Explaining the intention to uptake COVID-19 vaccination using the behavioral and social drivers of vaccination (BeSD) model.
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ABSTRACT: Background
The World Health Organization (WHO) has proposed a tool to measure behavioral and social drivers (BeSD) of vaccination uptake intentions of people across all countries. This study tests BeSD model to predict people's intentions to uptake COVID-19 vaccination in rural India.Methods
An online cross-sectional survey was developed for the purpose based on the components of the BeSD model, i.e., confidence, motivation, and behavioral intention. A convenient sampling technique was used to collect samples, amounting to a total of 625, from rural Bengaluru, in the Karnataka state of India. Structural equation modelling (SEM) was applied to examine the proposed model. All respondents for the survey were in the age category of 18-68 years with a mean age of 35 years.Findings
The results showed that 85% of COVID-19 vaccine uptake intentions can directly or indirectly be attributed to the government's vaccine communication strategy, perceived threats about the vaccine, and their trust in the healthcare sector. The dimensions of the vaccine acceptance scale (motivation factors) act as a mediator between these factors and COVID-19 vaccination uptake (the behavioral factor).Conclusion
The study demonstrates that the BeSD framework is an efficient model for predicting the COVID-19 vaccination uptake in India.
SUBMITTER: Alagarsamy S
PROVIDER: S-EPMC8730788 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Introduction Little is known about how drivers of COVID-19 vaccination vary across the U.S. To inform vaccination outreach efforts, this study explores geographic variation in correlates of COVID-19 non-vaccination among adults. Methods Participants were a nationally representative sample of U.S. adults identified through random-digit-dialing for the National Immunization Survey-Adult COVID Module. Analyses examined the geographic and temporal landscape of constructs in the Behavioral and Social Drivers of vaccination (BeSD) Framework among unvaccinated respondents from May to December 2021 (n=531,798) and sociodemographic and geographic disparities and BeSD predictors of COVID-19 non-vaccination from October to December 2021 (n=187,756). Results National coverage with at least 1 dose of COVID-19 vaccine was 79.3% by December 2021, with substantial geographic heterogeneity. Regions with the largest proportion of unvaccinated persons who would probably get a COVID-19 vaccine or were unsure resided in the Southeast and Midwest (Health and Human Services Regions 4 and 5). Both regions had similar temporal trends regarding concerns about COVID-19 and confidence in vaccine importance, though Region 4 had especially low confidence in vaccine safety in December 2021, lowest in Florida (5.5%) and highest in North Carolina (18.0%). The strongest BeSD correlate of not receiving a COVID-19 vaccination was lower confidence in COVID-19 vaccine importance (aPR=5.19, 95% CI=4.93, 5.47; strongest in the Northeast, Southwest, and Mountain West, and weakest in the Southeast and Midwest). Other BeSD correlates also varied by region. Conclusions Contributors to non-vaccination showed substantial geographic heterogeneity. Strategies to improve COVID-19 vaccination uptake may need to be tailored regionally.
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Project description:BackgroundIn 2021, twenty out of twenty-one countries in the Eastern and Southern Africa (ESA) region introduced COVID-19 vaccines. With variable willingness to uptake vaccines across countries, the aim of the present study was to better understand factors that impact behavioral and social drivers of vaccination (BeSD). Using the theory-based "increasing vaccination model", the drivers Thinking & Feeling, Social Processes, Motivation, and Practical Issues were adapted to the COVID-19 context and utilized in a cross-country assessment.MethodsData was collected on 27.240 health workers in Kenya, Malawi, Mozambique, South Africa and South Sudan. This was done by administering a survey of seven target questions via the UNICEF Internet of Good Things (IoGT) online platform between February and August 2021.ResultsFindings showed a gap between perceived importance and trust in vaccines: Most health workers thought Covid-19 vaccination was very important for their health, while less than 30% trusted it very much. The pro-vaccination social and work norm was not well established since almost 66% of all respondents would take the vaccine if recommended to them, but only 49% thought most adults would, and only 48% thought their co-workers would. Access was highlighted as a crucial barrier, with less than a quarter reporting that accessing vaccination services for themselves would be very easy. Women exhibited slightly lower scores than men across the board. When testing the associations between drivers in Kenya and South Africa, it appears that when target interventions are developed for specific age groups, social norms become the main drivers of intention to get vaccinated.ConclusionsThe present study revealed various key relations with demographic variables that would help immunization programmes and implementing partners to develop targeted interventions. First, there is a serious gap between perceived importance of COVID-19 vaccines and how much trust people in them. Second, problems with access are still rather serious and solving this would strongly benefit those who demand a vaccine, Third, the role of social norms is the most important predictor of willingness when considering age differences.
