Positive Association between Individualism and Vaccination Resistance against COVID-19 Vaccination among Chinese Adults: Mediations via Perceived Personal and Societal Benefits

Yu, Yanqiu; Lau, Mason M. C.; Lau, Joseph T. F.

doi:10.3390/vaccines9111225

Cited by 15 publications

(14 citation statements)

References 43 publications

(72 reference statements)

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“…The latter was comparable to the 25.1% reported in another local study among unvaccinated adults who had been surveyed two months after the beginning of the rollout [17]. People with a low vaccination intention might be hesitating, waiting to see [15], or refusing COVID-19 vaccination firmly [6]. The low prevalence of COVID-19 vaccination intention is a good reminder to the government that the achievement of herd immunity through vaccination in the next six months remains an uphill mission.…”

Section: Discussionsupporting

confidence: 75%

“…Ongoing health promotion efforts are thus needed for all countries, regardless of their vaccination rates. These groups of unvaccinated people may include individuals who firmly resist COVID-19 vaccination [6] and those who show psychological reactance against health promotion related to vaccination. Research in such unvaccinated groups is warranted.…”

Section: Introductionmentioning

confidence: 99%

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Opposing Mechanisms Involving Perceived Benefits versus Safety Partially Explained an Increase in COVID-19 Vaccination Intention among Unvaccinated Chinese Adults during a Post-Rollout Period: Results of Two Serial Surveys

Lau

2021

Vaccines

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Background: Perceptions related to COVID-19 vaccination are evolving over time, leading to potential changes in vaccination intention among unvaccinated people, which helps in the predictions of vaccination rates. This study investigated the changes in COVID-19 vaccination intention at the population level during a post-rollout period and two potential mechanisms underlying the change via the mediation/suppression effects that involve the perceived benefits/severe side effects of vaccination. Methods: Two serial random population-based telephone surveys interviewed 358 and 145 Chinese adults (aged 18–70) who were unvaccinated and who were unscheduled for COVID-19 vaccination, respectively, in May and August 2021 in Hong Kong, China. Results: The prevalence of vaccination intention increased from 14.5% to 22.8%, while the levels of perceived benefits (protection and travel-related advantages due to vaccination) and the perceived risk of severe side effects resulting from COVID-19 vaccination both significantly declined over time. Structural equation modeling found a simultaneous partial suppression effect via perceived benefits and a partial mediation effect via perceived severe side effects between the time when the surveys were conducted and COVID-19 vaccination intention, with adjustment for background factors. Conclusion: Perceptions related to COVID-19 vaccination are likely to change over time and partially account for changes in vaccination intention, sometimes in opposite directions. Ongoing health promotion may take such changes into account. Serial surveillance is warranted to monitor these changes.

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Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Opposing Mechanisms Involving Perceived Benefits versus Safety Partially Explained an Increase in COVID-19 Vaccination Intention among Unvaccinated Chinese Adults during a Post-Rollout Period: Results of Two Serial Surveys

Lau

2021

Vaccines

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“…Collectivism was even cited among lay members of the public in qualitative research examining the prevention behaviors of Chinese–Canadians during the early wave of the COVID-19 pandemic (Lee et al, 2021 ) – giving face validity to the hypothesized link between collectivism and prevention behavior. These are further supported with individual-level quantitative research showing that greater collectivism is associated with more support for and uptake of COVID-19 prevention behaviors (Bok, Shum, Harvie, & Lee, 2021 ; Cho, Guo, & Torelli, 2022 ; Lu, Jin, & English, 2021 ; Travaglino & Moon, 2021 ; Yu, Lau, & Lau, 2021 ). Greater collectivism has also been shown to be correlated with fear of COVID-19 (Ahuja, Banerjee, Chaudhary, & Gidwani, 2021 ; Germani, Buratta, Delvecchio, & Mazzeschi, 2020 ).…”

Section: The Role Of Individualism–collectivism In the Covid-19 Pandemicmentioning

confidence: 66%

“…Given the evidence summarized above, it is clear that considering nuanced models of cultural orientations along with personality traits can help isolate the independent relationship of these on COVID-19 prevention; thereby assisting public health leaders in responding to COVID-19 (Bayeh, Yampolsky, & Ryder, 2021 ; Caulkins, 1999 ; Erman & Medeiros, 2021 ; Nair & Selvaraj, 2021 ; Siritzky, Condon, & Weston, 2022 ). This exploratory analyses may be especially beneficial when considering how public health messaging can be best tailored to promote widespread uptake among individuals with diverse personal characteristics and cultural dispositions (Borah, Hwang, & Hsu, 2021 ; Clark, Davila, Regis, & Kraus, 2020 ; Courtney, Felig, & Goldenberg, 2022 ; Kemmelmeier & Jami, 2021 ; Mo & Park, 2021 ; Yu et al, 2021 ). As such, the present exploratory study sought to examine the independent relationships of cultural orientations and personality traits with the uptake of COVID-19 prevention behaviors among people living in Canada.…”

Section: Study Objectivesmentioning

confidence: 99%

Collectivism, individualism and COVID-19 prevention: a cross sectional study of personality, culture and behavior among Canadians

