake was high in Quebec for the primary series, vaccine acceptance decreased for the subsequent booster doses. This article presents the evolution of vaccine intention, self-reported vaccination behaviors, and vaccine hesitancy over 2 years. A series of cross-sectional surveys were conducted in Quebec between March 2020 and March 2023, with a representative sample of 3,330 adults recruited biweekly via a Web panel. Panelists could have answered multiple times over the course of the project. A cohort of respondents was created to assess how attitudes and behaviors about COVID-19 vaccines evolved. Descriptive statistics and multivariate logistic regressions were performed. Among the 1,914 individuals with no or low intention of getting vaccinated in Fall 2021 (Period 1), 1,476 (77%) reported having received at least two doses in the Winter 2023 (Period 2). Not believing in conspiracy theory (OR = 2.08, 95% CI: 1.65-2.64), being worried about catching COVID-19 (OR = 2.12, 95% CI: 1.65-2.73) and not living in a rural area (ORs of other areas are 2.27, 95% CI: 1.58-3.28; 1.66, 95% CI: 1.23-2.26; 1.82 95% CI: 1.23-2.73) were the three main factors associated with being vaccinated at Period 2. Among the 11,117 individuals not hesitant at Period 1, 1,335 (12%) became hesitant at Period 2. The three main factors significantly associated with becoming vaccine hesitant were the adherence to conspiracy theories (OR = 2.28, 95% CI: 1.95-2.66), being a female (OR = 1.67, 95% CI: 1.48-1.90) and being younger than 65 years old (the ORs for 18-34, 35-49, and 50-64 compared with 65 and over are 2.82, 95% CI: 2.32-3.44; 2.39, 95% CI: 2.00-2.86 and 1.82, 95% CI: 1.55-2.15 respectively). As the pandemic is over, monitoring the evolution of vaccine attitudes and uptake will be important.
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Affiliation(s)
- Maude Dionne
- Direction des risques biologiques, Institut national de santé publique du Québec, Québec, Canada
| | - Louis Rochette
- Direction des risques biologiques, Institut national de santé publique du Québec, Québec, Canada
| | - Denis Hamel
- Direction des risques biologiques, Institut national de santé publique du Québec, Québec, Canada
| | - Ève Dube
- Direction des risques biologiques, Institut national de santé publique du Québec, Québec, Canada
- Maladies infectieuses et immunitaires, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
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Li X, Bai Y, Weng L, Bai Y, Gong W. COVID-19 vaccine hesitancy among the Chinese elderly: A multi-stakeholder qualitative study. Hum Vaccin Immunother 2024; 20:2315663. [PMID: 38439589 PMCID: PMC10936594 DOI: 10.1080/21645515.2024.2315663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/04/2024] [Indexed: 03/06/2024] Open
Abstract
The United Nations reported that the mortality risk of Corona Virus Disease 2019 (COVID-19) is five times higher in the elderly than the global average. Although the COVID-19 vaccine effectively prevents infections and reduce mortality among the elderly, vaccine hesitancy among the Chinese elderly poses a significant threat. This study, utilizing the "Confidence, Convenience and Complacency (3 Cs)" vaccine hesitancy model, aimed to explore factors contributing to vaccine hesitancy among the Chinese elderly and assess national countermeasures and potential improvement approaches. Thirteen elderly with vaccine hesitancy and eleven vaccine-related staff participated in semi-structured interviews. Thematic analysis revealed three key determinants of vaccine hesitancy among the elderly: perceived low threat of COVID-19, lack of confidence in COVID-19 vaccine, and poor accessibility to vaccination. China has implemented strategies, including advocacy through diverse channels, joint multi-sectoral promotion vaccination, and enhancing ongoing vaccination services. Recommendations from the vaccine-related staff emphasize improving vaccine awareness among the elderly, and prioritizing the vaccination environment and process. The study underscores the importance of targeted vaccination promotion programs addressing hesitation reasons to improve vaccination rates. Furthermore, existing countermeasures can serve as a foundation for enhancing vaccination strategies, including improved publicity, administration, and management approaches.
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Affiliation(s)
- Xiaoyu Li
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yanping Bai
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Lijun Weng
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yunshan Bai
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Wenjie Gong
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Department of Psychiatry, University of Rochester, Rochester, NY, USA
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El Tantawi M, Elwan AH, Hassan R, Mohamed NF, Elsheikh EI, Hassan HA, Abdelwahab SF. Assessing vaccinated persons' intention to take the COVID-19 boosters using a combined theoretical framework: an online survey in Egypt. Sci Rep 2024; 14:22795. [PMID: 39353979 DOI: 10.1038/s41598-024-72093-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/03/2024] [Indexed: 10/03/2024] Open
Abstract
Vaccines, like the Corona Virus Disease-2019 (COVID-19) vaccines, can control diseases, but vaccine hesitancy reduces their use. It is important to assess the intention to use COVID-19 vaccines boosters and the determinants of this intention to help in developing programs to promote the uptake of boosters. An online survey collected data from adults in Egypt between March and June 2022 using a questionnaire that assessed demographic characteristics, and constructs of the Theory of Planned Behaviour (TPB) and the Health Belief Model (HBM). The survey was uploaded to SurveyMonkey and the links were posted on social media platforms. Binary regression analysis was used and the dependent variable was intention to use boosters of COVID-19 vaccines. The independent variables were indicators of the HBM including perceived susceptibility to COVID-19 infection (medical history) and possibility of disease prevention (awareness of the availability of types of COVID-19 vaccines); and indicators of the TPB including attitude toward COVID-19 vaccines (that they are harmful, that they may lead to death and confidence in locally and foreign manufactured vaccines), perceived norms (the percentage of vaccinated persons in one's circle) and perceived control over booster uptake (presence of government mandates for COVID-19 vaccination). The confounders were sociodemographic factors (age, sex, education, and place of residence). Complete responses were available from 1113 out of 1401 participants (79.4%), with mean (SD) age = 25 (9.5) years, of whom, 66.7% (n = 742) were females and 68.6% (n = 764) were university students. About 39.4% and 31.2% indicated that they would get or would definitely get the booster dose of the COVID-19 vaccines. In multiple regression, intention to use a booster dose was significantly related to not agreeing (AOR = 4.87, P < 0.001) or not agreeing at all (AOR = 8.46, P = 0.001) that vaccines are harmful and to having no confidence (AOR = 0.21, P < 0.001) or no confidence at all (AOR = 0.14, P < 0.001) in foreign-manufactured vaccines. Most university-educated Egyptians in the study intended to take the COVID-19 vaccine booster dose and this intention was associated with attitude toward the harm of the vaccine and confidence in foreign-manufactured vaccines. Awareness campaigns are needed to counteract misinformation and promote booster dose uptake.
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Affiliation(s)
- Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion, Alexandria, Egypt.
| | - Amira H Elwan
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion, Alexandria, Egypt
| | - Reham Hassan
- Department of Endodontics, Faculty of Dentistry, The Egyptian Russian University, Badr City, Egypt
- Department of Endodontics, Faculty of Dentistry, Minia University, Minia, Egypt
| | - Nesreen Farouk Mohamed
- Department of Public Health, Community, Environmental and Occupational Medicine, Faculty of Medicine Port Said University, Port Said, Egypt
| | - Enas I Elsheikh
- Department of Public Health, Community, Environmental and Occupational Medicine, Faculty of Medicine Port Said University, Port Said, Egypt
| | - Heba Ali Hassan
- Department of Pharmacognosy, Faculty of Pharmacy, Sohag University, Sohag, 82524, Egypt
| | - Sayed F Abdelwahab
- Department of Microbiology and Immunology, Faculty of Medicine, Minia University, Minia, 61511, Egypt
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Sun KA, Moon J. The Theory of Planned Behavior and Antecedents of Attitude toward Bee Propolis Products Using a Structural Equation Model. Foods 2024; 13:3002. [PMID: 39335931 PMCID: PMC11431277 DOI: 10.3390/foods13183002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 09/11/2024] [Accepted: 09/21/2024] [Indexed: 09/30/2024] Open
Abstract
This work examines consumers' perceptions of products containing bee propolis using the theory of planned behavior as a theoretical foundation. As antecedents of attitude, this work employs price fairness, healthiness, eco-friendliness, and ease of use. A survey was issued to participants who had experience using bee propolis products and who were recruited using the Clickworker platform service. In total, 305 valid observations were collected for analysis. This study used a maximum likelihood-based structural equation model to test the research hypotheses and find that price fairness, healthiness, eco-friendliness, and ease of use positively affected attitude. Moreover, the intention to use is positively impacted by attitude, subjective norms, and behavioral control. This research contributes to the literature by demonstrating the explanatory power of the theory of planned behavior with respect to bee propolis products.
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Affiliation(s)
- Kyung-A Sun
- Department of Tourism Management, Gachon University, Sungnam-si 13120, Republic of Korea
| | - Joonho Moon
- Department of Tourism Administration, Kangwon National University, Chuncheon 24341, Republic of Korea
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Sharp M, Lozano P, Southworth A, Peters A, Lam H, Randal FT, Quinn M, Kim KE. Mixed methods approach to understanding COVID-19 vaccine hesitancy among immigrants in the Chicago. Vaccine 2024; 42:125552. [PMID: 38199924 DOI: 10.1016/j.vaccine.2023.12.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/30/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND COVID-19 vaccine hesitancy has been particularly high among immigrant populations, whose experience is shaped by a history of racism and discriminations, and distrust of the healthcare system. In this study we draw from the Theory of Planned Behavior to examine COVID-19 vaccine hesitancy among immigrants in Chicago. METHODS A mixed-methods approach comprising of both focus groups and a health survey was conducted from February to August 2022. Five focus groups were held (N = 35) among Black, Asian and Arab/Palestine participants to understand attitudes and beliefs around the COVID-19 vaccine. Focus groups were analyzed using a modified template approach to text analysis. Based on these findings and themes, we developed a survey that was conducted among 413 immigrants from the mentioned communities. We used hierarchical ordinal regression analyses to examine the relationship between COVID-19 vaccine hesitancy and vaccination status. RESULTS Qualitative analysis suggest that the major factors influencing COVID-19 vaccine hesitancy included fear of adverse reactions, misinformation around COVID-19 and the vaccine, negative social norms around vaccination, and external pressure to get vaccinated. From our quantitative analysis we found that 24% of participants were unvaccinated, 5% were partially vaccinated, 32.3% were vaccinated but not boosted, and 39% were vaccinated and boosted for COVID-19. Hierarchical regression models suggest that immigrants who hold negative attitudes and social norms around the COVID-19 vaccine are less likely to vaccinate. CONCLUSIONS Understanding vaccine hesitancy among immigrants allows for the creation of culturally and linguistically tailored education that can be utilized to increase vaccine confidence and uptake.
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Affiliation(s)
| | - Paula Lozano
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
| | | | - Aven Peters
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
| | - Helen Lam
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
| | | | - Michael Quinn
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
| | - Karen E Kim
- University of Chicago Center for Asian Health Equity, Chicago, IL, United States
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Appiah-Brempong E, Appiah-Brempong M. Examining the psychosocial drivers of handwashing behaviour among school children. Health Psychol Behav Med 2024; 12:2391932. [PMID: 39165273 PMCID: PMC11334745 DOI: 10.1080/21642850.2024.2391932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 08/05/2024] [Indexed: 08/22/2024] Open
Abstract
Aim Handwashing with soap remains the single most cost-effective strategy for reducing the spread of infectious diseases. From our scoping search, no study was identified which examined the predictors of children's handwashing behaviour within the context of the Health Belief Model (HBM) and Theory of Planned Behaviour (TPB) combined. This paper contributes to bridging this gap in literature. We sought to examine variables emanating from the HBM and TPB which could potentially predict handwashing behaviour; determine whether behavioural intention will potentially predict behaviour; and identify school children's motivation for proper handwashing behaviour. Subject and Methods Data were collected from 717 school children recruited from four basic schools. A structured questionnaire was used for data collection. Data were analysed using multi-variable linear regression models. Results Participants' knowledge of hand hygiene failed to predict behavioural intention and handwashing behaviour. As regards participants' perception of severity, there was an association with behavioural intention in a crude model, but this was not so in an adjusted model. Also, perception of severity was not associated with handwashing behaviour. Attitude to handwashing (β = 0.120, 95% CI [0.00, 0.24] p = 0.046), possession of handwashing skills (β = 0.037, 95% CI [0.01, 0.07] p = 0.008), and subjective norms (β = 0.263, 95% CI [0.20, 0.33] p < 0.001) were among the psychosocial variables that showed potential for predicting both behavioural intention and behaviour. The TPB's intention-behaviour relationship was corroborated by our results. Among others, motivation for adherence to proper handwashing behaviour included the desire to make hands smell better. Conclusion Interventions targeting the handwashing behaviour of school children should consider strategies that move beyond mere knowledge improvement, but rather target attitude and skill enhancement strategies implemented in partnership with 'significant others' such as teachers, and adult peers.
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Affiliation(s)
- Emmanuel Appiah-Brempong
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Miriam Appiah-Brempong
- Department of Civil Engineering, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Saaka SA, Antabe R. Endorsement of HIV-related stigma among men in Ghana: What are the determinants? PLoS One 2024; 19:e0305811. [PMID: 38950016 PMCID: PMC11216618 DOI: 10.1371/journal.pone.0305811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/05/2024] [Indexed: 07/03/2024] Open
Abstract
INTRODUCTION Stigma and discrimination against people living with HIV (PLHIV) remain a major barrier to effective HIV prevention. Despite the understanding that the creation of a socially inclusive environment for PLHIV is crucial for the promotion of testing, status disclosure, and treatment uptake, HIV stigma persists. Additionally, evidence suggests the endorsement of HIV stigma may be gender specific. Nonetheless, very little is known about the factors influencing men's discrimination against PLHIV in the Ghanaian context. Guided by the theory of planned behavior, our study fills this void by exploring the factors associated with the endorsement of HIV stigma in Ghana. METHODS Utilizing a nationally representative data from the 2022 Ghana Demographic and Health Survey (DHS) (N = 7044 men with ages ranging from 15-49 years), and applying logistic regression models, this study examined the factors associated with the endorsement of HIV-related stigma in Ghana. RESULTS The notion that HIV can be transmitted through the sharing of food with PLHIV was significantly associated with increased odds of stigma endorsement against children with HIV (OR = 3.381; P<0.001) and vendors with HIV (OR = 3.00; P<0.001). On the contrary, knowing that a healthy-looking person can have HIV was significantly associated with decreased odds of endorsement of stigma against children living with HIV (OR = 0.505; P<0.001), and vendors living with HIV (OR = 0.573; P<0.001). Likewise, having knowledge of drugs that help PLHIV to live longer, was significantly associated with decreased odds of stigma endorsement against children living with HIV (OR = 0.768; P<0.001), and vendors living with HIV (OR = 0.719; P<0.001). Moreover, participants with higher educational attainment reported lower odds of stigma endorsement against children living with HIV (OR = 0.255; P<0.01), and vendors living with HIV (OR = 0.327; P<0.01). Furthermore, age was significant and inversely associated with the endorsement of HIV stigma against children living with HIV (OR = 0.951; P<0.05), and vendors living with HIV (OR = 0.961; P<0.05). Also, wealth, ethnicity, and the region of residence significantly predicted endorsement of HIV stigma. CONCLUSION For Ghana to achieve UNAIDS target 95-95-95 by 2030, targeted educational campaigns are necessary to dispel misconceptions about HIV and to promote social inclusion for reducing HIV-related stigma and discrimination in the country.
