The intention to get COVID-19 vaccine and vaccine uptake among cancer patients: An extension of the theory of planned behaviour (TPB)

Vaccine Hesitancy and Its Epistemic Antecedents: A Meta-Analysis

Although much attention has been given to vaccine hesitancy, there is still considerable ambiguity regarding its epistemological antecedents. The current meta-analysis addresses this theoretical and practical gap by focusing on the interplay between trust, belief in conspiracy theories, and COVID-19 vaccine hesitancy (k = 32), as well as key moderators such as the availability of the vaccine and the state and progress of the pandemic. Overall, results indicate that while both trust and beliefs in conspiracy theories are important correlates of vaccine hesitancy, considerable difference emerges when adopting a more granular approach that distinguishes between types of trust (government, public health organizations, science, and healthcare professionals/providers) and conspiracies (specific versus general). These findings cement the importance of health communication, not only as a useful framework to study and understand vaccine hesitancy but also as a potential way to intervene in order to prepare for future infectious disease outbreaks.

Vaccination intentions of hypertensive Chinese individuals during the COVID-19 epidemic: a structural equation modeling study

OBJECTIVE

Given the high prevalence of hypertension among Chinese adults, this population is at a significantly increased risk of severe COVID-19 complications. The purpose of this study is to assess the willingness of Chinese hypertensive adults to receive the COVID-19 vaccine and to identify the diverse factors that shape their vaccination decisions.

METHODS

Sampling was conducted utilizing multistage stratified random sampling, and ultimately, a total of 886 adult hypertensive patients from Luzhou City in Southwest China were included in this study. The questionnaire design was based on the Theory of Planned Behaviour and was used to investigate their willingness to be vaccinated with COVID-19. Structural equation modeling was employed for data analysis.

RESULTS

The results showed that 75.6% of hypertensive individuals were willing to receive COVID-19 vaccination. The structural equation modeling revealed that Subjective Norms (path coefficient = 0.361, CR = 8.049, P < 0.001) and Attitudes (path coefficient = 0.253, CR = 4.447, P < 0.001) had positive effects on vaccination willingness, while Perceived Behavioral Control (path coefficient=-0.004, CR=-0.127, P = 0.899) had no significant impact on Behavioral Attitudes. Mediation analysis indicated that Knowledge (indirect path coefficient = 0.032, LLCI = 0.014, ULCI = 0.058), Risk Perception (indirect path coefficient = 0.077, LLCI = 0.038, ULCI = 0.124), and Subjective Norms (indirect path coefficient = 0.044, LLCI = 0.019, ULCI = 0.087) significantly influenced vaccination willingness through Attitudes as a mediating factor.

CONCLUSION

The willingness of hypertensive individuals to receive the COVID-19 vaccination is not satisfactory. The Theory of Planned Behavior provides valuable insights into understanding their vaccination intentions. Efforts should be concentrated on enhancing the subjective norms, attitudes, and knowledge about vaccination of hypertensive patients.

Pandemic fatigue, behavioral intention and predictors of COVID-19 vaccination among individuals living with HIV in Bench Sheko Zone, in Southern Ethiopia, application of TBP: a facility based cross sectional study

Introduction

People living with HIV often face inequalities and negative outcomes, which make them vulnerable. To protect this population and achieve herd immunity, it is crucial for COVID-19 vaccination efforts to prioritize and encourage vaccination among people living with HIV (PLWH). However, in Ethiopia, there is a lack of motivation in this regard. To tackle this issue, a study was conducted in the Bench Sheko Zone of Southwest Ethiopia. The study aimed to assess pandemic fatigue, behavioral intention to get vaccinated, and factors influencing COVID-19 vaccine acceptance among PLWH in that region.

Methods

A facility-based cross-sectional study was conducted among individuals living with HIV who were over 18 years old in Bench-Sheko Zone, located in Southwest Ethiopia. The study included a total of 590 participants from four ART healthcare facilities within the zone. The researchers utilized the Theory of Planned Behavior to examine the predictors of intention to use preconception care. Multiple linear regression analysis was employed to determine these predictors, with a p-value of less than 0.05 considered as indicative of a significant association. The final analysis of the study involved the use of linear regression analysis, and the measure of association was presented as the standardized B coefficient following a multivariable logistic regression analysis.