Card

2022

Health Psychology and Behavioral Medicine

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Background Collectivism has been identified as a protective factor against COVID-19 – perhaps due to increased conformity with social norms regarding prevention behaviors. Other studies have also found that individualism can inspire uptake of preventative behaviors as a means of personal protection. It is possible that these cultural orientations may promote different patterns of prevention (e.g. mask wearing vs. social distancing). Furthermore, existing studies examining the role of individualism and collectivism during the COVID-19 pandemic have frequently failed to account for other psychological processes, including differences in personality, which could help provide a better understanding of the psychological process underlying prevention behavior. Methods Participants were recruited using social media advertisements. The Cultural Orientations Scale measured individualism–collectivism and hierarchism-egalitarianism. The Ten Item Personality Inventory measured the five factor model of personality. Multivariable models, dominance analyses and structural equation mediation tests were used to identify the most important predictors of COVID-19 prevention behavior (i.e. mask-wearing, hand-washing, reducing social interactions, physical distancing, staying at home and social bubbling), controlling for demographic and situational factors. Results Among 774 participants, most (i.e. 60–80%) reported uptake of COVID-19 prevention behaviors. Higher vertical (hierarchical) collectivism was associated with staying at home and higher horizontal (egalitarian) individualism was associated with mask-wearing and reducing social interactions. Neither Vertical Collectivism nor Horizontal Collectivism were significantly associated with any of the prevention behaviors when controlling for personality traits and confounding variables. Agreeableness was identified as a key mediator of the correlation between these cultural orientations on general uptake of COVID-19 prevention behaviors. Conclusions Cultural orientations (e.g. collectivism-individualism, hierarchism-egalitarianism) and personality traits (e.g. Agreeableness) are salient correlates of COVID-19 prevention behaviors and therefore should be accounted for in the development, design and delivery of health promotion messages aiming to increase uptake of these behaviors.

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“…For example, interventions could be adapted to include other forms of prosocial motivations, such as collectivism (the practice of prioritizing a group over individuals within the group) [ 66 ]. Previous research has shown that collectivism is associated with COVID-19 vaccine acceptance [ 12 , 67 ], while individualism (ie, emphasis on the autonomous individual) is associated with COVID-19 vaccine hesitancy [ 68 ]. Therefore, to override feelings of personal invulnerability to COVID-19 in countries that are more individualistic than collectivistic (eg, Canada, the United States), messages that promote community well-being, highlight shared goals, and induce feelings of interdependence should be used to encourage COVID-19 vaccination [ 69 ].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of a Brief, Altruism-Eliciting Video Intervention in Enhancing COVID-19 Vaccination Intentions Among a Population-Based Sample of Younger Adults: Randomized Controlled Trial

Zhu¹,

Tatar²,

Griffin-Mathieu³

et al. 2022

JMIR Public Health Surveill

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Background High COVID-19 vaccine uptake is crucial to containing the pandemic and reducing hospitalizations and deaths. Younger adults (aged 20-39 years) have demonstrated lower levels of vaccine uptake compared to older adults, while being more likely to transmit the virus due to a higher number of social contacts. Consequently, this age group has been identified by public health authorities as a key target for vaccine uptake. Previous research has demonstrated that altruistic messaging and motivation is associated with vaccine acceptance. Objective This study had 2 objectives: (1) to evaluate the within-group efficacy of an altruism-eliciting short, animated video intervention in increasing COVID-19 vaccination intentions amongst unvaccinated Canadian younger adults and (2) to examine the video’s efficacy compared to a text-based intervention focused exclusively on non-vaccine-related COVID-19 preventive health measures. Methods Using a web-based survey in a pre-post randomized control trial (RCT) design, we recruited Canadians aged 20-39 years who were not yet vaccinated against COVID-19 and randomized them in a 1:1 ratio to receive either the video intervention or an active text control. The video intervention was developed by our team in collaboration with a digital media company. The measurement of COVID-19 vaccination intentions before and after completing their assigned intervention was informed by the multistage Precaution Adoption Process Model (PAPM). The McNemar chi-square test was performed to evaluate within-group changes of vaccine intentions. Exact tests of symmetry using pairwise McNemar tests were applied to evaluate changes in multistaged intentions. Between-group vaccine intentions were assessed using the Pearson chi-square test postintervention. Results Analyses were performed on 1373 participants (n=686, 50%, in the video arm, n=687, 50%, in the text arm). Within-group results for the video intervention arm showed that there was a significant change in the intention to receive the vaccine (χ21=20.55, P<.001). The between-group difference in postintervention intentions (χ23=1.70, P=.64) was not significant. When administered the video intervention, we found that participants who had not thought about or were undecided about receiving a COVID-19 vaccine were more amenable to change than participants who had already decided not to vaccinate. Conclusions Although the video intervention was limited in its effect on those who had firmly decided not to vaccinate, our study demonstrates that prosocial and altruistic messages could increase COVID-19 vaccine uptake, especially when targeted to younger adults who are undecided or unengaged regarding vaccination. This might indicate that altruistic messaging provides a “push” for those who are tentative toward, or removed from, the decision to receive the vaccine. The results of our study could also be applied to more current COVID-19 vaccination recommendations (eg, booster shots) and for other vaccine-preventable diseases. Trial Registration ClinicalTrials.gov NCT04960228; https://clinicaltrials.gov/ct2/show/NCT04960228

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Positive Association between Individualism and Vaccination Resistance against COVID-19 Vaccination among Chinese Adults: Mediations via Perceived Personal and Societal Benefits

Cited by 15 publications

References 43 publications

Opposing Mechanisms Involving Perceived Benefits versus Safety Partially Explained an Increase in COVID-19 Vaccination Intention among Unvaccinated Chinese Adults during a Post-Rollout Period: Results of Two Serial Surveys

Opposing Mechanisms Involving Perceived Benefits versus Safety Partially Explained an Increase in COVID-19 Vaccination Intention among Unvaccinated Chinese Adults during a Post-Rollout Period: Results of Two Serial Surveys

Collectivism, individualism and COVID-19 prevention: a cross sectional study of personality, culture and behavior among Canadians

The Efficacy of a Brief, Altruism-Eliciting Video Intervention in Enhancing COVID-19 Vaccination Intentions Among a Population-Based Sample of Younger Adults: Randomized Controlled Trial

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