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Affiliation(s)
| | - Roger Antabe
- Department of Health and Society, University of Toronto Scarborough, Toronto, Canada
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Lei Z, Liu D, Li M, Xian D, Fan S. Vaccination intentions of hypertensive Chinese individuals during the COVID-19 epidemic: a structural equation modeling study. BMC Infect Dis 2024; 24:642. [PMID: 38926657 PMCID: PMC11201319 DOI: 10.1186/s12879-024-09480-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
OBJECTIVE Given the high prevalence of hypertension among Chinese adults, this population is at a significantly increased risk of severe COVID-19 complications. The purpose of this study is to assess the willingness of Chinese hypertensive adults to receive the COVID-19 vaccine and to identify the diverse factors that shape their vaccination decisions. METHODS Sampling was conducted utilizing multistage stratified random sampling, and ultimately, a total of 886 adult hypertensive patients from Luzhou City in Southwest China were included in this study. The questionnaire design was based on the Theory of Planned Behaviour and was used to investigate their willingness to be vaccinated with COVID-19. Structural equation modeling was employed for data analysis. RESULTS The results showed that 75.6% of hypertensive individuals were willing to receive COVID-19 vaccination. The structural equation modeling revealed that Subjective Norms (path coefficient = 0.361, CR = 8.049, P < 0.001) and Attitudes (path coefficient = 0.253, CR = 4.447, P < 0.001) had positive effects on vaccination willingness, while Perceived Behavioral Control (path coefficient=-0.004, CR=-0.127, P = 0.899) had no significant impact on Behavioral Attitudes. Mediation analysis indicated that Knowledge (indirect path coefficient = 0.032, LLCI = 0.014, ULCI = 0.058), Risk Perception (indirect path coefficient = 0.077, LLCI = 0.038, ULCI = 0.124), and Subjective Norms (indirect path coefficient = 0.044, LLCI = 0.019, ULCI = 0.087) significantly influenced vaccination willingness through Attitudes as a mediating factor. CONCLUSION The willingness of hypertensive individuals to receive the COVID-19 vaccination is not satisfactory. The Theory of Planned Behavior provides valuable insights into understanding their vaccination intentions. Efforts should be concentrated on enhancing the subjective norms, attitudes, and knowledge about vaccination of hypertensive patients.
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Affiliation(s)
- Zhi Lei
- Department of Chronic Disease Control and Prevention, Luzhou Center for Disease Control and Prevention, Luzhou, China
- Administrative Office, Luzhou People's Hospital, Luzhou, China
| | - Dongyang Liu
- School of Public Health, Southwest Medical University, Luzhou, China
| | - Minghui Li
- Department of Human Resource, Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Deqiang Xian
- Administrative Office, Luzhou People's Hospital, Luzhou, China.
| | - Song Fan
- School of Public Health, Southwest Medical University, Luzhou, China.
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Yu H, Bonett S, Oyiborhoro U, Aryal S, Kim A, Kornides ML, Jemmott JB, Glanz K, Villarruel AM, Bauermeister JA. Psychosocial correlates of parents' willingness to vaccinate their children against COVID-19. PLoS One 2024; 19:e0305877. [PMID: 38913679 PMCID: PMC11195945 DOI: 10.1371/journal.pone.0305877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 06/05/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Public health guidance recommended that children who are 6 months or older be vaccinated against COVID-19 in June of 2022. In the U.S., 56% of children under 17 had not received the COVID-19 vaccination in 2023. We examine parents' willingness to vaccinate their children against COVID-19 using the theory of planned behavior in order to design effective strategies to promote vaccine uptake. METHODS The Philadelphia Community Engagement Alliance is part of an NIH community-engaged consortium focused on addressing COVID-19 disparities across the U.S. We surveyed 1,008 Philadelphia parents (mean age 36.86, SD 6.55; 42.3% racial/ethnic minorities) between September 2021 and February 2022, a period when guidance for child vaccination was anticipated. Structural Equation Modeling analysis examined associations between parental willingness and vaccine-related attitudes, norms, and perceived control. Covariates included parents' COVID-19 vaccination status, race/ethnicity, gender, and survey completion post-CDC pediatric COVID-19 vaccination guidelines. Subgroup analyses by race/ethnicity and gender were conducted. RESULTS Our model demonstrated good fit (χ2 = 907.37, df = 419, p<0.001; comparative fit index [CFI] = 0.951; non-normed fit index [NNFI] = 0.946; root mean square error of approximation [RMSEA] = 0.034 with 95% CI = 0.030-0.038). Attitudes ([Formula: see text] = 0.447, p<0.001) and subjective norms ([Formula: see text] = 0.309, p = 0.002) were predictors of intention. Racial/ethnic minority parents exhibited weaker vaccination intentions ([Formula: see text] = -0.053, p = 0.028) than non-Hispanic White parents. CONCLUSIONS Parents' attitudes and norms influence their vaccination intentions. Despite the survey predating widespread child vaccine availability, findings are pertinent given the need to increase and sustain pediatric vaccinations against COVID-19. Interventions promoting positive vaccine attitudes and prosocial norms are warranted. Tailored interventions and diverse communication strategies for parental subgroups may be useful to ensure comprehensive and effective vaccination initiatives.
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Affiliation(s)
- Hyunmin Yu
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Stephen Bonett
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Ufuoma Oyiborhoro
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Subhash Aryal
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Andrew Kim
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Melanie L. Kornides
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - John B. Jemmott
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Karen Glanz
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Antonia M. Villarruel
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - José A. Bauermeister
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Panahi S, Ghalavand H. The mediating role of health literacy in the relationship between self-care and planned behavior against Covid-19. BMC Infect Dis 2024; 24:608. [PMID: 38902618 PMCID: PMC11188506 DOI: 10.1186/s12879-024-09513-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/13/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Planned behaviors and self-care against the coronavirus are two important factor in controlling its spread and self-care behaviors depend on the level of health literacy. This research was conducted to determine the mediating role of health literacy in the relationship between elements of planned behavior and self-care in dealing with the Covid-19. METHODS In this descriptive-analytical quantitative study, the sample size was calculated using Cochrane's formula and considering a p-value of 0.51, α = 0.05, and d = 0.05, and 313 students were selected based on stratified and random method. To gather data and assess various aspects of variables, a questionnaires were utilized, focusing on health literacy, self-car and planned behavior. The relationship between the variables was examined by SPSS version 26 and via descriptive statistics, including the mean and standard deviation, and inferential statistics such as Pearson's correlation coefficient (P = 0.05), path analysis, and determining the standard coefficients between self-care and planned behavior, mediated by the indicators of the health literacy. RESULTS A significant difference was found between the level of health literacy of women and men. The comparison of the mean health literacy and self-care behavior in terms of other variables did not show any significant difference. Meanwhile, the comparison of health status control behaviors, hand washing, and mask use did not show any significant difference between the two groups. A positive and significant correlation was found between self-care behaviors, attitude, subjective norms, perceived behavioral control, and behavioral intention. The relationship of health literacy and psychological variables of attitude, subjective norms, and perceived behavioral control with self-care against COVID-19 was significant. CONCLUSION The direct and significant impact of health literacy on individuals' self-care behaviors against the coronavirus was not observed. However, health literacy did have a significant effect on subjective norms. This finding is important because subjective norms significantly influenced individuals' behavioral intention, which in turn had a significant effect on self-care behaviors against the coronavirus. Thus, health literacy played a mediating role in this relationship. Furthermore, attitude emerged as the strongest predictor of behavioral intention, exerting a direct effect. Conversely, perceived behavioral control did not directly and significantly affect students' self-care behaviors.
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Affiliation(s)
- Sirous Panahi
- Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Ghalavand
- Department of Medical Library and Information Science, Abadan University of Medical Sciences, Abadan, Iran.
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12
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Huang MF, Yeh YC, Liu TL, Hsiao RC, Chen CS, Yen CF. Factors Related to Caregivers' Intention to Vaccinate Their Elderly Family Members with Major Neurocognitive Disorders against COVID-19. Vaccines (Basel) 2024; 12:668. [PMID: 38932397 PMCID: PMC11209509 DOI: 10.3390/vaccines12060668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 05/29/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Vaccination helps reduce the risk of coronavirus disease 2019 (COVID-19) infection in elderly individuals with major neurocognitive disorders (MNDs). However, some caregivers are hesitant to have their elderly family members with MNDs vaccinated against COVID-19. This study explored the factors influencing caregivers' intentions to vaccinate elderly family members with MNDs against COVID-19. A total of 232 caregivers of elderly family members with MNDs participated in this study. In this survey, data regarding COVID-19 vaccination acceptance, fear, side effects, family members' attitudes toward vaccination, mental health status, neuropsychiatric symptoms, and cognitive impairments were collected from the elderly participants with MNDs. The associations between these variables and the caregivers' intention to vaccinate their elderly family members with MNDs against COVID-19 were examined using a multivariable linear regression analysis model. The results revealed that caregivers' perceived familial support for vaccination, the perceived value of vaccination, and autonomy to vaccinate elder family members were positively correlated with caregivers' intention to vaccinate elderly family members with MNDs, whereas elderly family members' age was negatively correlated with caregiver intentions. This study demonstrated that caregiver factors (perceived familial support, value of vaccination, and autonomy) and elderly family members' age were correlated with caregiver intention. These factors should be considered in developing interventions to enhance caregivers' intentions to vaccinate their elderly family members with MNDs against COVID-19.
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Affiliation(s)
- Mei-Feng Huang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80754, Taiwan; (M.-F.H.)
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Yi-Chun Yeh
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80754, Taiwan; (M.-F.H.)
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80754, Taiwan; (M.-F.H.)
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry, Seattle Children’s, Seattle, WA 98195, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA 98105, USA
| | - Cheng-Sheng Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80754, Taiwan; (M.-F.H.)
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80754, Taiwan; (M.-F.H.)
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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Bahri AA, Jareebi MA, Ryani MA, Othman JA, Mohrag M, Akish EA, Shami MO, Alessa HA, Madkhali JY, Bakri K, Hakami A, Otayn HA, Shok AA. Exploring COVID-19 Vaccine Intentions, Perceptions, and Uptake Among the Saudi Population. Cureus 2024; 16:e63404. [PMID: 39070374 PMCID: PMC11283866 DOI: 10.7759/cureus.63404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2024] [Indexed: 07/30/2024] Open
Abstract
Background The widespread hesitancy, delays in acceptance, or outright refusal to receive vaccinations, even when readily available, present a notable global challenge. This is particularly pertinent in the context of COVID-19 vaccine hesitancy, where research shows considerable variability in hesitancy rates worldwide. The primary aim of this study is to investigate COVID-19 vaccine intentions among the Saudi population using behavioral theories as a framework. Methodology A descriptive cross-sectional study was conducted in the Kingdom of Saudi Arabia from January 2022 to December 2022. An online self-administered survey was distributed via social media to reach the targeted participants. Both men and women aged >18 years were included, while non-Saudi individuals and people who are less than 18 years old were excluded. A total of 1,139 participants were included. Results The study found that about 96% of respondents were willing to receive a COVID-19 vaccination. Analyzing sociodemographic and COVID-19-related factors with vaccine intention showed that those previously diagnosed with COVID-19 were less likely to refuse vaccination (P = 0.015). Univariate analyses revealed significant differences in the health belief model (HBM) and theory of planned behavior (TPB) dimensions between willing and unwilling participants. Willing individuals perceived greater infection severity (P = 0.543), higher vaccination benefits (P < 0.01), fewer barriers (P < 0.01), more cues to action (P < 0.01), and lower infection prevention self-efficacy (P < 0.01) compared to the unwilling group. TPB dimensions also differed, with willing individuals having more favorable vaccine attitudes (P < 0.01) and stronger vaccination social norms (P < 0.01). A multivariate logistic regression indicated that having COVID-19 increased vaccine willingness likelihood (odds ratio [OR] = 2.11, 95% confidence interval [CI] 1.14-3.91). Perceived barriers (OR = 0.61, 95% CI 0.44-0.85), self-efficacy (OR = 1.96, 95% CI 1.16-3.32) from HBM, and favorable vaccine attitudes (OR = 1.55, 95% CI 1.02-2.35) from TPB were significant predictors of vaccine willingness. Conclusions The TPB highlighted the importance of attitudes and perceived norms in vaccination acceptance, suggesting their value in vaccination promotion strategies. However, further research, including prospective and interventional studies drawing from a wider array of psychological theories, is needed to develop effective interventions for promoting vaccination.