Result

In the conducted study, the response rate was an impressive 98%. The researchers aimed to investigate the behavioral intention toward the COVID-19 vaccine, which was found to be 55.7%. The average age of the participants in the study was 34.65 ± 6.67. The study was the assessment of pandemic fatigue, which had a mean value of 17.22 ± 5.28. During the multivariate linear regression analysis, four predictor variables were identified. Among these, three variables, namely subjective norm, pandemic fatigue, and age, positively influenced the behavioral intention toward the COVID-19 vaccine. Comprehending these factors can assist healthcare professionals and policymakers in formulating precise interventions and strategies aimed at enhancing the acceptance and adoption of vaccines.

Conclusion

The study indicates that individuals living with HIV have shown lower vaccine intention compared to previous research. The study identifies subjective norm, pandemic control measures, income, and age as predictors of individuals' intention to receive the COVID-19 vaccine.

Testing an extended theory of planned behaviour in predicting Covid-19 vaccination intention over the course of the pandemic: A three-wave repeated cross-sectional study

Background

Mass vaccination against Covid-19 has been recognised as the most effective strategy for overcoming the pandemic emergency and remains crucial in the ongoing efforts to mitigate the impact of the virus. The present study aimed to test the efficacy of an extended Theory of Planned Behaviour (TPB) model in predicting vaccination intention in three different phases of the pandemic. Understanding how psychological drivers of vaccine acceptance may have changed throughout the pandemic is essential for informing public health strategies and addressing vaccine hesitancy, even in the current post-pandemic context.

Methods

Using a repeated cross-sectional survey, we tested the hypothesised extended TPB model (intention, attitude, subjective norms, perceived behavioural control, anticipated affective reactions, risk perception, trust in science, trust in institutions and religiosity) across three independent samples: before (T1: November-December 2020; N = 657), during (T2: March-May 2021; N = 818), and after (T3: February-March 2022; N = 605) the start of the vaccination campaign in Italy.

Results

Results indicated significant differences between the time points in all investigated variables, pointing to a general trend of improvement in vaccine acceptability levels at T2 compared to T1, and a worsening at T3 compared to the other two time points. Interestingly, net of these differences, a multi-group Structural Equation Modeling analysis supported the invariance, across time, of the structural relationships examined within the extended TPB.

Conclusion

Findings demonstrated the efficacy of the TPB in predicting Covid-19 vaccination intention at different stages of the pandemic, suggesting that the model, in its extended version, represents a valuable framework for designing interventions aimed at promoting vaccine acceptance.

Effects of cancer severity on the relationship between emotional intelligence, perceived social support, and psychological distress in Italian women

PURPOSE

This study aims to understand the association between emotional intelligence, perceived social support, and psychological distress (i.e., anxiety, depression, stress) in women with cancer at different stages. Specifically, the aims of this study were to investigate: i) the links between emotional intelligence and psychological distress (i.e., symptoms of anxiety, stress and depression); ii) the mediating role of perceived social support provided by family members, friends, and significant others in the relationship between emotional intelligence and psychological distress; iii) the impact of cancer type and cancer stage (I-II vs III-IV) in moderating these relationships, among Italian women.

METHODS

The research sample consisted of 206 Italian women (mean age = 49.30 ± 10.98 years; 55% breast cancer patients) who were administered a questionnaire to assess emotional intelligence, perceived social support, and psychological distress. Structural equation model (SEM) analysis was carried out to confirm the hypothetical-theoretical model.

RESULTS

Emotional intelligence had a positive association with perceived social support, which in turn prevented psychological distress only in women with early-stages cancers. The type of cancer has no effect on these relationships.

