Predicting intention to receive COVID-19 vaccine among the general population using the Health Belief Model and the Theory of Planned Behavior Model

Abstract

BackgroundA novel coronavirus (COVID-19) was declared a global pandemic by the World Health Organization (WHO) in March, 2020. Until such time as a vaccine becomes available, it is important to identify the determining factors that influence the intention of the general public to accept a future COVID-19 vaccine. Consequently, we aim to explore behavioral-related factors predicting intention to receive COVID-19 vaccine among the general population using the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) model.MethodsAn online survey was conducted among adults aged 18 years and older from May 24 to June 24, 2020. The survey included socio-demographic and health-related questions, questions related to the HBM and TPB dimensions, and intention to receive COVID-19 vaccine. Associations between questionnaire variables and COVID-19 vaccination intention were assessed by univariate and multivariate analyses.ResultsEighty percent of 398 eligible respondents stated their willingness to receive COVID-19 vaccine. A unified model including HBM and TPB covariates as well as demographic and health-related factors, proved to be a powerful predictor of intention to receive COVID-19 vaccine, explaining 78% of the variance (adjusted R2 = 0.78). Men (OR=4.35, 95% CI 1.58–11.93), educated respondents (OR=3.54, 95% CI 1.44–8.67) and respondents who had received the seasonal influenza vaccine in the previous year (OR=3.31, 95% CI 1.22–9.00) stated higher intention to receive COVID-19 vaccine. Participants were more likely to be willing to get vaccinated if they reported higher levels of perceived benefits of COVID-19 vaccine (OR=4.49, 95% CI 2.79–7.22), of perceived severity of COVID-19 infection (OR=2.36, 95% CI 1.58–3.51) and of cues to action (OR=1.99, 95% CI 1.38–2.87), according to HBM, and if they reported higher levels of subjective norms (OR=3.04, 95% CI 2.15–4.30) and self-efficacy (OR=2.05, 95% CI 1.54–2.72) according to TPB. Although half of the respondents reported they had not received influenza vaccine last year, 40% of them intended to receive influenza vaccine in the coming winter and 66% of them intended to receive COVID-19 vaccine.ConclusionsProviding data on the public perspective and predicting intention for COVID-19 vaccination using HBM and TPB is important for health policy makers and healthcare providers and can help better guide compliance as the COVID-19 vaccine becomes available to the public.

Health Belief Model, Theory of Planned Behavior, or Psychological Antecedents: What Predicts COVID-19 Vaccine Hesitancy Better Among the Bangladeshi Adults?

“…Moreover, given the newness of the 5C scale (10), the available literature is still scanty that tests this model's predictive validity (34,35). However, various other studies that adopted only the HBM and the TPB validate our findings that TPB constructs are a better predictor of vaccination behavior (36), specifically in the intention to vaccinate against swine flu (23) human papillomavirus (37) or in the context of COVID-19 vaccination (25,26,30).…”

“…According to the findings of the TPB constructs, an increase of negative attitude toward the COVID-19 vaccine and a decrease in perceived behavioral control significantly increased the COVID-19 vaccine hesitancy. Other studies support these findings (25,36), though perceived behavioral control was found non-significant predictor in other contexts (23,39,40).…”

“…The health belief model (HBM) is one of the most widely used models in vaccination behavior, particularly in influenza (22), swine flu (23), ebola (22), hepatitis B (24), and COVID-19 (25)(26)(27). The key argument of HBM is that the likelihood of an individual adopting a particular health behavior (e.g., getting COVID-19 vaccine) is determined by the perceived susceptibility and severity of illness or disease (e.g., COVID-19), along with the belief in the effectiveness of the recommended health behavior (e.g., COVID-19 vaccination) (28).…”

“…The key argument of HBM is that the likelihood of an individual adopting a particular health behavior (e.g., getting COVID-19 vaccine) is determined by the perceived susceptibility and severity of illness or disease (e.g., COVID-19), along with the belief in the effectiveness of the recommended health behavior (e.g., COVID-19 vaccination) (28). Thus, the model is comprised of, as applied to COVID-19 and its vaccine, perceived severity of and perceived susceptibility to COVID-19, perceived benefits of and perceived barriers to getting a COVID-19 vaccine, and cues to action which include implicit or explicit incentives or situations that serve to motivate vaccination, such as information from mass media (25).…”

Pharmacists and COVID-19 vaccination – Considering mobile phone caller tunes as a novel approach to promote vaccine uptake in low- and middle-income countries

“…Table 3 highlights these key constructs and describes how they could be used to implement caller tunes-based public health messaging on COVID-19 vaccination. It is noteworthy that some studies have already explored the use of theory of planned behaviour to predict the intention to get COVID-19 vaccines in countries such as Bangladesh, 15 India, 16 Israel, 17 Nigeria, 18 and the United States. 19 , 20 …”