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Project description:Conformist social influence is a double-edged sword when it comes to vaccine promotion. On the one hand, social influence may increase vaccine uptake by reassuring the hesitant about the safety and effectiveness of the vaccine; on the other hand, people may forgo the cost of vaccination when the majority is already vaccinated - giving rise to a public goods dilemma. Here, we examine whether available information on the percentage of double-vaccinated people affects COVID-19 vaccination intention among unvaccinated people in Turkey. In an online experiment, we divided participants (n = 1013) into low, intermediate and high social influence conditions, reflecting the government's vaccine promotion messages. We found that social influence did not predict COVID-19 vaccination intention, but psychological reactance and collectivism did. People with higher reactance (intolerance of others telling one what to do and being sceptical of consensus views) had lower vaccination intention, whilst people with higher collectivism (how much a person considers group benefits over individual success) had higher vaccination intention. Our findings suggest that advertising the percentage of double-vaccinated people is not sufficient to trigger a cascade of others getting themselves vaccinated. Diverse promotion strategies reflecting the heterogeneity of individual attitudes could be more effective.
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Project description:Background Homeless people have a higher risk of COVID-19 infection, linked to several social, economic and environmental determinants, frequent comorbidities, obstacles to exercising their constitutional social and health rights, poor medical cover, and insufficient use of the healthcare system. Data on COVID-19 vaccine uptake and its main determinants are lacking for this underserved population.Objectives To construct and test a conceptual framework to model structural social determinants of COVID-19 vaccine uptake among underserved homeless populations, and to test this model to identify the determinants of COVID-19 vaccine uptake on the homeless population living in two metropolitan areas in France.Methods We implemented a multicenter cross-sectional survey from 15/11/2021 to 22/12/2021 in homeless adults in the city of Marseille and in the greater Paris area. Persons sheltered in migrant worker hostels or in emergency social shelters, members of the COVID HOMELESS cohort study in Marseille, and Travelers living in traditional housing were all eligible. A standardized face-to-face questionnaire was administered to the participants where they lived in various languages by trained interviewers. We used structural equation modeling to analyze the structural social determinants of COVID-19 vaccine uptake, the latter defined as receiving at least one dose.Results The participation rate was 64 %, accounting for 3811 participants. There were three main factors associated with greater vaccine uptake: i) opportunity, which included having a personal general practitioner (β = 0.05, p < 0.05), healthcare cover (β = 0.05, p < 0.05), and somebody to accompany the participant for medical appointments (β = -0.04, p < 0.05); ii) motivation, which included attitudes towards vaccination (β = 0.55, p < 0.05), press- and poster-based information (β = 0.03, p < 0.05), and vaccination history (β = 0.03, p < 0.05); iii) type of housing (β = 0.13, p < 0.05) and housing stability (β = 0.04, p < 0.05).Conclusion Our results highlight that housing exclusion is a structural social determinant of COVID-19 vaccine uptake in homeless people in France. They also underline the role which opportunity and motivation play in improving uptake in this underserved homeless population.