CONCLUSIONS

The findings of this study indicate a pressing need to screen and recognize women with lower emotional intelligence and perceived social support, as they may be more prone to experiencing psychological distress. For such individuals, our results recommend the implementation of psychological interventions aimed at enhancing emotional intelligence and fortifying their social support networks, with consideration for the stage of cancer they are facing.

Longitudinal study of theory-based predictors of COVID-19 vaccination

Efforts to mitigate the impact of COVID-19 now focus primarily on encouraging vaccination. These efforts have been hampered, however, by vaccine hesitancy. A better understanding of the factors associated with vaccination may help identify those most likely to experience hesitancy and inform the content of public health outreach efforts. The aims of this study were to evaluate whether two theory-based factors (perceived vaccine efficacy and vaccination intention) and political party affiliation were associated with vaccination in the United States (US) and to provide descriptive analysis of factors shaping vaccination decisions. A longitudinal online survey was conducted with 108 adults in the US. Participants completed surveys in July 2020 (Time 1) and October 2021 (Time 2). As hypothesized, greater vaccination intention and perceived vaccine efficacy were significant predictors of vaccine uptake. The second hypothesis was also supported as political party affiliation was associated with vaccination (i.e. Democrats were more likely to vaccinate than Republicans). Descriptive data indicated that vaccinated participants (including those reluctant to vaccinate at Time 1) had been motivated by a desire to protect themselves and others from COVID-19. Participants who had chosen not to vaccinate were influenced by a variety of factors including concerns about vaccine safety and efficacy. Understanding the predictors of vaccination is critical to identifying those unlikely to vaccinate and creating effective interventions to encourage the uptake of this essential public health strategy. Messaging should emphasize the efficacy of COVID-19 vaccines and be delivered by those seen as trustworthy in communities prone to vaccine hesitancy.

Influence of social and psychological factors on smartphone usage during the COVID-19 pandemic

Objective

This study investigates the influence of psychological factors-specifically affective and cognitive risk perceptions, social distancing attitudes, subjective norms, and cabin fever syndrome-on smartphone usage intensity during the COVID-19 pandemic, with a particular focus on university students.

Methods

Utilizing a cross-sectional survey design, data were collected from 314 university students from South Korea and Vietnam. Structural equation modeling was employed to analyze the relationships between the psychological constructs and their impact on smartphone usage.

Results

The analysis confirms that both affective and cognitive risk perceptions significantly influence attitudes towards social distancing. Furthermore, these social distancing attitudes are found to significantly affect cabin fever syndrome, suggesting that positive attitudes towards social distancing are closely associated with higher reports of cabin fever. Notably, cabin fever syndrome emerges as a significant predictor of increased smartphone usage, underscoring its role as a mediator between prolonged isolation and digital engagement. Additionally, subjective norms are also shown to significantly influence smartphone usage intensity, highlighting the impact of social expectations on digital behaviors during the pandemic.

Conclusion

The study highlights the complex interplay between psychological distress induced by social restrictions and increased reliance on digital technology for social connectivity. These insights suggest that mental health interventions and digital literacy programs tailored to university students' needs can be effective in managing the negative impacts of prolonged social isolation.

Factors Associated with COVID-19 Vaccination Promptness after Eligibility in a North Carolina Longitudinal Cohort Study

Many studies identified factors associated with vaccination intention and hesitancy, but factors associated with vaccination promptness and the effect of vaccination intention on vaccination promptness are unknown. This study identified factors associated with COVID-19 vaccination promptness and evaluated the role of vaccination intention on vaccination promptness in 1223 participants in a community-based longitudinal cohort study (June 2020 to December 2021). Participants answered questions regarding COVID-19 vaccination intention, vaccination status, and reasons for not receiving a vaccine. The association of baseline vaccine hesitancy with vaccination was assessed by the Kaplan-Meier survival analysis. Follow-up analyses tested the importance of other variables predicting vaccination using the Cox proportional hazards model. Older age was associated with shorter time to vaccination (HR = 1.76 [1.37-2.25] 85-year-old versus 65-year-old). Lower education levels (HR = 0.80 [0.69-0.92]), household incomes (HR = 0.84 [0.72-0.98]), and baseline vaccination intention of 'No' (HR = 0.16 [0.11-0.23]) were associated with longer times to vaccination. The most common reasons for not being vaccinated (N = 58) were vaccine safety concerns (n = 33), side effects (n = 28), and vaccine effectiveness (n = 25). Vaccination campaigns that target populations prone to hesitancy and address vaccine safety and effectiveness could be helpful in future vaccination rollouts.

