Research on Knowledge, Attitudes, and Practices of Influenza Vaccination Among Healthcare Workers in Chongqing, China—Based on Structural Equation Model

Abstract

BackgroundInfluenza is associated with a large number of disease burdens, and it is generally recommended that all healthcare workers (HCWs) get an influenza vaccination. However, the vaccination rates among HCWs are still low. This study aimed to assess HCWs' knowledge, attitude, and practice (KAP) about the influenza vaccine, and by establishing a structural equation model (SEM) to explore the influencing factors of medical personnel's influenza vaccination in Chongqing, China.MethodsFrom September to November 2019, we conducted a cross-sectional survey in four sentinel hospitals and four non-sentinel hospitals in Chongqing, China. We calculated knowledge, attitude, and behavior scores for each study participant and assessed the level of knowledge, attitude, and behavior of the medical staff. An SEM was used to evaluate the relationship between latent variables, and the path graph between knowledge, attitude, and behavior was established.ResultsA total of 1,412 valid questionnaires were collected in this survey, including four sentinel hospitals (N = 606, 42.92%) and four non-sentinel hospitals (N = 806, 57.08%). Women (N = 1,102, 78.05%) were more than men (N = 310, 21.95%), with an average age of 32.36 ± 7.78 years old and under 30 years old (N = 737, 52.20%), respectively. Nurses (741, 52.48%) were the main subjects, followed by physicians (457, 32.37%). The final SEM model was obtained after the model was modified and adjusted. A bootstrap analysis of path coefficients was carried out on the final model. Knowledge has a direct influence on behavior. The normalized path coefficient is 0.071 (95% CI: 0.002–0.161), and the value of P of the hypothesis test result of the path coefficient is 0.042. The direct influence of knowledge on attitude standardization was 0.175 (95% CI: 0.095–0.281). The direct influence of attitude on practice standardization was 0.818 (95% CI: 0.770–0.862). The indirect effect of knowledge on the standardization of practice through attitude was 0.144 (95% CI: 0.076–0.235).ConclusionsAccording to the SEM, there is a direct positive correlation between KAP and the influenza vaccine. The indirect influence of knowledge on the standard of behavior through attitude is about two times as much as the direct influence on behavior, indicating that attitude plays a strong mediating role between knowledge and practice.

The impact of exposure to HPV related information and injunctive norms on young women's intentions to receive the HPV vaccine in China: A structural equation model based on KAP theory

“…Surprisingly, a negative association between knowledge about HPV and intention to receive HPV vaccine was found in the results, which was contrary to prior studies ( 36 ). Firstly, some authors have speculated that this may be related to individual knowledge about relevant side-effects or adverse reactions of vaccines.…”

“…On the topic of vaccination, Chen et al ( 36 ) investigated influenza vaccination among healthcare workers in Chongqing and noted that influenza-related knowledge was positively associated with attitude and vaccination practice, with a strong mediating effect of attitude between knowledge and practice. In a survey on the current knowledge, attitude and practice of HPV vaccination among female college students in Hong Kong, Leung and Law ( 37 ) found that female college students with high HPV vaccine knowledge and positive attitude toward HPV vaccine were more likely to receive the HPV vaccine.…”

Dietary knowledge-attitude-practice status in hemodialysis patients: a latent profile analysis

“…Moreover, the study found that attitude mediated between knowledge and practice, indicating that attitude influenced knowledge translation into behavior. These findings were consistent with the KAP theoretical model and previous findings [ 29 , 30 ]. According to the KAP model, dietary behavioral changes in HD patients involved three successive processes: knowledge acquisition, belief generation, and behavior formation.…”

Knowledge, attitudes, perceptions, and practice toward seasonal influenza and its vaccine: A cross-sectional study from a country of conflict

“…Influenza is an overlooked contributor to morbidity and mortality ( 40 – 42 ). Several studies assessed knowledge about influenza and attitudes toward its vaccine among healthcare professionals ( 43 – 50 ). However, studies to assess the same among the public are generally scarce ( 46 , 51 – 53 ), especially in a low-income, war-torn developing country such as Yemen.…”