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Affiliation(s)
- Ahmed A Bahri
- Department of Community and Family Medicine, Jazan University, Jazan, SAU
| | - Mohammad A Jareebi
- Department of Community and Family Medicine, Jazan University, Jazan, SAU
| | - Majed A Ryani
- Department of Community and Family Medicine, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Jamaludeen A Othman
- Department of Anesthesia and Critical Care, Jazan University Hospital, Jazan, SAU
| | - Mostafa Mohrag
- Department of Internal Medicine, Jazan University, Jazan, SAU
| | - Eyas A Akish
- Department of Medicine, Jazan University, Jazan, SAU
| | | | - Hanan A Alessa
- Department of Family Medicine, Health Affairs in Jazan Region, Jazan, SAU
| | - Jalal Y Madkhali
- Department of Family Medicine, Health Affairs in Jazan Region, Jazan, SAU
| | - Khalid Bakri
- Department of Medicine and Surgery, Jazan University, Jazan, SAU
| | | | - Hamad A Otayn
- Department of Family Medicine, Health Affairs in Jazan Region, Jazan, SAU
| | - Ahmad A Shok
- Department of Pediatric Medicine, Health Affairs in Jazan Region, Jazan, SAU
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Kim SY, Wen W, Coulter KM, Du Y, Tse HW, Hou Y, Chen S, Shen Y. Survival Analysis and Socio-Cognitive Factors in the Timing of COVID-19 Vaccination Among Mexican-Origin Youth. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01995-1. [PMID: 38580808 DOI: 10.1007/s40615-024-01995-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/02/2024] [Accepted: 03/27/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVE The COVID-19 pandemic disproportionately affected ethnic minority populations and exacerbated preexisting health disparities. The current study aims to promote vaccine uptake among Mexican-origin youth from immigrant families by examining their time to COVID-19 vaccine uptake and assessing the influence of demographic, cognitive, and social factors on the incidence of COVID-19 vaccination. METHODS The study conducted Survival Analysis using a Cox proportional hazards model based on a sample of 202 Mexican-origin youth (61.39% female; Mage = 20.41) with data collected from August 2021 to January 2023 in central Texas. RESULTS The results show a critical time period for vaccine uptake (i.e., in the first six months after the vaccines were publicly available), evidenced by a surge decrease in COVID-19 unvaccination probability. In addition, more positive attitudes toward the COVID-19 vaccine (Hazard ratio/HR = 1.89, 95% Confidence Interval/CI = [1.64, 2.18]), greater motivation (HR = 2.29, 95% CI = [1.85, 2.85]), higher education levels (HR = 1.52, 95% CI = [1.24, 1.86]), and fewer general barriers to COVID-19 vaccine knowledge (HR = 0.75, 95% CI = [0.60, 0.94]) were associated with greater incidences of receiving COVID-19 vaccines at any given time point during the pandemic. CONCLUSION The findings suggest that COVID-19 vaccine uptake among Mexican-origin youth occurred primarily within the initial months of vaccines being publicly distributed. To encourage vaccination among Mexican-origin youth, sustained COVID-19 vaccine promotion efforts are needed by targeting their motivation and positive attitudes and reducing barriers to vaccine information, particularly for youth with lower education levels.
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Affiliation(s)
- Su Yeong Kim
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, TX, USA.
| | - Wen Wen
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Kiera M Coulter
- Population Research Center, The University of Texas at Austin, Austin, TX, USA
| | - Yayu Du
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Hin Wing Tse
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Yang Hou
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, FL, USA
| | - Shanting Chen
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Yishan Shen
- School of Family and Consumer Sciences, Texas State University, San Marcos, TX, USA
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15
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Tsao SF, Chen H, Butt ZA. Validating part of the social media infodemic listening conceptual framework using structural equation modelling. EClinicalMedicine 2024; 70:102544. [PMID: 38516101 PMCID: PMC10955635 DOI: 10.1016/j.eclinm.2024.102544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/23/2024] Open
Abstract
Background The literature has identified various factors that promote or hinder people's intentions towards COVID-19 vaccination, and structural equation modelling (SEM) is a common approach to validate these associations. We propose a conceptual framework called social media infodemic listening (SoMeIL) for public health behaviours. Hypothesizing parameters retrieved from social media platforms can be used to infer people's intentions towards vaccination behaviours. This study preliminarily validates several components of the SoMeIL conceptual framework using SEM and Twitter data and examines the feasibility of using Twitter data in SEM research. Methods A total of 2420 English tweets in Toronto or Ottawa, Ontario, Canada, were collected from March 8 to June 30, 2021. Confirmatory factor analysis and SEM were applied to validate the SoMeIL conceptual framework in this cross-sectional study. Findings The results showed that sentiment scores, the log-numbers of favourites and retweets of a tweet, and the log-numbers of a user's favourites, followers, and public lists had significant direct associations with COVID-19 vaccination intention. The sentiment score of a tweet had the strongest relationship, whereas a user's number of followers had the weakest relationship with the intention of COVID-19 vaccine uptake. Interpretation The findings preliminarily validate several components of the SoMeIL conceptual framework by testing associations between self-reported COVID-19 vaccination intention and sentiment scores and the log-numbers of a tweet's favourites and retweets as well as users' favourites, followers, and public lists. This study also demonstrates the feasibility of using Twitter data in SEM research. Importantly, this study preliminarily validates the use of these six components as online reaction behaviours in the SoMeIL framework to infer the self-reported COVID-19 vaccination intentions of Canadian Twitter users in two cities. Funding This study was supported by the 2023-24 Ontario Graduate Scholarship.
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Affiliation(s)
- Shu-Feng Tsao
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Helen Chen
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Zahid A. Butt
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
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Malița MA, Manolescu LSC, Perieanu VȘ, Babiuc I, Marcov EC, Ionescu C, Beuran IA, Prasacu I, Perieanu MV, Voinescu I, Radu MC, Burlibasa L, Dumitrescu AI, Burlibasa M. COVID-19 and flu vaccination in Romania, post pandemic lessons in healthcare workers and general population. PLoS One 2024; 19:e0299568. [PMID: 38451954 PMCID: PMC10919663 DOI: 10.1371/journal.pone.0299568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/13/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Influenza and corona viruses generate vaccine preventable diseases and have pandemic potential, frequently dramatic. A co-infection with these viruses, may be a new worldwide threat, researchers name it flurona. The aim of our study is to assess flu and COVID-19 Romanian vaccination for 2022-2023 season and the factor associated with higher odds to receive flu and COVID-19 vaccine. METHODS An analytical cross-sectional observational survey was conducted in the general population; a self-administered questionnaire was used. RESULTS 1056 responders were analyzed, mean age 32.08 ±13.36 years (limits:18-76), majority, 880 (83.33%), from urban areas, 608 (57.58%), high school graduated, 400 (37.88%) parents. More than half of the responders were healthcare workers, 582 (55.11%), also considered study population. In the study group, 796 (73.37%) responders consider flurona vaccination useful; and 872 (82.57%) responders consider that no sanctions are needed for not flurona vaccinating. In the 2022-2023 season, 162 (15.34%) responders vaccinated against the flu and 300 (28.41%) against COVID-19. The factor associated with higher odds to receive flu and COVID-19 vaccine was the habit of flu vaccination: for flu (OR = 58.43; 95% CI: (34.95-97.67)) and for COVID-19 (OR = 1.67; 95% CI: (1.21-2.31)). Other factors such as having university degree (OR = 1.46; 95% CI: (1.08-1.98)) and being a healthcare worker, (OR = 1.41; 95% CI: (1.07-1.87)) were influencing factors only for adult COVID-19 vaccination in the 2022-2023 season. In the parents' group, in 2022-2023 season, only 48 (12%) vaccinated their children against the flu and 68 (17%) against COVID-19, mostly parents that vaccinated themselves, p<0.001. In the 2022-2023 season, there were only 82 (7.65%) responders vaccinated against both diseases. Logistic regression analysis showed that no factor analyzed influenced the flurona vaccinated parent's decision to vaccinate their children for flu and for COVID-19. CONCLUSIONS In the season 2022-2023, in Romania, the vaccination against flu and COVOD-19 is low, in adults and children as well. More efforts must be done to increase flurona vaccination, public health educational programs are strongly needed. Children, that are at greater risk when co-infecting with these viruses, must be vaccinated, school vaccination programs should be considered.
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Affiliation(s)
- Mădălina Adriana Malița
- Department of Dental Technology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Loredana Sabina Cornelia Manolescu
- Department of Microbiology, Parasitology and Virology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Viorel Ștefan Perieanu
- Department of Dental Technology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Iuliana Babiuc
- Department of Dental Technology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Elena Cristina Marcov
- Department of Restorative Dentistry, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Camelia Ionescu
- Department of Dental Prostheses, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Irina Adriana Beuran
- Department of Dental Technology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Irina Prasacu
- Department of Fundamental Sciences, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Mădălina Violeta Perieanu
- Department of Restorative Dentistry, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Ioana Voinescu
- Department of Dental Technology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Mihaela Corina Radu
- Department of Microbiology, Parasitology and Virology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Liliana Burlibasa
- Department of Genetics, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Anca Irina Dumitrescu
- Department of Fundamental Sciences, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Mihai Burlibasa
- Department of Dental Technology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
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Jilani MMAK, Uddin MA, Uddin MS, Das AK, Dey M. Extending the theory of planned behavior to envisage social distancing behavior in containing the COVID-19 outbreak. Heliyon 2024; 10:e26113. [PMID: 38390150 PMCID: PMC10881367 DOI: 10.1016/j.heliyon.2024.e26113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
The study investigates the antecedents that influence social distancing behavior during the COVID-19 outbreak and develops a hypothetical model integrating additional pertinent variables into the classic theory of planned behavior (TPB) to grasp the social distancing behavior accurately. The extended model was investigated employing structural equation modeling using the data collected through Snowball Technology from 331 respondents. The results unearth significant influences of all the predictor variables on their outcome variables. Surprisingly, the supportive government strategy has no crucial impact on perceived behavioral control toward social distancing. Furthermore, the study reports no trivial difference between young and old and high-low income groups on the intention-actual social distancing. The study outlines policy interventions to prevent mass transmission of the COVID-19 catastrophe. Lastly, limitations are specified to open up novel insights for future researchers.
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Affiliation(s)
| | - Md Aftab Uddin
- Department of Human Resource Management, University of Chittagong, Chattogram, Bangladesh
| | | | - Anupam Kumar Das
- Department of Management, University of Chittagong, Chattogram, Bangladesh
| | - Mouri Dey
- Department of Accounting, University of Chittagong, Chattogram, Bangladesh
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Capasso M, Conner M, Caso D. Testing an extended theory of planned behaviour in predicting Covid-19 vaccination intention over the course of the pandemic: A three-wave repeated cross-sectional study. Heliyon 2024; 10:e24826. [PMID: 38314287 PMCID: PMC10837554 DOI: 10.1016/j.heliyon.2024.e24826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/06/2024] [Accepted: 01/15/2024] [Indexed: 02/06/2024] Open
Abstract
Background Mass vaccination against Covid-19 has been recognised as the most effective strategy for overcoming the pandemic emergency and remains crucial in the ongoing efforts to mitigate the impact of the virus. The present study aimed to test the efficacy of an extended Theory of Planned Behaviour (TPB) model in predicting vaccination intention in three different phases of the pandemic. Understanding how psychological drivers of vaccine acceptance may have changed throughout the pandemic is essential for informing public health strategies and addressing vaccine hesitancy, even in the current post-pandemic context. Methods Using a repeated cross-sectional survey, we tested the hypothesised extended TPB model (intention, attitude, subjective norms, perceived behavioural control, anticipated affective reactions, risk perception, trust in science, trust in institutions and religiosity) across three independent samples: before (T1: November-December 2020; N = 657), during (T2: March-May 2021; N = 818), and after (T3: February-March 2022; N = 605) the start of the vaccination campaign in Italy. Results Results indicated significant differences between the time points in all investigated variables, pointing to a general trend of improvement in vaccine acceptability levels at T2 compared to T1, and a worsening at T3 compared to the other two time points. Interestingly, net of these differences, a multi-group Structural Equation Modeling analysis supported the invariance, across time, of the structural relationships examined within the extended TPB. Conclusion Findings demonstrated the efficacy of the TPB in predicting Covid-19 vaccination intention at different stages of the pandemic, suggesting that the model, in its extended version, represents a valuable framework for designing interventions aimed at promoting vaccine acceptance.
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Affiliation(s)
- Miriam Capasso
- Department of Humanities, University of Naples Federico II, Italy
| | - Mark Conner
- School of Psychology, University of Leeds, UK
| | - Daniela Caso
- Department of Humanities, University of Naples Federico II, Italy
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19
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Saaka SA, Mohammed K, K. A. Pienaah C, Luginaah I. Child malaria vaccine uptake in Ghana: Factors influencing parents' willingness to allow vaccination of their children under five (5) years. PLoS One 2024; 19:e0296934. [PMID: 38241404 PMCID: PMC10798622 DOI: 10.1371/journal.pone.0296934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/20/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Malaria is a substantial health burden in Ghana, particularly among children. Despite the availability of malaria vaccines, uptake remains low. Notwithstanding, there is a paucity of nationally representative studies on the factors driving hesitance towards the new malaria vaccine. In response, this study, guided by the Theory of Planned Behaviors (TPB), seeks to understand the determinants of child malaria vaccine uptake in Ghana to inform strategies for improving coverage. MATERIALS AND METHODS We employed multiple regression model to examine the association between maternal awareness, socioeconomic status, ethnicity, geographical location, and vaccine uptake using data from the 2019 Ghana Malaria Indicator Survey (MIS). RESULTS Maternal awareness of vaccine (OR = 2.200; P<0.01) significantly predicted higher likelihood of vaccine uptake. Household wealth was associated with child vaccination as parents in middle-income households (OR = 9.342; P<0.01), and those in poorest households (OR = 9.409; P<0.05) recorded higher likelihood of allowing their children to be vaccinated. With regards to ethnicity, parents from the Mande ethnic group (OR = 0.106; P<0.05) were less likely to allow their children to be vaccinated when compared to parents from the Akan ethnic group. Knowing that malaria is covered by National Health Insurance (OR = 2.407; P<0.05) was associated with higher likelihood of allowing child vaccination compared to not knowing. More so, geographical variations were observed as parents who lived in rural areas (OR = 0.254; P<0.05) were significantly less likely to allow vaccination of their children compared to those in urban areas. CONCLUSIONS Enhancing awareness through education campaigns can improve child malaria vaccine coverage. Observing socioeconomic disparities in uptake and ensuring equitable access to vaccines are vital. Tailored strategies considering ethnic background and geographical location, can as well enhance acceptance of the vaccine. This study provides valuable insights for developing effective strategies to reduce the burden of malaria in children and improve coverage of uptake. This study underscores the need to improve parental awareness and the relevance of the vaccine in preventing child mortality.