Willingness of people living with HIV to receive a second COVID-19 booster dose: a multicenter cross-sectional study in China

Background

The coronavirus disease 2019 (COVID-19) pandemic has significantly affected the global population, with People Living with HIV (PLWH) being particularly vulnerable due to their compromised immune systems. Although vaccination is a crucial preventative measure against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, little is understood about the willingness of PLWH to receive a second COVID-19 booster dose and the factors that may influence this decision. This study investigates the willingness of PLWH in China to receive a second COVID-19 booster dose and its influencing factors, comparing these with a group of healthy individuals.

Methods

A multicenter cross-sectional study was conducted across five Chinese cities, namely, Beijing, Tianjin, Zhengzhou, Hohhot, and Harbin. Participants were recruited through five community-based organizations. Data were collected via participant self-administered questionnaires included demographic information, willingness to receive a second COVID-19 booster dose, and knowledge about HIV and COVID-19 vaccination. Factors influencing vaccination willingness were identified using multivariable logistic regression analyzes.

Results

A total of 156 PLWH and 151 healthy individuals were included in the study. After adjusting for potential confounders, it was found that PLWH demonstrated a lower willingness to receive a second COVID-19 booster dose compared to healthy individuals (77.6% vs. 88.7%, p = 0.009). Lower willingness was associated with HIV positive status (Adjusted Odds Ratio [AOR]: 0.39, 95%CI: 0.20, 0.75), perceived barriers (AOR: 0.05, 95%CI: 0.01, 0.26), and perceived severity (AOR: 0.32, 95%CI: 0.12, 0.90).

Conclusion

PLWH in China demonstrated a lower willingness to receive a second COVID-19 booster dose compared to healthy individuals. The findings suggest that perceptions and understanding of the COVID-19 vaccination and its necessity for protection against SARS-CoV-2 could influence this willingness. Efforts should be made to strengthen and disseminate knowledge about HIV and COVID-19 vaccinations among this population. In addition, developing interventions and policies that target specific subgroups and address misconceptions about vaccination could be instrumental in improving vaccination rates among PLWH.

Factors influencing COVID-19 vaccination intention among parents of children aged 5-11 years in South Korea: a cross-sectional study

PURPOSE

The purpose of this study was to identify factors affecting parents' intentions to have their children aged 5-11 years vaccinated against coronavirus disease 2019 (COVID-19).

METHODS

The participants of the study were 298 parents with children aged 5-11 years in South Korea. Data collection took place from October 20 to October 26, 2022 and used an online survey (Google Forms). Data were analyzed using descriptive statistics, the t test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical regression in IBM SPSS version 26.0.

RESULTS

The factors influencing participants' vaccination intentions for their children aged 5-11 years were cognitive behavioral control (β=.40, p<.001), attitudes (β=.37, p<.001), subjective norms (β=.20, p<.001), and awareness of whether their child could receive the COVID-19 vaccine (β=.07, p=.016). The explanatory power of the regression equation was 89%.

CONCLUSION

Parents' intentions to vaccinate their children against COVID-19 are influenced by their attitudes, subjective norms, and perceived behavioral control toward vaccines. Since parents are concerned about vaccine side effects, it is important to establish a trusted line of communication to keep them informed about vaccinations.

A Study of Reasons for Self-Disclosure on Social Media among Chinese COVID-19 Patients: Based on the Theory of Planned Behavior Model

BACKGROUND

With a massive population of internet users, China has witnessed a shift in the behavior of social media users towards the COVID-19 pandemic, transitioning from reticence to frequent sharing of information in response to changing circumstances and policy adjustments of the disease. This study aims to explore how perceived benefits, perceived risks, subjective norms, and self-efficacy influence the intentions of Chinese COVID-19 patients to disclose their medical history on social media, and thus to examine their actual disclosure behaviors.