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Project description:BackgroundA healthy healthcare system requires healthy healthcare workers. Protecting healthcare workers including nurses against COVID-19 is crucial, and vaccination could be a viable future option. However, vaccine hesitancy remains a global challenge. Nurses, as a trustworthy and creditable source of vaccine-related information, may build public confidence in vaccination. Hence, research on vaccine hesitancy among nurses is warranted.ObjectivesThis study estimated nurses' influenza vaccination behaviors and intention to receive COVID-19 vaccine when available, and examined their corresponding 5C psychological antecedents (confidence, complacency, constraints, calculation, and collective responsibility). To investigate the impact of COVID-19-related work demands, the mediation effects of work stress on the association between work demands and COVID-19 vaccination intention were also examined.DesignCross-sectional online survey SETTINGS: Nurses were invited to participate via the promotion of a professional nursing organization and by personal referrals during the COVID-19 outbreak in Hong Kong between mid-March and late April 2020.Participants1,205 eligible nurses (mean age = 40.79, SD = 10.47; 90% being female) were included in the analyses.MethodsDemographics, influenza vaccination, intention to have COVID-19 vaccine, the 5C vaccine hesitancy components, work stress and COVID-19-related work demands (insufficient supply of personal protective equipment, involvement in isolation rooms, and unfavorable attitudes towards workplace infection control policies) were reported in the survey.ResultsThe influenza vaccine uptake rate and the proportion intending to take COVID-19 vaccine were 49% and 63%, respectively. Influenza vaccination was associated with working in public hospitals and all 5C constructs (more confidence, more collective responsibility and less complacency, constraints, and calculation), whereas stronger COVID-19 vaccination intention was associated with younger age, more confidence, less complacency and more collective responsibility. COVID-19-related demands were associated with greater work stress, and hence stronger COVID-19 vaccination intention.ConclusionThe potential uptake rate of COVID-19 vaccine among nurses was suboptimal to achieve herd immunity. The 5C constructs were useful in predicting influenza vaccination and, to a lesser extent, the intention to take COVID-19 vaccine. The uncertain attributes such as effectiveness, side effects, and effective duration of the COVID-19 vaccine may contribute to this discrepancy. With less work stress among nurses in the post-pandemic period, the intention to take COVID-19 vaccine will likely drop. The 5C constructs should be infused in vaccination campaigns. While a COVID-19 vaccine could be ready soon, the nursing profession may not be ready to accept it. More research work is needed to boost the uptake rate.Tweetable abstractLess than two-third of nurses intended to take COVID-19 vaccine when available. While a COVID-19 vaccine could be ready soon, nursing profession is not ready to accept it.
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Project description:BackgroundCOVID-19 vaccines will become available in China soon. Understanding communities' responses to the forthcoming COVID-19 vaccines is important. We applied the theory of planned behavior as the theoretical framework.ObjectiveThis study investigates the prevalence of and factors associated with behavioral intention to receive self-financed or free COVID-19 vaccinations among Chinese factory workers who resumed work during the pandemic. We examined the effects of factors including sociodemographics, perceptions related to COVID-19 vaccination, exposure to information about COVID-19 vaccination through social media, and COVID-19 preventive measures implemented by individuals and factories.MethodsParticipants were full-time employees 18 years or older who worked in factories in Shenzhen. Factory workers in Shenzhen are required to receive a physical examination annually. Eligible workers attending six physical examination sites were invited to complete a survey on September 1-7, 2020. Out of 2653 eligible factory workers, 2053 (77.4%) completed the online survey. Multivariate two-level logistic regression models and ordinal logistic regression models were fitted.ResultsThe prevalence of behavioral intention to receive a COVID-19 vaccination was 66.6% (n=1368, conditional on 80% vaccine efficacy and market rate) and 80.6% (n=1655, conditional on 80% vaccine efficacy and free vaccines). After adjusting for significant background characteristics, positive attitudes toward COVID-19 vaccination (adjusted odds ratio [AOR] 1.20, 95% CI 1.15-1.25 and AOR 1.24, 95% CI 1.19-1.30), perceived support from significant others for getting a COVID-19 vaccination (AOR 1.43, 95% CI 1.32-1.55 and AOR 1.37, 95% CI 1.25-1.50), and perceived behavioral control to get a COVID-19 vaccination (AOR 1.51, 95% CI 1.32-1.73 and AOR 1.28, 95% CI 1.09-1.51) were positively associated with both dependent variables (conditional on 80% vaccine efficacy and market rate or free vaccines, respectively). Regarding social media influence, higher frequency of exposure to positive information related to COVID-19 vaccination was associated with a higher intention to receive a COVID-19 vaccination at market rate (AOR 1.53, 95% CI 1.39-1.70) or a free vaccination (AOR 1.52, 95% CI 1.35-1.71). Higher self-reported compliance with wearing a face mask in the workplace (AOR 1.27, 95% CI 1.02-1.58 and AOR 1.67, 95% CI 1.24-2.27) and other public spaces (AOR 1.80, 95% CI 1.42-2.29 and AOR 1.34, 95% CI 1.01-1.77), hand hygiene (AOR 1.21, 95% CI 1.00-1.47 and AOR 1.52, 95% CI 1.19-1.93), and avoiding social gatherings (AOR 1.22, 95% CI 1.01-1.47 and AOR 1.55, 95% CI 1.23-1.95) and crowded places (AOR 1.24, 95% CI 1.02-1.51 and AOR 1.73, 95% CI 1.37-2.18) were also positively associated with both dependent variables. The number of COVID-19 preventive measures implemented by the factory was positively associated with the intention to receive a COVID-19 vaccination under both scenarios (AOR 1.08, 95% CI 1.04-1.12 and AOR 1.06, 95% CI 1.01-1.11).ConclusionsFactory workers in China reported a high behavioral intention to receive a COVID-19 vaccination. The theory of planned behavior is a useful framework to guide the development of future campaigns promoting COVID-19 vaccination.