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Affiliation(s)
- Sulemana Ansumah Saaka
- Department of Geography and Environment, Faculty of Social Science, University of Western, London, Ontario, Canada
| | - Kamaldeen Mohammed
- Department of Geography and Environment, Faculty of Social Science, University of Western, London, Ontario, Canada
| | - Cornelius K. A. Pienaah
- Department of Geography and Environment, Faculty of Social Science, University of Western, London, Ontario, Canada
| | - Isaac Luginaah
- Department of Geography and Environment, Faculty of Social Science, University of Western, London, Ontario, Canada
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20
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AlMuammar S, Alshora W, Sadik Gari A, Bahaj RK, Alansari BA. Parental Willingness and Factors Influencing COVID-19 Vaccination for Children in Saudi Arabia. Pediatric Health Med Ther 2024; 15:29-48. [PMID: 38260725 PMCID: PMC10800286 DOI: 10.2147/phmt.s443272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Purpose The study aimed to examine the parents' willingness and its association with demographic factors, attitudes, and practices to vaccinate their child against COVID-19. Patients and Methods The study involved 2500 participants from various regions of Saudi Arabia and was conducted between July 1, 2021, and August 31, 2021. Information was gathered via an online questionnaire comprising 26 questions, distributed across social media platforms. Informed consent was obtained from all participants before the commencement of the study. A chi-square test was applied to analyze the association among variables, utilizing a subset of 2127 participants based on study inclusion criteria. A chi-square test was applied to observe the association. Results The willingness of parents to vaccinae their children against COVID-19 was found 61%. The main reason for taking was "Protect the child" by 1094 (51.4%%) and the main reason for refusing was "Side effects/safety concerns" by 477 (22.4%). 1846 (86.8%) participants, received the COVID-19 vaccine or were planning to receive it. Conclusion Our study concluded that parent's willingness to vaccinate their children against COVID-19 was relatively high in our sample as about two-thirds of them accept the vaccine for their child once it is available. The use of the health belief model demonstrated the urgent requirement for awareness and education campaigns in the private and public sectors to increase awareness of parents not only related to COVID-19 but also to cater to any unexpected or suspected pandemic of infectious disease in the future full capacity.
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Affiliation(s)
- Sarah AlMuammar
- Family Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Weam Alshora
- Family Medicine Department, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Atheer Sadik Gari
- Family Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Reem Khalid Bahaj
- Family Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia
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21
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Yuan Y, Yeo SY, Lee KS. Different roles of interpersonal trust and institutional trust in motivating older adults to receive COVID-19 vaccines in Singapore. Soc Sci Med 2024; 340:116475. [PMID: 38064820 DOI: 10.1016/j.socscimed.2023.116475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/23/2023] [Accepted: 11/25/2023] [Indexed: 01/23/2024]
Abstract
Since the approvals of several vaccines against COVID-19 by the World Health Organization, a large body of research has studied the determinants of individuals' intention to be vaccinated against COVID-19 in a variety of societies. Vaccine intention is a complex construct rooted in the social context that informs the decision-making process. The underlying reasons for older adults' intention to receive the vaccination is even more important to health authorities in societies with large proportions of older adults. In this paper, we interview 27 women over age 55 in Singapore about their COVID-19 vaccine decision-making. Using a social-ecological framework of trust, we identify factors at both individual and institutional levels that build or undermine trust and underlie older women's decisions to receive COVID-19 vaccinations in an authoritarian regime. Findings show that both interpersonal trust and institutional trust contribute to vaccine uptake, however, trust can also contribute to delays in vaccination. Moreover, a sizable minority of respondents report that they were vaccinated not because of institutional trust, but because they felt compelled to do so. The results shed light on directions for future vaccination campaigns.
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Affiliation(s)
- Yaqi Yuan
- School of History and Sociology, Georgia Institute of Technology, USA.
| | - Shun Yuan Yeo
- Department of Humanities, Arts and Social Sciences, Singapore University of Technology and Design, Singapore
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22
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Pokhrel TN, Karki K, Tinkari BS, Upreti SR, Khatiwada SU, Amatya R, Zervos J, Kaljee L, Zenlea K, Prentiss T, Maki G, Shallal A, Joshi S, Zervos M, Latack K, Pokhrel B, Upreti A, Lal BK, Dahal S, Gautam JS, Singh DR, Bajracharya DC. COVID-19 vaccination up-take in three districts of Nepal. Hum Vaccin Immunother 2023; 19:2166321. [PMID: 36691997 PMCID: PMC9988332 DOI: 10.1080/21645515.2023.2166321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Vaccine hesitancy during the COVID-19 pandemic continues to be an issue in terms of global efforts to decrease transmission rates. Despite high demand for the vaccines in Nepal, the country still contends with challenges related to vaccine accessibility, equitable vaccine distribution, and vaccine hesitancy. Study objectives were to identify: 1) up-take and intention for use of COVID-19 vaccines, 2) factors associated with vaccine up-take, and 3) trusted communication strategies about COVID-19 and the vaccines. A quantitative survey was implemented in August and September 2021 through an initiative at the Nepali Ministry of Health and Population Department of Health Services, Family Welfare Division. Data were collected from 865 respondents in three provinces (Bagmati, Lumbini, and Province 1). Ordinal multivariate logistic regression was utilized to determine relationships between vaccination status and associated factors. Overall, 62% (537) respondents were fully vaccinated and 18% (159) were partially vaccinated. Those respondents with higher education (p < .001) and higher household income (p < .001) were more likely vaccinated. There were also significant differences in vaccine up-take across the three provinces (p < .001). Respondents who were vaccinated were significantly more likely to perceive vaccines as efficacious in terms of preventing COVID-19 (p = .004) and preventing serious outcomes (p = .010). Among both vaccinated and unvaccinated individuals, there was a high level of trust in information about COVID-19 vaccines provided through local health-care workers [e.g. nurses and physicians]. These results are consistent with other findings within the South Asia region. Targeted advocacy and outreach efforts are needed to support ongoing COVID-19 vaccination campaigns throughout Nepal.
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Affiliation(s)
| | | | | | | | | | | | - John Zervos
- Global Health Initiative, Henry Ford Health, Detroit, MI, USA
| | - Linda Kaljee
- Global Health Initiative, Henry Ford Health, Detroit, MI, USA
| | - Kate Zenlea
- Global Health Initiative, Henry Ford Health, Detroit, MI, USA
| | - Tyler Prentiss
- Global Health Initiative, Henry Ford Health, Detroit, MI, USA
| | - Gina Maki
- Division of Infectious Diseases, Henry Ford Health, Detroit, MI, USA
| | - Anita Shallal
- Division of Infectious Diseases, Henry Ford Health, Detroit, MI, USA
| | - Seema Joshi
- Division of Infectious Diseases, Henry Ford Health, Detroit, MI, USA
| | - Marcus Zervos
- Division of Infectious Diseases, Henry Ford Health, Detroit, MI, USA
| | - Katie Latack
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI, USA
| | - Bidushi Pokhrel
- Hospital for Advanced Medicine and Surgery, Kathmandu, Nepal
| | | | - Bibek Kumar Lal
- Family Welfare Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
| | - Sagar Dahal
- Family Welfare Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
| | - Jhalak Sharma Gautam
- Management Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
| | - Dipendra Raman Singh
- Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
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Chery MJ, Dubique K, Higgins JM, Faure PA, Phillips R, Morris S, Clisbee M, Conserve DF, Ricthwood T, Lefruit RM, Hedt-Gauthier BL. COVID-19 vaccine acceptance in three rural communes in Haiti: A cross-sectional study. Hum Vaccin Immunother 2023; 19:2204048. [PMID: 37157153 PMCID: PMC10171132 DOI: 10.1080/21645515.2023.2204048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Vaccines are the most effective mechanism for ending the COVID-19 pandemic. However, reluctance to accept vaccines has hindered the efforts of health authorities to combat the virus. In Haiti, as of July 2021, less than 1% of the country's population has been fully vaccinated in part due to vaccine hesitancy. Our goal was to assess Haitian attitudes toward COVID-19 vaccination and investigate the primary reasons for Moderna vaccine hesitancy. We conducted a cross-sectional survey across three rural Haitian communities, in September 2021. The research team used electronic tablets to collect quantitative data from 1,071 respondents, selected randomly across the communities. We report descriptive statistics and identify variables associated with vaccine acceptance using logistic regression built using a backward stepwise approach. Among 1,071 respondents, the overall acceptance rate was 27.0% (n = 285). The most common reason for vaccine hesitancy was "concern about side effects" (n = 484, 67.1%) followed by "concern about contracting COVID-19 from the vaccine" (n = 472, 65.4%). Three-quarters of respondents (n = 817) identified their healthcare workers as their most trustworthy source for information related to the vaccine. In the bivariate analysis, male gender (p = .06) and no history of drinking alcohol (p < .001) were significantly associated with being more likely to take the vaccine. In the final reduced model, only those with a history of drinking alcohol were significantly more likely to take the vaccine (aOR = 1.47 (1.23, 1.87) p < .001). The acceptance rate for the COVID-19 vaccine is low, and public health experts should design and strengthen vaccination campaigns to combat misinformation and public distrust.
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Affiliation(s)
- Maurice J Chery
- Research Department, Zanmi Lasante/Partners in Health Mirebalais: Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Kobel Dubique
- Research Department, Zanmi Lasante/Partners in Health Mirebalais: Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Julia M Higgins
- Strategic Information Systems, Partners in Health, Boston, MA, USA
| | - Peterson Abnis Faure
- Research Department, Zanmi Lasante/Partners in Health Mirebalais: Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Roslyn Phillips
- Research Department, Zanmi Lasante/Partners in Health Mirebalais: Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Sarah Morris
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Mary Clisbee
- Research Department, Zanmi Lasante/Partners in Health Mirebalais: Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Donaldson F Conserve
- Department of Prevention and Community Health, George Washington University School of Public Health and Health Services: The George Washington University Milken Institute of Public Health, Washington, DC, USA
| | - Tiarney Ricthwood
- Department of Medicine & Community Health and Global Health, Duke Institute of Global Health, Durham, NC, USA
| | - Ralph M Lefruit
- Research Department, Zanmi Lasante/Partners in Health Mirebalais: Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Bethany L Hedt-Gauthier
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- The Cross-Site COVID-19 Cohort Technical Working Group is Composed of the Following Members- Partners In Health/Boston: Jean Claude Mugunga, Donald Fejfar, Stefanie Joseph; Partners In Health/Haiti: Wesler Lambert, Mary Clisbee, Fernet Leandre; Partners In Health/Liberia: Prince F. Varney; Partners In Health/Lesotho: Melino Ndayizigiye, Patrick Nkundanyirazo, Afom Andom; Partners In Health/Malawi: Emilia Connolly, Chiyembekezo Kachimanga, Fabien Munyaneza; Partners In Health/Mexico: Zeus Aranda; Partners In Health/Peru: Jesus Peinado, Marco Tovar; Partners In Health/Rwanda: Vincent Cubaka, Nadine Karema; Partners In Health/Sierra Leone: Foday Boima, Gregory Jerome; Harvard Medical School: Bethany Hedt-Gauthier, Isabel Fulcher, Dale Barnhart, Megan Murray
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24
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Patwary MM, Disha AS, Hasan M, Bardhan M, Hasan M, Tuhi FI, Rahim SJ, Newaz MN, Imran SA, Haque MZ, Hossain MR, Kabir MP, Swed S. Integrating health belief model and theory of planned behavior to assess COVID-19 vaccine acceptance among urban slum people in Bangladesh. PLoS One 2023; 18:e0290412. [PMID: 38117841 PMCID: PMC10732453 DOI: 10.1371/journal.pone.0290412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 08/08/2023] [Indexed: 12/22/2023] Open
Abstract
INTRODUCTION The vaccination against coronavirus disease 2019 (COVID-19) has been identified as a promising strategy to reduce the severity of the pandemic. Despite the safe and effective COVID-19 vaccines, bringing socioeconomically disadvantaged people under vaccination coverage has been challenging for developing countries like Bangladesh. Therefore, this study explored the determinants of vaccine acceptance among urban slum residents of Bangladesh using the Health Belief Model (HBM) and Theory of Planned Behavior (TPB). METHODS A face-to-face survey of 400 urban slum dwellers in two large cities in Bangladesh was conducted between July 5 to August 5, 2021. The questionnaire included vaccine acceptance, socio-demographics, health-related characteristics, trust in health authorities, reasons for vaccine hesitancy, and dimensions of HBM and TPB frameworks. Hierarchical logistic regression was performed to evaluate the association between these characteristics and vaccination acceptance. RESULTS Around 82% (n = 327) of respondents were willing to accept the COVID-19 vaccine. In a fully adjusted model, respondents with secondary level education had higher intention (OR = 46.93, 95%CI = 1.21-1807.90, p < 0. 05) to accept COVID-19 vaccine. Respondents with bad (OR = 0.11, 95%CI = 0.01-0.35, p<0.05) or very bad (OR = 0.01, 95%CI = 0.01-0.35, p<0.05) health conditions were less interested in the COVID-19 vaccination. In regard to HBM dimensions, greater perceived susceptibility (OR = 1.75, 95% CI = 1.12-2.75, p < 0.05), and perceived benefits (OR = 3.28, 95% CI = 1.17-6.00, p < 0.001) were associated with a greater willingness to get vaccinated. In regard to TPB, higher self-efficacy in preventing illness without the vaccine increased the desire to get vaccinated (OR = 1.55, 95% CI = 1.02-2.37, p < 0.05). Fear of unknown side effects, religious beliefs, contraindications to vaccination, and insufficient information on the vaccine were the main reasons for vaccine hesitancy. CONCLUSIONS These findings offer valuable insights for policymakers in Bangladesh to design targeted interventions that address vaccine hesitancy and increase vaccination acceptability among socially disadvantaged individuals in urban areas. Strategies should focus on providing accurate and accessible information about the vaccine, communicating its positive impact effectively, engaging with religious leaders to address misconceptions, and tailoring vaccination campaigns to meet the unique needs of different demographic groups.