METHODS

Based on the Theory of Planned Behavior (TPB) and Privacy Calculus Theory (PCT), a structural equation model was constructed to analyze the influence paths among perceived benefits, perceived risks, subjective norms, self-efficacy, and behavioral intentions to disclose medical history on social media among Chinese COVID-19 patients. A total of 593 valid surveys were collected via a randomized internet-based survey, which constituted a representative sample. Firstly, we used SPSS 26.0 to conduct reliability and validity analyses of the questionnaire, as well as the tests of demographic differences and correlations between variables. Next, Amos 26.0 was employed to construct and test the model fit degree, identify the relationships among latent variables, and conduct path tests.

RESULTS

Our findings revealed the following: (1) There were significant gender differences in the self-disclosure behaviors of medical history on social media among Chinese COVID-19 patients. (2) Perceived benefits had a positive effect on self-disclosure behavioral intentions (β = 0.412, p < 0.001); perceived risks had a positive effect on self-disclosure behavioral intentions (β = 0.097, p < 0.05); subjective norms had a positive effect on self-disclosure behavioral intentions (β = 0.218, p < 0.001); self-efficacy had a positive effect on self-disclosure behavioral intentions (β = 0.136, p < 0.001). (3) Self-disclosure behavioral intentions had a positive effect on disclosure behaviors (β = 0.356, p < 0.001).

CONCLUSIONS

Our study, by integrating TPB and PCT to examine the influencing factors of the self-disclosure behaviors among Chinese COVID-19 patients on social media, found that perceived risks, perceived benefits, subjective norms, and self-efficacy had a positive influence on the self-disclosure intentions of Chinese COVID-19 patients. We also found that self-disclosure intentions, in turn, positively influenced disclosure behaviors. However, we did not observe a direct influence of self-efficacy on disclosure behaviors. Our study provides a sample of the application of TPB in the context of social media self-disclosure behavior among patients. It also introduces a novel perspective and potential approach for individuals to address the feelings of fear and shame related to illness, particularly within the context of collectivist cultural values.

Positive Touch Deprivation during the COVID-19 Pandemic: Effects on Anxiety, Stress, and Depression among Italian General Population

Physical distancing due to the COVID-19 Pandemic has limited the opportunities for family members, friends, and significant others to show physical affection (i.e., hugs, kisses, caresses, holding hands) during social interactions. The present study investigated the effects of positive touch and psychological distress in 991 Italian participants (Mage = 34.43, SD = 14.27). Results showed the frequency of hugs with the cohabiting partner significantly decreased the symptoms of depression (β = -1.187, p = 0.018, eβ = 0.30, 95% CI = 0.11-0.82), whereas the frequency of caresses with cohabiting relatives predicted the symptoms of anxiety (β = 0.575, p = 0.034, eβ = 1.78, 95% CI = 1.04-3.03). The frequency of hugs (β = -0.609, p = 0.049, eβ = 0.54, 95% CI = 0.30-1.00), and kisses (β = 0.663, p = 0.045, eβ = 1.94, 95% CI = 1.01-3.71) with non-cohabiting relatives predicted the symptoms of anxiety (χ2 = 1.35, df = 5, p = 0.93). These results suggest the importance of positive touch on psychological well-being in the social context.

Usage of Heat and Moisture Exchange Devices, Virtual Visits, Masking, and Vaccinations Among People With a Laryngectomy During COVID-19

PURPOSE

This study described the COVID-19 risk mitigation actions of people with a total laryngectomy (TL) during the pandemic.

METHOD

An online survey was completed by 215 people with a TL who lived in the United States. The survey was open from December 1, 2021, to January 15, 2022.

