Health Belief Model Perspective on the Control of COVID-19 Vaccine Hesitancy and the Promotion of Vaccination in China: Web-Based Cross-sectional Study

被引:84
作者
Chen, Hao [1 ]
Li, Xiaomei [1 ]
Gao, Junling [1 ]
Liu, Xiaoxi [1 ]
Mao, Yimeng [1 ]
Wang, Ruru [1 ]
Zheng, Pinpin [1 ]
Xiao, Qianyi [1 ]
Jia, Yingnan [1 ]
Fu, Hua [1 ]
Dai, Junming [1 ]
机构
[1] Fudan Univ, Sch Publ Hlth, Dept Prevent Med & Hlth Educ, 138 Yixueyuan Rd, Shanghai 200032, Peoples R China
基金
中国国家自然科学基金; 国家重点研发计划;
关键词
COVID-19; pandemic; vaccination behavior; vaccine hesitancy; health belief model; HUMAN-PAPILLOMAVIRUS VACCINE; INFLUENZA VACCINATION; IMPLEMENTATION INTENTIONS; PARENTAL ACCEPTANCE; BEHAVIOR; COMMUNICATION; DETERMINANTS; WILLINGNESS; PREDICT; SPREAD;
D O I
10.2196/29329
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: The control of vaccine hesitancy and the promotion of vaccination are key protective measures against COVID-19. Objective: This study assesses the prevalence of vaccine hesitancy and the vaccination rate and examines the association between factors of the health belief model (HBM) and vaccination. Methods: A convenience sample of 2531 valid participants from 31 provinces and autonomous regions of mainland China were enrolled in this online survey study from January 1 to 24, 2021. Multivariable logistic regression was used to identify the associations of the vaccination rate and HBM factors with the prevalence of vaccine hesitancy after other covariates were controlled. Results: The prevalence of vaccine hesitancy was 44.3% (95% CI 42.3%-46.2%), and the vaccination rate was 10.4% (9.2%-11.6%). The factors that directly promoted vaccination behavior were a lack of vaccine hesitancy (odds ratio [OR] 7.75, 95% CI 5.03-11.93), agreement with recommendations from friends or family for vaccination (OR 3.11, 95% CI 1.75-5.52), and absence of perceived barriers to COVID-19 vaccination (OR 0.51, 95% CI 0.35-0.75). The factors that were directly associated with a higher vaccine hesitancy rate were a high level of perceived barriers (OR 1.63, 95% CI 1.36-1.95) and perceived benefits (OR 0.51, 95% CI 0.32-0.79). A mediating effect of self-efficacy, influenced by perceived barriers (standardized structure coefficient [SSC]=-0.71, P<.001), perceived benefits (SSC=0.58, P<.001), agreement with recommendations from authorities (SSC=0.27, P<.001), and agreement with recommendations from friends or family (SSC=0.31, P<.001), was negatively associated with vaccination (SSC=-0.45, P<.001) via vaccine hesitancy (SSC=-0.32, P<.001). Conclusions: It may be possible to increase the vaccination rate by reducing vaccine hesitancy and perceived barriers to vaccination and by encouraging volunteers to advocate for vaccination to their friends and family members. It is also important to reduce vaccine hesitancy by enhancing self-efficacy for vaccination, due to its crucial mediating function.
引用
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页数:17
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