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Affiliation(s)
- Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Environmental Science Discipline, Khulna University, Khulna, Bangladesh
| | - Asma Safia Disha
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Department of Environmental Science and Management, North South University, Bashundhara, Dhaka, Bangladesh
| | - Mahadi Hasan
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Environmental Science Discipline, Khulna University, Khulna, Bangladesh
| | - Mondira Bardhan
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Environmental Science Discipline, Khulna University, Khulna, Bangladesh
| | - Mehedi Hasan
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Department of Environmental Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Faiza Imam Tuhi
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
| | - Sama Jamila Rahim
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
| | - Md. Navid Newaz
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
| | - Sardar Al Imran
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Development Studies Discipline, Khulna University, Khulna, Bangladesh
| | - Md. Zahidul Haque
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Environmental Science Discipline, Khulna University, Khulna, Bangladesh
| | - Md. Riad Hossain
- Institute of Disaster Management, Khulna University of Engineering & Technology, Khulna, Bangladesh
| | - Md Pervez Kabir
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Environmental Science Discipline, Khulna University, Khulna, Bangladesh
| | - Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
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25
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Caycho-Rodríguez T, Tomás JM, Yupanqui-Lorenzo DE, Valencia PD, Carbajal-León C, Vilca LW, Ventura-León J, Paredes-Angeles R, Arias Gallegos WL, Reyes-Bossio M, Delgado-Campusano M, Gallegos M, Rojas-Jara C, Polanco-Carrasco R, Cervigni M, Martino P, Lobos-Rivera ME, Moreta-Herrera R, Palacios Segura DA, Samaniego-Pinho A, Buschiazzo Figares A, Puerta-Cortés DX, Camargo A, Torales J, Monge Blanco JA, González P, Smith-Castro V, Petzold-Rodriguez O, Corrales-Reyes IE, Calderón R, Matute Rivera WY, Ferrufino-Borja D, Ceballos-Vásquez P, Muñoz-del-Carpio-Toia A, Palacios J, Burgos-Videla C, Florez León AME, Vergara I, Vega D, Shulmeyer MK, Barria-Asenjo NA, Urrutia Rios HT, Lira Lira AE. Relationship Between Fear of COVID-19, Conspiracy Beliefs About Vaccines and Intention to Vaccinate Against COVID-19: A Cross-National Indirect Effect Model in 13 Latin American Countries. Eval Health Prof 2023; 46:371-383. [PMID: 37439361 PMCID: PMC10345832 DOI: 10.1177/01632787231186621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
The present study explored the predictive capacity of fear of COVID-19 on the intention to be vaccinated against COVID-19 and the influence in this relationship of conspiracy beliefs as a possible mediating psychological variable, in 13 Latin American countries. A total of 5779 people recruited through non-probabilistic convenience sampling participated. To collect information, we used the Fear of COVID-19 Scale, Vaccine conspiracy beliefs Scale-COVID-19 and a single item of intention to vaccinate. A full a priori Structural Equation Model was used; whereas, cross-country invariance was performed from increasingly restricted structural models. The results indicated that, fear of COVID-19 positively predicts intention to vaccinate and the presence of conspiracy beliefs about COVID-19 vaccines. The latter negatively predicted intention to vaccinate against COVID-19. Besides, conspiracy beliefs about COVID-19 vaccines had an indirect effect on the relationship between fear of COVID-19 and intention to vaccinate against COVID-19 in the 13 countries assessed. Finally, the cross-national similarities of the mediational model among the 13 participating countries are strongly supported. The study is the first to test a cross-national mediational model across variables in a large number of Latin American countries. However, further studies with other countries in other regions of the world are needed.
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Affiliation(s)
| | - José M. Tomás
- Department of Methodology for the Behavioral Sciences, Universidad de Valencia, España
| | | | - Pablo D. Valencia
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de Mexico, Tlanepantla de Baz, Mexico
| | - Carlos Carbajal-León
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
| | - Lindsey W. Vilca
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
| | - José Ventura-León
- Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Peru
| | - Rubí Paredes-Angeles
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Mario Reyes-Bossio
- Facultad de Psicología, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | | | - Miguel Gallegos
- Programa de Pós-graduação de Psicologia, Pontificia Universidade Católica de Minas Gerais, Belo Horizonte, Brasil
- Consejo Nacional de Investigaciones Científicas y Técnicas, Argentina
| | - Claudio Rojas-Jara
- Facultad de Ciencias de la Salud, Departamento de Psicología, Universidad Católica del Maule, Talca, Chile
| | | | - Mauricio Cervigni
- Consejo Nacional de Investigaciones Científicas y Técnicas, Argentina
- Centro de Investigación en Neurociencias de Rosario, Facultad de Psicología, Universidad Nacional de Rosario, Argentina
| | - Pablo Martino
- Laboratorio de Investigaciones en Ciencias del Comportamiento (LICIC), Facultad de Psicología, Universidad Nacional de San Luis, San Luis, Argentina
| | - Marlon Elías Lobos-Rivera
- Escuela de Psicología, Facultad de Ciencias Sociales, Universidad Tecnológica de El Salvador, San Salvador, El Salvador
| | | | | | - Antonio Samaniego-Pinho
- Carrera de Psicología, Facultad de Filosofía, Universidad Nacional de Asunción, Asunción, Paraguay
| | | | | | - Andrés Camargo
- School of Health and Sport Sciences, Fundación Universitaria del Área Andina, Bogotá, Colombia
| | - Julio Torales
- Departamento de Psiquiatría, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | | | | | - Vanessa Smith-Castro
- Instituto de Investigaciones Psicológicas, Facultad de Ciencias Sociales, Universidad de Costa Rica, Costa Rica
| | | | - Ibraín Enrique Corrales-Reyes
- Servicio de Cirugía Maxilofacial, Hospital General Universitario Carlos Manuel de Céspedes, Universidad de Ciencias Médicas de Granma, Bayamo, Cuba
| | - Raymundo Calderón
- Colegio Estatal de Psicólogos en Intervención de Jalisco A.C. Guadalajara, Jalisco, México
| | | | - Daniela Ferrufino-Borja
- Facultad de Humanidades, Comunicación y Artes, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz, Bolivia
| | - Paula Ceballos-Vásquez
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile
| | - Agueda Muñoz-del-Carpio-Toia
- Vicerrectorado de Investigación, Escuela de Postgrado, Escuela de Medicina Humana, Universidad Católica de Santa María, Arequipa, Perú
| | - Jorge Palacios
- Facultad de Psicología, Universidad del Valle de México, Querétaro, México
| | - Carmen Burgos-Videla
- Instituto de Investigación en Ciencias Sociales y Educación, Universidad de Atacama, Copiapó, Chile
| | | | - Ibeth Vergara
- Asociación Panameña de Psicólogos, Ciudad de Panamá, Panamá
- Escuela de Psicología, Universidad Latina de Panamá, Panamá
| | - Diego Vega
- Escuela de Psicologia, Universidad Latina de Costa Rica, San José, Costa Rica
| | - Marion K. Shulmeyer
- Facultad de Humanidades, Comunicación y Artes, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz, Bolivia
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Man SS, Wen H, Zhao L, So BCL. Role of Trust, Risk Perception, and Perceived Benefit in COVID-19 Vaccination Intention of the Public. Healthcare (Basel) 2023; 11:2589. [PMID: 37761786 PMCID: PMC10530888 DOI: 10.3390/healthcare11182589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/16/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023] Open
Abstract
COVID-19 vaccination is an effective method for dealing with the COVID-19 pandemic. This study proposed and validated a theoretical intention model for explaining the COVID-19 vaccination intention (CVI) of the public. The theoretical intention model incorporated trust in vaccines, two types of risk perception (risk perception of COVID-19 and risk perception of COVID-19 vaccination), and perceived benefit into a theory of planned behavior (TPB). Structural equation modeling was utilized to test the theoretical intention model with data collected from 816 Chinese adults in China. The results confirmed the crucial role of trust in vaccines, risk perception, and perceived benefit in shaping the CVI of the public. In addition, TPB was found to be applicable in a research context. The theoretical intention model accounted for 78.8% of the variance in CVI. Based on the findings, several practical recommendations for improving COVID-19 vaccination rates were discussed.
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Affiliation(s)
- Siu-Shing Man
- School of Design, South China University of Technology, Guangzhou 510641, China; (S.-S.M.); (H.W.)
| | - Huiying Wen
- School of Design, South China University of Technology, Guangzhou 510641, China; (S.-S.M.); (H.W.)
| | - Ligao Zhao
- Guangzhou Huadu Huacheng Community Health Service Centre, Guangzhou 510810, China;
| | - Billy Chun-Lung So
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Sisay AL, Getahun HA, Getachew N, Gebremedhin T, Sebero FM, Birhanu A, Gizaw AT. Barriers and Intention to Get Vaccinated for COVID-19 and Associated Factors Among Adults in Southwest Ethiopia: A Theory of Planned Behavior Approach. Infect Drug Resist 2023; 16:5741-5754. [PMID: 37670980 PMCID: PMC10476652 DOI: 10.2147/idr.s419952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/22/2023] [Indexed: 09/07/2023] Open
Abstract
Background Different vaccines have been approved for use against coronavirus disease and distributed globally in different regions. Efforts should be made on the vaccination to control the spread and impacts of the coronavirus pandemic. However, the general population's attitudes and intention to uptake coronavirus disease 2019 (COVID-19) vaccinations were poor. Objective This study aimed to assess the barriers to and intention to be vaccinated against COVID-19 and the associated factors among adults in the Jimma zone, Ethiopia. Methods A community-based cross-sectional study with multistage sampling was conducted with 621 participants from 16 April to 17 May 2022. Multivariable logistic regression was used to identify factors associated with the outcome of interest. Statistical p-value ≤0.05 was set at p ≤ 0.05. Qualitative data were supplemented with quantitative results. Results The majority of the study participants (382 [61.5%]) intended to uptake the COVID-19 vaccine. In this study, travel history (Adjusted Odds Ratio (AOR) = 2.18, 95% CI 1.23-3.87), vaccination history (AOR = 2.64, 95% CI 1.69-4.12), perceptions of infection prevention for COVID-19 (AOR = 1.97, 95% CI 1.28-3.03), subjective norm (AOR = 2.27, 95% CI 1.52-3.39), and perceived behavioral control (PBC) (AOR = 2.30, 95% CI 1.55-3.41) were significantly associated with the intention to be vaccinated against COVID-19. Conclusion More than half of the adult participants intended to be vaccinated against COVID-19. The study participant's traveling history, vaccination history, perception of infection prevention for COVID-19, subjective norms, and Perceived Behavioral Control were significantly associated with the intention to be vaccinated.
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Affiliation(s)
- Assefa Legesse Sisay
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Habtamu Abebe Getahun
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Nigusu Getachew
- Department of Health Policy and Management, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tadesse Gebremedhin
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | | | - Addis Birhanu
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Abraham Tamirat Gizaw
- Department of Health, Behavior and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Reyes CT, Cao W, Astorini AG, Drohan MM, Schulz CT, Shuster CL, Robbins ML, Yang M, Stamates AL. Using the theory of planned behavior to assess willingness and attitudes towards COVID-19 vaccination among a predominantly white U.S. college sample. Health Psychol Behav Med 2023; 11:2248236. [PMID: 37601893 PMCID: PMC10438853 DOI: 10.1080/21642850.2023.2248236] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 08/07/2023] [Indexed: 08/22/2023] Open
Abstract
Objective Through the lens of behavioral models such as the Theory of Planned Behavior (TPB) and the Health Belief Model, the present study (1) investigated U.S. university students' willingness to receive the COVID-19 vaccine and (2) examined predictors (e.g. demographics, past vaccine experience, TPB constructs) of vaccine willingness. Method University students (n = 170) completed a survey assessing demographics, health behaviors, attitudes, perceived severity/susceptibility, norms, and vaccine intentions related to the COVID-19 pandemic. Data were collected from April 2020 through July 2020. Results Overall, 56.5% of participants indicated that they would be willing to receive the COVID-19 vaccine once it is available, 39.4% were unsure of whether they would receive the vaccine, and 4.1% indicated they would not receive the vaccine. Multinomial logistic regression indicated that greater adherence to CDC guidelines (p = .030) and greater perceived pro-vaccine norms (p < .001) predicted greater vaccine willingness. Conclusions Results from this study are consistent with previous literature on vaccine hesitancy, whereby normative beliefs and adherence to CDC guidelines were found to be determinants of vaccine willingness. To reduce transmission of the COVID-19 pandemic, interventions aimed at promoting positive attitudes towards vaccination should aim to incorporate these observed determinants.
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Affiliation(s)
- Cheyenne T. Reyes
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Wenqiu Cao
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | | | - Megan M. Drohan
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | | | - Coral L. Shuster
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Mark L. Robbins
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Manshu Yang
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Amy L. Stamates
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
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Zhu K, Ma S, Chen H, Xie J, Huang D, Ma G, Huang Y. Factors associated with COVID-19 vaccination coverage in hypertensive patients with Omicron infection in Shanghai, China. Hum Vaccin Immunother 2023; 19:2253599. [PMID: 37905728 PMCID: PMC10760500 DOI: 10.1080/21645515.2023.2253599] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/27/2023] [Indexed: 11/02/2023] Open
Abstract
The potential future burden of COVID-19 is determined by the level of susceptibility of the population to infection. The protective effect provided by those previously infected diminishes over several months, while individuals with mixed immunity have the highest degree and persistence of protection. This study aimed to clarify the vaccination status of COVID-19 patients with hypertension and to analyze the characteristics and risk factors of non-vaccinated patients to protect this vulnerable population in the future. The study ultimately enrolled 4576 hypertensive patients with Omicron infection from April 6, 2022, to May 15, 2022. Among them, 3556 patients (77.7%) had received at least one dose of vaccine, and 2058 patients (45.0%) received a booster dose. In the multivariate logistic analysis, male (OR 1.328, 95% CI 1.138-1.550, p < .001), age (60-69 years vs.18-49 years) (OR 0.348, 95% CI 0.270-0.448, p < .001), age (≥70 years vs.18-49 years) (OR 0.130, 95% CI 0.100-0.169, p < .001), diabetes mellitus (OR 0.553, 95% CI 0.463-0.661, p < .001), chronic pulmonary diseases (OR 0.474, 95% CI 0.260-0.863, p = .015), chronic kidney disease (OR 0.177, 95% CI 0.076-0.410, p < .001), and cancer (OR 0.225, 95% CI 0.094-0.535, p = .001) were associated with vaccinated status. The vaccine coverage rate, especially the booster vaccine, was low for hypertensive patients with Omicron infection. Females, increasing age, and coexisting chronic diseases were associated with more inadequate vaccine coverage in hypertensive COVID-19 patients. Targeted interventions are required to address the under-vaccination of diverse hypertensive populations.