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Project description:BackgroundWomen have been significantly more likely than men to express hesitancy toward COVID-19 vaccination and, to a lesser extent, to refuse vaccination altogether. This gender gap is puzzling because women have been more likely to perceive higher risks from COVID-19, to approve more restrictive measures to fight the pandemic and to be more compliant with such measures.MethodsThis article studies the gender gap in COVID-19 vaccination attitudes using two nationally representative surveys of public opinion fielded in February 2021 and May 2021 in 27 European countries. The data are analyzed using generalized additive models and multivariate logistic regression.ResultsThe data analyses show that hypotheses about (i) pregnancy, fertility and breastfeeding concerns, (ii) higher trust in Internet and social networks as sources of medical information, (iii) lower trust in health authorities and (iv) lower perceived risks of getting infected with COVID-19 cannot account for the gender gap in vaccine hesitancy. One explanation that receives support from the data is that women are more likely to believe that COVID-19 vaccines are unsafe and ineffective and this leads them to perceive the net benefits of vaccination as lower than the associated risks.ConclusionsThe gender gap in COVID-19 vaccine hesitancy results to a large extent from women perceiving higher risks than benefits of the vaccines. While accounting for this and other factors decreases the gap in vaccine hesitancy, it does not eliminate it completely, which suggests further research is needed.
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Project description:BackgroundSocial distancing is a key behavior to minimize COVID-19 infections. Identification of potentially modifiable determinants of social distancing behavior may provide essential evidence to inform social distancing behavioral interventions.PurposeThe current study applied an integrated social cognition model to identify the determinants of social distancing behavior, and the processes involved, in the context of the COVID-19 pandemic.MethodsIn a prospective correlational survey study, samples of Australian (N = 365) and U.S. (N = 440) residents completed online self-report measures of social cognition constructs (attitude, subjective norm, moral norm, anticipated regret, and perceived behavioral control [PBC]), intention, action planning, habit, and past behavior with respect to social distancing behavior at an initial occasion. Follow-up measures of habit and social distancing behavior were taken 1 week later.ResultsStructural equation models indicated that subjective norm, moral norm, and PBC were consistent predictors of intention in both samples. Intention, action planning, and habit at follow-up were consistent predictors of social distancing behavior in both samples. Action planning did not have consistent effects mediating or moderating the intention-behavior relationship. Inclusion of past behavior in the model attenuated effects among constructs, although the effects of the determinants of intention and behavior remained.ConclusionsCurrent findings highlight the importance of subjective norm, moral obligation, and PBC as determinants of social distancing intention and intention and habit as behavioral determinants. Future research on long-range predictors of social distancing behavior and reciprocal effects in the integrated model is warranted.
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Project description:Despite generally high coronavirus disease 2019 (COVID-19) vaccination rates in the UK, vaccination hesitancy and lower take-up rates have been reported in certain ethnic minority communities. We used vaccination data from the National Immunisation Management System (NIMS) linked to the 2011 Census and individual health records for subjects aged ≥40 years (n = 24 094 186). We estimated age-standardized vaccination rates, stratified by ethnic group and key sociodemographic characteristics, such as religious affiliation, deprivation, educational attainment, geography, living conditions, country of birth, language skills and health status. To understand the association of ethnicity with lower vaccination rates, we conducted a logistic regression model adjusting for differences in geographic, sociodemographic and health characteristics. ResultsAll ethnic groups had lower age-standardized rates of vaccination compared with the white British population, whose vaccination rate of at least one dose was 94% (95% CI: 94%-94%). Black communities had the lowest rates, with 75% (74-75%) of black African and 66% (66-67%) of black Caribbean individuals having received at least one dose. The drivers of these lower rates were partly explained by accounting for sociodemographic differences. However, modelled estimates showed significant differences remained for all minority ethnic groups, compared with white British individuals. Lower COVID-19 vaccination rates are consistently observed amongst all ethnic minorities.
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