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Affiliation(s)
- Kongbo Zhu
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Shaolei Ma
- Department of Emergency and Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Hui Chen
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jianfeng Xie
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Dan Huang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Genshan Ma
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yingzi Huang
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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Alshagrawi SS. Examining health sciences students' intention to uptake COVID-19 vaccination using the theory of planned behavior. Hum Vaccin Immunother 2023; 19:2256044. [PMID: 37694723 PMCID: PMC10496529 DOI: 10.1080/21645515.2023.2256044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/24/2023] [Accepted: 09/03/2023] [Indexed: 09/12/2023] Open
Abstract
To examine the association between the theory of planned behavior (TPB) constructs and Health Sciences students' intentions to receive COVID-19 vaccination. A cross-sectional study was conducted in Saudi Arabia by recruiting Health Sciences students as participants. Using Structural Equation Modeling (SEM), the proposed TPB model was evaluated. The sample of 505 individuals consisted of more males (n = 275; 54.5%) than females and was relatively young (88% were between the ages of 18 and 30). The suggested TPB model explained 78.2% of the variation in intention to get COVID-19 immunization. We found that greater levels of perceived behavioral control (β = 1.58, p < .001) and attitude (β = .44, p < .001) strongly predicted increased vaccination intentions. The subjective norm construct was not a significant predictor of vaccination intentions (β = 0.06, p = .34). The findings of this study indicate that the TPB can be utilized effectively to obtain insight into the factors associated with COVID-19 adherence and help in the development of effective COVID-19 intervention strategies.
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Affiliation(s)
- Salah S. Alshagrawi
- College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
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31
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Apuke OD, Asude Tunca E. Modelling the Factors That Predict the Intention to Take COVID-19 Vaccine in Nigeria. JOURNAL OF ASIAN AND AFRICAN STUDIES 2023; 58:664-680. [PMID: 37461427 PMCID: PMC10345828 DOI: 10.1177/00219096211069642] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
This study developed a model that predicted factors that prompt the intention to take the COVID-19 vaccine among Nigerians. Data were collected from 385 respondents across Nigeria using snowball sampling technique with online questionnaire as instrument. Results indicated that cues to action, health motivation, subjective norms, and perceived behavioural control positively predicted the intention to take COVID-19 vaccine in Nigeria. However, perceived susceptibility, severity, and COVID-19 vaccine benefits did not predict the intention to take the COVID-19 vaccine. Further findings showed that COVID-19 vaccine barrier and attitude was negatively associated with the intention to take the COVID-19 vaccine.
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Affiliation(s)
- Oberiri Destiny Apuke
- Oberiri Destiny Apuke, Faculty of Communication and Media Studies, Taraba State University, PMB 1167 Jalingo, Nigeria.
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32
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Choi J, Ryu JG. COVID-19 vaccination intention among nursing, medical, and dental students: A systematic review and meta-regression analysis. Hum Vaccin Immunother 2023; 19:2253600. [PMID: 37732552 PMCID: PMC10515672 DOI: 10.1080/21645515.2023.2253600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/28/2023] [Indexed: 09/22/2023] Open
Abstract
The introduction of the COVID-19 vaccine amidst the pandemic has heralded a paradigm shift. Healthcare students in nursing, medicine, and dentistry must have positive attitudes owing to their future role in vaccine recommendations to the public and patients. This meta-regression analysis assessed the differences in COVID-19 vaccination intention (VI) of nursing, medical, and dental students. Medline/PubMed, EMBASE, CINAHL, Cochrane Library, and Korean MBASE were searched for eligible studies. Quality was assessed by the Joanna Briggs Institute's quality appraisal. Forty-one studies were included in the final analysis, and the estimation of pooled prevalence (68%) and relevant factors were assessed. Dental students were found to have the lowest VI (57%), which significantly (p = .018) differed from that of nursing students (64%). Countries in South-East Asia and those with high income levels were found to have high VI. Therefore, global vaccine programs for healthcare students should be prepared considering their geographical and economic status.
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Affiliation(s)
- Jongrim Choi
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Jae Geum Ryu
- College of Nursing, Chodang University, Muan, Republic of Korea
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Catalano HP, Richards K, Shaw KHH, Catalano M. Applying the theory of planned behavior to predict COVID-19 booster vaccination intentions of college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 37437193 DOI: 10.1080/07448481.2023.2228425] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 01/16/2023] [Accepted: 06/11/2023] [Indexed: 07/14/2023]
Abstract
Objective: The purpose of this study was: (a) to determine COVID-19 vaccination rates among college students, (b) to assess what proportion of college students self-report currently or previously having COVID-19, and (c) to test theory of planned behavior (TPB)-based constructs in predicting the COVID-19 booster vaccination behavioral intentions. Methods: A non-experimental, cross-sectional study design was applied. Participants: The sample consisted of 288 college students ages 18 years and older. Results: The stepwise multiple regression revealed that attitude (β = .329; p < .001) and subjective norm (β = .244; p < .001) were statistically significant predictors of intention to receive the COVID-19 booster, accounting for 86.7% (Adjusted R2 = .867, F (2, 204 = 673.002, p < .001) of the variance. Conclusions: College students are at high risk for more severe complications of COVID-19 infection due to low vaccination rates. The instrument designed for this study may be used to design TPB-based interventions to increase COVID-19 vaccination and booster intentions of college students.
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Affiliation(s)
- Hannah Priest Catalano
- School of Health & Applied Human Sciences, University of North Carolina, Wilmington, NC, USA
| | - Keith Richards
- School of Communication, East Carolina University, Greenville, NC, USA
| | | | - Michael Catalano
- School of Communication, East Carolina University, Greenville, NC, USA
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Nsubuga EJ, Fitzmaurice AG, Komakech A, Odoi TD, Kadobera D, Bulage L, Kwesiga B, Elyanu PJ, Ario AR, Harris JR. Community dialogue meetings among district leaders improved their willingness to receive COVID-19 vaccines in Western Uganda, May 2021. BMC Public Health 2023; 23:969. [PMID: 37237258 DOI: 10.1186/s12889-023-15903-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Widespread COVID-19 vaccine uptake can facilitate epidemic control. A February 2021 study in Uganda suggested that public vaccine uptake would follow uptake among leaders. In May 2021, Baylor Uganda led community dialogue meetings with district leaders from Western Uganda to promote vaccine uptake. We assessed the effect of these meetings on the leaders' COVID-19 risk perception, vaccine concerns, perception of vaccine benefits and access, and willingness to receive COVID-19 vaccine. METHODS All departmental district leaders in the 17 districts in Western Uganda, were invited to the meetings, which lasted approximately four hours. Printed reference materials about COVID-19 and COVID-19 vaccines were provided to attendees at the start of the meetings. The same topics were discussed in all meetings. Before and after the meetings, leaders completed self-administered questionnaires with questions on a five-point Likert Scale about risk perception, vaccine concerns, perceived vaccine benefits, vaccine access, and willingness to receive the vaccine. We analyzed the findings using Wilcoxon's signed-rank test. RESULTS Among 268 attendees, 164 (61%) completed the pre- and post-meeting questionnaires, 56 (21%) declined to complete the questionnaires due to time constraints and 48 (18%) were already vaccinated. Among the 164, the median COVID-19 risk perception scores changed from 3 (neutral) pre-meeting to 5 (strong agreement with being at high risk) post-meeting (p < 0.001). Vaccine concern scores reduced, with medians changing from 4 (worried about vaccine side effects) pre-meeting to 2 (not worried) post-meeting (p < 0.001). Median scores regarding perceived COVID-19 vaccine benefits changed from 3 (neutral) pre-meeting to 5 (very beneficial) post-meeting (p < 0.001). The median scores for perceived vaccine access increased from 3 (neutral) pre-meeting to 5 (very accessible) post-meeting (p < 0.001). The median scores for willingness to receive the vaccine changed from 3 (neutral) pre-meeting to 5 (strong willingness) post-meeting (p < 0.001). CONCLUSION COVID-19 dialogue meetings led to district leaders' increased risk perception, reduced concerns, and improvement in perceived vaccine benefits, vaccine access, and willingness to receive the COVID-19 vaccine. These could potentially influence public vaccine uptake if leaders are vaccinated publicly as a result. Broader use of such meetings with leaders could increase vaccine uptake among themselves and the community.
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Affiliation(s)
| | | | - Allan Komakech
- Uganda Public Health Fellowship Program, Kampala, Uganda
| | - Tom Dias Odoi
- Baylor College of Medicine Children's Foundation, Kampala, Uganda
| | - Daniel Kadobera
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | - Lilian Bulage
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | - Benon Kwesiga
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | | | - Alex Riolexus Ario
- Uganda Public Health Fellowship Program, Kampala, Uganda
- Uganda National Institute of Public Health, Kampala, Uganda
| | - Julie R Harris
- United States Centers for Disease Control and Prevention, Kampala, Uganda
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35
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Thaker J, Richardson LM, Holmes DC. Audience segmentation analysis of public intentions to get a COVID-19 vaccine in Australia. PUBLIC UNDERSTANDING OF SCIENCE (BRISTOL, ENGLAND) 2023; 32:470-488. [PMID: 36546333 PMCID: PMC9790861 DOI: 10.1177/09636625221138494] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
While previous studies provide broad categories of the public who intend to get a COVID-19 vaccine, few systematically segment and help understand and engage with distinct publics to improve COVID-19 vaccine uptake. Using data from a national sample of the Australian public (N = 1054) and using measures primarily based on the Theory of Planned Behaviour, a latent class analysis of 16 items was undertaken to identify COVID-19 audience segments for potential future message targeting. We found five different segments of COVID-19 vaccine intentions: vaccine enthusiasts (28%), supporters (26%), socials (20%), hesitant (15%) and sceptics (10%). These five audience segments also differ on demographic variables and their level of trust in mainstream media, scientists and health experts, social media and family and friends. Understanding the COVID-19 vaccine attitudinal and information-seeking characteristics of these sub-publics will help inform appropriate messaging campaigns.
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Affiliation(s)
- Jagadish Thaker
- Jagadish Thaker, University of Auckland, 502 Room, Bldg 207, Symonds Street, Auckland 1010, New Zealand.
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36
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Prado ADS, Kohls E, Baldofski S, Bianchi AS, Trindade LIP, Freitas JDL, Rummel-Kluge C. How are Brazilian university students coping with the COVID-19 pandemic? Results of an online survey on psychosocial well-being, perceived burdens, and attitudes toward social distancing and vaccination. PLoS One 2023; 18:e0284190. [PMID: 37099492 PMCID: PMC10132549 DOI: 10.1371/journal.pone.0284190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/24/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic caused significant disruption to education systems worldwide, increasing pre-existing concerns regarding university students' mental health. Brazil was among the countries most affected by COVID-19 cases and deaths and was considered a pandemic epicenter. This study aimed to investigate Brazilian university students' mental health status and perceived burdens during the COVID-19 pandemic. MATERIAL AND METHODS From November 2021 to March 2022, a cross-sectional and anonymous online survey was conducted among students of a Brazilian federal university. Mental health status (depressive symptoms, alcohol and drug consumption) and social and emotional aspects in the pandemic context (social support, perceived stress, loneliness, resilience, and self-efficacy) were assessed with standardized measures. Students' attitudes toward the COVID-19 pandemic and vaccination and perceived burdens of the pandemic were also investigated. RESULTS A total of N = 2,437 students completed the online survey. The PHQ-9 mean sum score was 12.85 (SD = 7.40), while n = 1,488 (61.10%) participants reported a sum score of 10 or more, indicating clinically relevant depressive symptoms. Further, n = 808 (33.1%) of the total sample reported suicidal thoughts. Levels of depressive symptoms, perceived stress, and loneliness were higher among undergraduate/bachelor students than doctoral students. Almost all participants (97.3%) reported being fully vaccinated against COVID-19. Multiple regression analyses showed that being single, having an income decreased during the pandemic, having a previous mental illness, having a chronic somatic condition, not finding positive aspects in the pandemic, lower self-efficacy, lower social support, lower resilience, and higher experienced loneliness were significantly associated with higher levels of depression. CONCLUSIONS The study showed high levels of depressive symptoms and suicidal ideation among Federal University of Parana students. Therefore, health care providers and universities need to recognize and address mental health issues; psychosocial policies must be enhanced to mitigate the impact of the pandemic on students' mental health and wellbeing.
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Affiliation(s)
- Aneliana da Silva Prado
- Faculty of Life Sciences, Wilhelm Wundt Institute for Psychology, Leipzig University, Leipzig, Sachsen, Germany
- Department of Psychology, Federal University of Parana, Curitiba, Parana, Brazil
- Campus Curitiba, Federal Institute of Education, Science and Technology of Parana, Curitiba, Parana, Brazil
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Sachsen, Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Sachsen, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Sachsen, Germany
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Sachsen, Germany
| | | | | | | | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Sachsen, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Sachsen, Germany
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Iloanusi ON, Iloanusi NI, Ross AA. Analyzing the impact of vaccinations and weather factors on the COVID-19 pandemic. Curr Med Res Opin 2023; 39:719-729. [PMID: 37009993 DOI: 10.1080/03007995.2023.2197493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
OBJECTIVES A world-wide immunization project was launched at the peak of COVID-19 pandemic to contain and minimize the adverse effects of SARS-CoV-2 virus. We carried out a series of statistical analyses in this paper to determine, confirm and quantify the impact of the vaccinations on COVID-19 cases and mortalities, amidst critical confounding factors - temperature and solar irradiance. METHODS The experiments in this paper were carried out on the world data, data from 21 countries and the five major continents. The significance of the 2020 - 2022 vaccinations on the COVID-19 cases and mortalities response data were evaluated via Hypotheses' tests. Correlation coefficient analyses were carried out to determine the extent of the relationship between vaccination coverage and corresponding COVID-19 mortalities data. The impact of vaccination was quantified. The effects of the weather factors - temperature and solar irradiance, on COVID-19 cases and mortalities data were analyzed. RESULTS The series of hypotheses tests carried out reveal that vaccinations did not affect cases; however, vaccinations significantly impacted the mean daily mortalities in all five major continents and globally. The correlation coefficient analysis results show vaccination coverage to be highly and negatively correlated with daily mortalities in the world - the five major continents and most of the countries studied in this work. The percentage reduction in mortalities as a result of wider vaccination coverage was indeed significant. Temperature and solar irradiance impacted daily COVID-19 cases and mortalities data during the vaccination and post vaccination periods. CONCLUSION Results show that the world-wide Vaccination against COVID-19 project had a significant impact in reducing mortalities and minimizing the adverse effects due to COVID-19 globally, in all five (5) major continents of the world and the countries studied in this work, however, temperature and solar irradiance still had effects on COVID-19 response in the vaccination eras.
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Affiliation(s)
- Ogechukwu N Iloanusi
- Department of Electronic Engineering, University of Nigeria, Nsukka 410001, Enugu State, Nigeria
| | - Nneka I Iloanusi
- Department of Radiation Medicine, College of Medicine. University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Arun A Ross
- Department of Computer Science and Engineering, Michigan State University, East Lansing, MI 48824 USA
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Shim J, Lee E, Kim E, Choi Y, Kang G, Kim BI. COVID-19 outbreak in a religious village community in Republic of Korea and risk factors for transmission. Osong Public Health Res Perspect 2023; 14:110-118. [PMID: 37183331 PMCID: PMC10211447 DOI: 10.24171/j.phrp.2023.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/22/2023] [Accepted: 03/06/2023] [Indexed: 04/08/2023] Open
Abstract
OBJECTIVES This study aimed to assess the scale and transmission patterns of coronavirus disease 2019 (COVID-19) in a religious village community in South Korea, to determine the risk factors of transmission, and to evaluate vaccine effectiveness. METHODS An epidemiological survey was conducted, and data were collected and analyzed from 602 villagers in the religious village community. Multivariate logistic regression analysis was used to identify the risk factors for COVID-19 transmission and to evaluate vaccine effectiveness. RESULTS The outbreak attack rate was 72.1% (434/602). The attack rate was high among women in their 60s, the unemployed, residents living near religious facility (<500 m), and the unvaccinated. Age, the distance between religious facility and residences, and the absence of vaccination were identified as risk factors for transmission. Vaccine effectiveness was 49.0%, and the highest effectiveness was seen in the age group of 59 years or younger (65.8%). CONCLUSION This village community was isolated, with little communication with the outside world. However, the frequency of close contact between residents was relatively high, contributing to the spread of COVID-19 in the village even with relatively short exposure. Vaccination rates in the village community were also lower than those in the general public. Public health authorities should consider the potential impact of cultural factors, including religion, that could lead to the exponential spread of COVID-19 in closed village communities.
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Affiliation(s)
- Jiae Shim
- Division of Infectious Disease Response, Chungnam Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Daejeon, Republic of Korea
| | - Eunju Lee
- Division of Infectious Disease Response, Chungnam Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Daejeon, Republic of Korea
| | - Eunyoung Kim
- Division of Infectious Disease Response, Chungnam Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Daejeon, Republic of Korea
| | - Yeonhwa Choi
- Division of Infectious Disease Response, Chungnam Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Daejeon, Republic of Korea
| | - Giseok Kang
- Chungnam Center for Infectious Diseases Control and Prevention, Hongseong, Republic of Korea
| | - Bryan Inho Kim
- Division of Infectious Disease Control, Bureau of Infectious Disease Policy, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
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Su Y, Li S, Huang F, Xue J, Zhu T. Exploring the Influencing Factors of COVID-19 Vaccination Willingness among Young Adults in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3960. [PMID: 36900971 PMCID: PMC10001881 DOI: 10.3390/ijerph20053960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Vaccine uptake is considered as one of the most effective methods of defending against COVID-19 (coronavirus disease 2019). However, many young adults are hesitant regarding COVID-19 vaccines, and they actually play an important role in virus transmission. Based on a multi-theory model, this study aims to explore the influencing factors related to COVID-19 vaccine willingness among young adults in China. Using semi-structured interviews, this study explored the factors that would motivate young adults with vaccine hesitancy to get the COVID-19 vaccine. Thematic analysis was used to analyze the interview data with topic modeling as a complementarity method. After comparing the differences and similarities of results generated by thematic analysis and topic modeling, this study ultimately identified ten key factors related to COVID-19 vaccination intention, including the effectiveness and safety of vaccines, application range of vaccine, etc. This study combined thematic analysis with machine learning and provided a comprehensive and nuanced picture of facilitating factors for COVID-19 vaccine uptake among Chinese young adults. Results may be taken as potential themes for authorities and public health workers in vaccination campaigns.
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Affiliation(s)
- Yue Su
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Sijia Li
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Feng Huang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jia Xue
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1A1, Canada
- Faculty of Information, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Tingshao Zhu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
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Li M, Yang BK, Yu Z, Zhu L, Chen X, Kreps GL, Kansangra R. Exploring Factors Associated with Chinese-Americans' Willingness to Receive an Additional Hypothetical Annual Dose of the COVID-19 Vaccine. Vaccines (Basel) 2023; 11:185. [PMID: 36680029 PMCID: PMC9866834 DOI: 10.3390/vaccines11010185] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/01/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
Chinese-Americans are one of the largest groups of Asian-Americans in the US with distinctive behavioral and cultural characteristics that influence health service use. Although Chinese-Americans have significantly higher COVID-19-related mortality rates, relative to other racial and ethnic groups, limited literature is available examining their willingness to accept the COVID-19 vaccine. With recent development of the combination influenza-COVID-19 vaccine by biotechnology companies to mitigate COVID-19 infection, we examined factors associated with Chinese-Americans' acceptance of hypothetical annual doses of COVID-19 vaccination before the vaccine rollout. A total of 241 Chinese-Americans who received at least one dose of the COVID-19 vaccine completed an online questionnaire developed and based on health behavior theories. Our results indicated that Chinese-American participants who were satisfied with their prior COVID-19 vaccination experience, who had more accurate knowledge and perceived higher susceptibility of getting COVID-19, were more willing to receive the annual COVID-19 vaccine in the future. The findings of our current study may be used to guide the development of strategic messages to promote uptake of the annual COVID-19 vaccine by Chinese-Americans in the U.S.
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Affiliation(s)
- Ming Li
- Department of Health Sciences, Towson University, Towson, MD 21252, USA
| | - Bo Kyum Yang
- Department of Health Sciences, Towson University, Towson, MD 21252, USA
| | - Zuojin Yu
- Department of Health Sciences, Towson University, Towson, MD 21252, USA
| | - Lin Zhu
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19122, USA
| | - Xuewei Chen
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, OK 74077, USA
| | - Gary L. Kreps
- Center for Health & Risk Communication, George Mason University, Fairfax, VA 22030, USA
| | - Radhika Kansangra
- Department of Health Sciences, Towson University, Towson, MD 21252, USA
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Zhang L, Yang J, Cao Y, Kang W. Sociocultural-psychological predictors influencing parents' decision-making regarding HPV vaccination for their adolescent daughters in mainland China: An extended TPB model. Front Public Health 2023; 10:1035658. [PMID: 36684984 PMCID: PMC9853056 DOI: 10.3389/fpubh.2022.1035658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/12/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction Enhancing human papillomavirus (HPV) vaccine uptake rates to protect women's health is an important public health issue worldwide. China has taken a series of measures in recent years to promote HPV vaccination among school-aged girls, but the vaccine uptake rate remains low. Investigating the factors influencing vaccination-related decision-making of adolescent girls' parents is key to solving the problem. This study aimed to examine the influence of sociocultural-psychological predictors, including exposure to HPV-related stories (positive/negative), affective reactions (pride/regret), injunctive norms on the Internet and perceived moral obligation, on parents' HPV vaccination-related decision-making for girls aged 13-15 years in mainland China. Methods A cross-sectional online survey using quota sampling was conducted in February 2022. Four hundred and five valid and qualified questionnaires were obtained. Partial least squares structural equation modeling was performed by SmartPLS 3 (i) to evaluate the reliability and validity of the measurement models of 11 constructs, and (ii) to test the effect relationships of the sociocultural-psychological predictors on parents' intention to vaccinate their daughters. Results The study findings showed that parental decision-making regarding HPV vaccination was influenced by sociocultural and psychological factors. At the level of individual psychological factors, exposure to positive stories was significantly associated with perceived vaccine effectiveness (β = 0.331, t = 8.448, p < 0.001), which strongly predicted the attitude toward vaccination (β = 0.521, t = 8.133, p < 0.001); anticipated pride had more positive influence on vaccination-related decision-making (β = 0.156, t = 2.176, p < 0.05) than anticipated regret. In terms of social influence, injunctive norms on the Internet had a significantly positive influence on vaccination intention (β = 0.127, t = 2.382, p < 0.05), similar to descriptive norms (β = 0.135, t = 3.358, p < 0.01). Perceived moral obligation at the cultural level was the strongest predictor of parental decision-making regarding HPV vaccination (β = 0.193, t = 2.139, p < 0.05). Discussion This study is the first in mainland China to systematically examine the sociocultural-psychological predictors of parents' decision-making to vaccinate their 13-15-year-old daughters against HPV. A new extended TPB model with a sociocultural-psychological approach was developed. This model can support the investigation of factors affecting HPV vaccine uptake rates in the mainland Chinese population and similar populations and help to understand the differences in vaccination-related decision-making between Eastern and Western cultures. Furthermore, the study provided some suggestions for HPV vaccination communication campaigns targeting adolescent girls' parents.
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Affiliation(s)
- Lingmin Zhang
- School of Journalism and Communication, Guangzhou University, Guangzhou, China
| | - Jian Yang
- School of Journalism and Communication, Guangzhou University, Guangzhou, China,*Correspondence: Jian Yang ✉
| | - Ye Cao
- Archives Office, Guizhou Open University, Guiyang, China
| | - Wanying Kang
- School of Media and Communication, Shenzhen University, Shenzhen, China
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42
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Lee PC, Huang CY, Liang LL, Huang MH, Hsu MJ. The choice of Taiwanese college students to vaccinate against severe special infectious pneumonia COVID-19 based on the integrated theory of planning behavior. Hum Vaccin Immunother 2022; 18:2148500. [PMID: 36415127 PMCID: PMC9762833 DOI: 10.1080/21645515.2022.2148500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Taiwan's coronavirus (COVID-19) vaccine procurement was delayed until October 2021. With the vaccine's introduction in Taiwan, the public will have an opportunity to choose vaccination. Choosing to vaccinate involves considerations regarding the trade-off between the protective power of the vaccine and its side effects, which is a planned behavior. College students have considered high-risk objects for COVID-19 outbreaks given their lifestyle, and their efficient vaccination may help reduce mutual infection between college students and the general public. This study obtained 707 valid questionnaires from Taiwan college students (20 years old and above). We investigated several factors during our college students' survey regarding vaccination. Among this integrated TPB model, "Attitude," "Subjective Norm," "Perceived Behavioral Control," and "COVID-19 Information Asymmetry" had a positive impact on vaccination "Behavioral Intention." COVID-19 information asymmetry positively and significantly affected behavioral intention through perceived behavioral control, while perceived behavioral control had a mediating effect. To promote the behavioral intention of college students to choose COVID-19 vaccination, public and private departments for epidemic prevention must aim to overcome the self-efficacy barriers of perceived behavioral control and promote the primary group influence effect of subjective norm and the self-interest factor of attitude. Governments and NGOs should also ensure prompt and accurate transmission of epidemic and vaccine information and actively investigate and prohibit misleading details from unknown sources and no scientific basis. Such a policy will generate trust, effectively increasing the vaccination rate and reducing cluster infection.
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Affiliation(s)
- Po-Chun Lee
- Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan,Department of Business Management, National Sun Yat-sen University, Kaohsiung, Taiwan,CONTACT Po-Chun Lee Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, 7F., No. 1, Ln. 218, Jianxing S. Rd., Kaohsiung, Pingtung County 900044, Taiwan (R.O.C.)
| | - Ching-Yuan Huang
- Department of Marketing Management, SHU-TE University, Kaohsiung, Taiwan
| | - Li-Lin Liang
- Department of Business Management, National Sun Yat-sen University, Kaohsiung, Taiwan,Institute of Public Health, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Min-Hsin Huang
- Department of Business Management, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Meng-Jun Hsu
- Department of Hotel Management, National Kaohsiung University of Hospitality and Tourism, Kaohsiung, Taiwan
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Social cognitive predictors of vaccination status, uptake and mitigation behaviors in the Canadian COVID-19 Experiences survey. Vaccine 2022:S0264-410X(22)01526-2. [PMID: 36528446 PMCID: PMC9742224 DOI: 10.1016/j.vaccine.2022.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/02/2022] [Accepted: 12/03/2022] [Indexed: 12/14/2022]
Abstract
Emerging infectious diseases like COVID-19 will remain a concern for the foreseeable future, and determinants of vaccination and other mitigation behaviors are therefore critical to understand. Using data from the first two waves of the Canadian COVID-19 Experiences Survey (CCES; N = 1,958; 66.56 % female), we examined social cognitive predictors of vaccination status, transition to acceptance and mitigation behaviors in a population-representative sample. Findings indicated that all social cognitive variables were strong predictors of mitigation behavior performance at each wave, particularly among unvaccinated individuals. Among those who were vaccine hesitant at baseline, most social cognitive variables predicted transition to fully vaccinated status at follow-up. After controlling for demographic factors and geographic region, greater odds of transitioning from unvaccinated at CCES Wave 1 to fully vaccinated at CCES Wave 2 was predicted most strongly by a perception that one's valued peers were taking up the vaccine (e.g., dynamic norms (OR = 2.13 (CI: 1.54,2.93)), perceived effectiveness of the vaccine (OR = 3.71 (CI: 2.43,5.66)), favorable attitudes toward the vaccine (OR = 2.80 (CI: 1.99,3.95)), greater perceived severity of COVID-19 (OR = 2.02 (CI: 1.42,2.86)), and stronger behavioral intention to become vaccinated (OR = 2.99 (CI: 2.16,4.14)). As a group, social cognitive variables improved prediction of COVID-19 mitigation behaviors (masking, distancing, hand hygiene) by a factor of 5 compared to demographic factors, and improved prediction of vaccination status by a factor of nearly 20. Social cognitive processes appear to be important leverage points for health communications to encourage COVID-19 vaccination and other mitigation behaviors, particularly among initially hesitant members of the general population.
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44
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Luo C, Jiang W, Chen HX, Tung TH. Post-vaccination adverse reactions, decision regret, and willingness to pay for the booster dose of COVID-19 vaccine among healthcare workers: A mediation analysis. Hum Vaccin Immunother 2022; 18:2146964. [PMID: 36422511 DOI: 10.1080/21645515.2022.2146964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This study aimed to explore the relationship between post-vaccination adverse reactions, decision regret, and willingness to pay (WTP) for the booster dose. An online survey was conducted in Taizhou, China. Questionnaires were completed by 1,085 healthcare workers (HCWs) and 1,054 (97.1%) have received two doses of the COVID-19 vaccine. Mediation analysis method was adopted. Our study presented that post-vaccination adverse reactions in HCWs could decrease their WTP for the booster dose. Of note, HCWs experienced adverse reactions after vaccination would more likely regret their previous vaccination decisions, which, in turn, further reduced their WTP for a booster shot. Decision regret mediated the relationship between adverse post-vaccination reactions and WTP for the booster dose. The findings implied inextricable relationships among post-vaccination adverse reactions, decision regret, and WTP of the booster dose. It suggested that these post-vaccination adverse reactions should be further incorporated into vaccine campaigns to improve vaccine intention and potentially increase willingness to pay for booster doses of COVID-19 vaccine.
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Affiliation(s)
- Chengwen Luo
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
| | - Weicong Jiang
- Department of Information Technology, Linhai Rural Commercial Bank, Linhai, China
| | - Hai-Xiao Chen
- Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
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45
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Zhu W, Zou H, Song Y, Ren L, Xu Y. Understanding the impact process of vaccine adoption for COVID-19. Hum Vaccin Immunother 2022; 18:2099166. [PMID: 35905384 DOI: 10.1080/21645515.2022.2099166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Vaccination for the novel coronavirus disease 2019 (COVID-19) provides an effective approach for the general improvement of social safety and individual health. To date, few studies have analyzed the adoption of COVID-19 vaccines from an entire impact process perspective. Using the health belief model (HBM) and the valence theory, this research evaluates the impact process of vaccine adoption for COVID-19. The respondents in this study were individuals who have been vaccinated in China. The effective sample included 595 individuals. Four valuable and novel findings are identified through this research. First, neither perceived susceptibility nor perceived severity has a statistically significant impact on the benefits from vaccination, threats from vaccination and self-efficacy. Second, benefits from vaccination produce a significant positive effect on self-efficacy and vaccine adoption. Third, threats from vaccination produce a significant negative effect on self-efficacy and vaccine adoption. Fourth, both self-efficacy and cues to adoption produce a significantly positive impact on vaccine adoption. Our theoretical model, which is the main contribution of this research, indicates that individual vaccine adoption is simply a process that leads from behavioral cognition to behavioral intention, rather than from psychological perception to behavioral cognition and then from behavioral cognition to behavioral intention.
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Affiliation(s)
- Wenlong Zhu
- Business School, Qingdao University of Technology, Qingdao, China
| | - Hao Zou
- Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ying Song
- Business School, Qingdao University of Technology, Qingdao, China
| | - Lili Ren
- Business School, Qingdao University of Technology, Qingdao, China
| | - Yingjie Xu
- Central Laboratory, Qingdao Stomatological Hospital, Qingdao, China
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46
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Kang L, Wang Y, Xing S, Li H, Chien CW, Tung TH. Group-based trajectory modeling to identify health beliefs of COVID-19 vaccination and its predictors: A cohort study in China. Hum Vaccin Immunother 2022; 18:2091899. [PMID: 35977916 DOI: 10.1080/21645515.2022.2091899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES This study aimed to characterize distinct patterns of change in health beliefs and their dimensions of COVID-19 vaccination and to evaluate the predictors of various trajectory groups. METHODS A total of 1129 participants who completed two doses of COVID-19 vaccines in China were included in this prospective study. Participants' characteristics and health beliefs regarding COVID-19 vaccination were collected before and after the two doses of COVID-19 vaccination. A group-based trajectory model was used to identify the distinct longitudinal patterns of health beliefs and their dimensions. A multinomial logistic regression model was conducted to determine the predictors of different trajectory groups. RESULTS The group-based trajectory model identified two to four distinct patterns of global health beliefs and their domains, namely, very low-stable (16.1%), low-stable (30.2%), medium-stable (45.6%), and high-stable (8.1%) trajectories for global health beliefs. And the five domains of health beliefs showed two or three trajectory stable progression, which were similar to the global health beliefs trajectories. Sex, occupation post, adverse reactions foreboding, and quality of life were associated with the trajectory of global health beliefs or at least one domain of health beliefs. CONCLUSIONS During the study, individuals' health beliefs about COVID-19 vaccination were stable without the interference of external factors. Based on the impact of sex, occupation post, adverse reactions foreboding, and quality of life on individuals' health beliefs, personalized interventions can be developed to improve public health beliefs about COVID-19 vaccination and reduce vaccination hesitancy.
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Affiliation(s)
- Linlin Kang
- Department of Operations Management, Central lab, Shenzhen Bao'an District Traditional Chinese Medicine Hospital, Shenzhen, China.,Institute for Hospital Management, TsingHua University, Shenzhen, China
| | - Yanjiao Wang
- Institute for Hospital Management, TsingHua University, Shenzhen, China
| | - Sizhong Xing
- Department of Operations Management, Central lab, Shenzhen Bao'an District Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Hang Li
- Department of Operations Management, Central lab, Shenzhen Bao'an District Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Ching-Wen Chien
- Institute for Hospital Management, TsingHua University, Shenzhen, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, Linhai, China
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47
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Limbu YB, Gautam RK, Zhou W. Predicting Vaccination Intention against COVID-19 Using Theory of Planned Behavior: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10122026. [PMID: 36560436 PMCID: PMC9783170 DOI: 10.3390/vaccines10122026] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
This study systematically analyzed the literature using the theory of planned behavior (TPB) as a theoretical framework to examine the influence of its constructs on vaccination intention against COVID-19. Quantitative studies were searched in PubMed, CINAHL, Web of Science, and Google Scholar following the PRISMA guidelines. The average rate of COVID-19 vaccination intention was 73.19%, ranging from 31% to 88.86%. Attitude had the strongest association with vaccination intention (r+ = 0.487, 95% CI: 0.368-0.590), followed by subjective norms (r+ = 0.409, 95% CI: 0.300-0.507), and perceived behavioral control (r+ = 0.286, 95% CI: 0.198-0.369). Subgroup analyses showed that the pooled effect sizes of TPB constructs on vaccination intention varied across geographic regions and study populations. Attitude had large effect sizes in Asia, Europe, and Oceania, especially among the adult general population, parents, and patients. Subjective norms had large effect sizes in Asia and Oceania, especially among parents and patients. Perceived behavioral control was the most dominant predictor of vaccination acceptance in Africa among patients. These findings suggest that TPB provides a useful framework for predicting intention to receive a COVID-19 vaccine. Hence, public awareness and educational programs aimed at promoting COVID-19 vaccination intention should consider using TPB as a framework to achieve the goal.
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Affiliation(s)
- Yam B. Limbu
- Feliciano School of Business, Montclair State University, 1 Normal Ave., Montclair, NJ 07043, USA
- Correspondence: ; Tel.: +973-655-3361; Fax: +973-655-7673
| | - Rajesh K. Gautam
- Department of Anthropology, Dr. Harisingh Gour Central University, University Road, Sagar 470003, MP, India
| | - Wencang Zhou
- Feliciano School of Business, Montclair State University, 1 Normal Ave., Montclair, NJ 07043, USA
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48
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Barati M, Bashirian S, Abdi J, Sadri M, Afshari M, Taheri M, Khazaei S, Rostami-Moez M. Predictors of COVID-19 vaccination intention among Iranian population: applying the theory of planned behavior. GMS HYGIENE AND INFECTION CONTROL 2022; 17:Doc21. [PMID: 36570820 PMCID: PMC9761792 DOI: 10.3205/dgkh000424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background The present study was conducted to assess the determinants of the intention to receive the COVID-19 vaccination among the Iranian population. Methods In this cross-sectional study, 1,056 individuals of the general population living in Hamadan County were studied from April to June 2021. Using a proportional stratified sampling method, subjects were selected from those covered by 34 comprehensive health service centers and health bases. Then, the subjects were selected by simple random sampling. Data were collected by sending a questionnaire link to eligible individuals, who completed it online. The questionnaire determined demographic data and constructs of the Theory of Planned Behavior. Results 1,056 subjects answered the study; women accounted for 57.9% of the respondents. According to the findings, the majority of respondents (79.5%) reported that they would strongly agree and agree to get vaccinated against COVID-19. Older age, male gender, occupation, underlying chronic disease, death of relatives and friends due to COVID-19, and history of influenza vaccinations were significantly related to the intention to get vaccinated against COVID-19 (P>0.05). Also, the intention was associated with increased scores in the attitude toward the behavior, subjective norm, and perceived behavioral control. Conclusion Despite doubt about the details of the intention to receive COVID-19 vaccination, most subjects reported intending to be vaccinated against COVID-19, but the real rate of vaccination may be lower. Vaccination intention reflects overall vaccination attitudes, subjective norms, and perceived behavioral control.
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Affiliation(s)
- Majid Barati
- Department of Public Health, School of Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeed Bashirian
- Department of Public Health, School of Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jalal Abdi
- Public Health, Health Center of Hamadan, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohadeseh Sadri
- MSc of Health Education, Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Afshari
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran,Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran,Research Center for Health sciences, Hamadan University of Medical Sciences, Hamadan, Iran,*To whom correspondence should be addressed: Maryam Afshari, Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Shahid Fahmideh Ave., 6517838695 Hamadan, Iran, Tel: +98 813 8380090 09183502663, Fax: +98 813 8380509, E-mail:
| | - Malihe Taheri
- Public Health, Health Center of Hamadan, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Research Center for Health Sciences, Hamadan university of Medical Sciences, Hamadan, Iran
| | - Masomeh Rostami-Moez
- Public Health, Health Center of Hamadan, Hamadan University of Medical Sciences, Hamadan, Iran
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Schäfer M, Stark B, Werner AM, Mülder LM, Heller S, Reichel JL, Schwab L, Rigotti T, Beutel ME, Simon P, Letzel S, Dietz P. Determinants of university students' COVID-19 vaccination intentions and behavior. Sci Rep 2022; 12:18067. [PMID: 36302883 PMCID: PMC9610342 DOI: 10.1038/s41598-022-23044-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/25/2022] [Indexed: 01/24/2023] Open
Abstract
Vaccination hesitancy has been a major challenge for health authorities and societies during the COVID-19 pandemic. The general determinants of vaccination intentions and behavior include sociodemographic and health-related, psychological, and communication-related factors, with varying relevance for different types of vaccinations, countries, and target groups. The predictors of university students' COVID-19 vaccination behavior have not been sufficiently studied. Using a German university as an example and based on an online survey of 1398 university students, we investigated factors related to (a) the likelihood of vaccination against COVID-19 and (b) vaccination intention among those who had not been vaccinated by summer of 2021. Psychological factors showed high relevance. Field of study, trust in, and use of certain media and information channels were found to be important determinants of students' vaccination decision. Our findings can help better understand university students' vaccination behavior to develop and implement tailored strategies and campaigns.
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Affiliation(s)
- Markus Schäfer
- Department of Communication, Johannes Gutenberg University, Mainz, Germany.
| | - Birgit Stark
- Department of Communication, Johannes Gutenberg University, Mainz, Germany
| | - Antonia M Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Lina M Mülder
- Department of Work, Organizational, and Business Psychology, Institute for Psychology, Johannes Gutenberg University, Mainz, Germany
| | - Sebastian Heller
- Institute of Occupational, Social, and Environmental Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Jennifer L Reichel
- Institute of Occupational, Social, and Environmental Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Lisa Schwab
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Institute of Sport Science, Johannes Gutenberg University, Mainz, Germany
| | - Thomas Rigotti
- Department of Work, Organizational, and Business Psychology, Institute for Psychology, Johannes Gutenberg University, Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Perikles Simon
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Institute of Sport Science, Johannes Gutenberg University, Mainz, Germany
| | - Stephan Letzel
- Institute of Occupational, Social, and Environmental Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Pavel Dietz
- Institute of Occupational, Social, and Environmental Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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50
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Yu Y, Ling RHY, Ip TKM, Luo S, Lau JTF. Factors of COVID-19 Vaccination among Hong Kong Chinese Men Who Have Sex with Men during Months 5–8 since the Vaccine Rollout—General Factors and Factors Specific to This Population. Vaccines (Basel) 2022; 10:vaccines10101763. [PMID: 36298627 PMCID: PMC9609851 DOI: 10.3390/vaccines10101763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
This study investigated an under-researched topic regarding the prevalence of COVID-19 vaccination behavior among Chinese men who have sex with men (MSM) and the associations of this with general and MSM-specific perceptions grounded in the health belief model (HBM) and the theory of planned behaviors (TPB). A total of 400 Chinese MSM were recruited from multiple sources (site recruitment, online recruitment, and peer referral) in Hong Kong from July to October 2021, who then participated in a structured telephone interview. Of all the participants, the prevalence of COVID-19 vaccination (i.e., taking at least one dose of COVID-19 vaccination) was 78.3%. Multivariable logistic regression analyses showed that, after adjusting for background factors, (1) the general and MSM-specific HBM variables of perceived benefits and self-efficacy were positively associated with COVID-19 vaccination behavior; (2) the items or scale of general/MSM-specific perceived barriers and social norms were negatively associated with COVID-19 vaccination behavior; (3) the general perceived severity and MSM-specific perceived susceptibility, perceived severity, and cue to action were not significantly associated with COVID-19 vaccination behavior. The findings suggest that the HBM and social norm construct of the TPB only partially explained the participant’s COVID-19 vaccination behavior. Health promotion may need to focus more on modifying perceptions related to COVID-19 vaccination rather than COVID-19.
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Affiliation(s)
- Yanqiu Yu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
- Key Laboratory of Public Health Safety, Fudan University, Shanghai 200032, China
| | - Rachel Hau Yin Ling
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tsun Kwan Mary Ip
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sitong Luo
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Joseph T. F. Lau
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, China
- School of Mental Health, Wenzhou Medical University, Wenzhou 325000, China
- School of Public Health, Zhejiang University, Hangzhou 310058, China
- Correspondence:
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