RESULTS

There was a significant increase in frequency of heat and moisture exchange (HME) device use during the pandemic compared with pre-COVID-19. Frequency of HME use was significantly greater for those who were vaccinated and those who had at least one clinical visit with their speech-language pathologist (SLP). The use of virtual visits increased from 9% pre-COVID-19 to 37% during the pandemic. Seventy percent of respondents were "satisfied" or "very satisfied" with virtual visits and 51% judged them "as good as in-person." Eighty percent were vaccinated for COVID-19 and 75% received a booster. One third reported that they did not wear mask over the face or over the tracheostoma. Twenty percent had tested positive for COVID-19 with 70% of these people requiring hospitalization.

CONCLUSIONS

HME use and virtual SLP visits increased during the pandemic and the vaccination rate was high among this group of respondents. Overall, there were still large percentages of people with a TL who were not using an HME, not vaccinated, and did not wear a mask. SLPs should consider reaching out directly to their TL caseload, particularly those not yet seen during the pandemic, to support uptake of COVID-19 mitigation activities specific to people with a TL as the pandemic persists.

COVID-19 vaccine uptake and hesitation among men and women preparing for pregnancy: a cross-section survey based on the theory of planned behavior

BACKGROUND

Given the accelerated speed of COVID-19 vaccine research and administration, the main barriers to herd immunity appear to be concerns about safety and efficacy. Men and women preparing for pregnancy may have the same concerns about COVID-19 vaccination, but few studies have focused on COVID-19 vaccine uptake and hesitation among them.

METHODS

A cross-sectional study was conducted among men and women who were preparing for pregnancy in Southwest China. The questionnaire was designed based on the theory of planned behavior (TPB). Multiple logistic regression was used to explore the determinants of the behaviors of COVID-19 vaccination.

RESULTS

A total of 2878 participants completed the survey. A total of 53.89% of participants received at least one dose of the COVID-19 vaccine. A total of 45.21% of participants would receive the COVID-19 vaccine in the future. A total of 0.90% of participants never thought about receiving the COVID-19 vaccine. Multiple logistic regression model 1 showed that female participants (OR:5.497, 95%CI: 4.292-7.041), participants who never received influenza vaccine (OR:2.664, 95%CI: 1.908-3.718), participants who had never been tested for COVID-19 (OR:2.244, 95%CI:1.504-3.349), participants who had higher score of negative attitude (OR:1.448, 95%CI: 1.219-1.719), participants who had lower scores of injunctive norms (OR:0.440, 95%CI: 0.360-0.537) and descriptive norms (OR:0.105, 95%CI: 0.088-0.126) were more likely to delay COVID-19 vaccination. Model 2 showed that participants who had lower scores for positive attitude (OR: 0.406, 95% CI: 0.230-0.716), injunctive norms (OR: 0.283, 95% CI: 0.130-0.614) and descriptive norms (OR: 0.060, 95% CI: 0.038-0.094) were more likely to refuse COVID-19 vaccination.

CONCLUSIONS

The COVID-19 vaccination rate of men and women preparing for pregnancy was significantly lower than the average vaccination rate of China. Gender, protective health behaviors, vaccination attitudes, and subjective norms had effects on the vaccination behaviors of couples preparing for pregnancy.

Factors Influencing COVID-19 Vaccine Hesitancy among Patients with Serious Chronic Illnesses during the Initial Australian Vaccine Rollout: A Multi-Centre Qualitative Analysis Using the Health Belief Model

Background: People with chronic illnesses have increased morbidity and mortality associated with COVID-19 infection. The influence of a person's serious and/or comorbid chronic illness on COVID-19 vaccine uptake is not well understood. Aim: To undertake an in-depth exploration of factors influencing COVID-19 vaccine uptake among those with various serious and/or chronic diseases in the Australian context, using secondary data analysis of a survey study. Methods: Adults with cancer, diabetes and multiple sclerosis (MS) were recruited from 10 Australian health services to undertake a cross-sectional online survey (30 June to 5 October 2021) about COVID-19 vaccine uptake, vaccine hesitancy, confidence and complacency and disease-related decision-making impact. Free-text responses were invited regarding thoughts and feelings about the interaction between the participant's disease, COVID-19, and vaccination. Qualitative thematic analysis was undertaken using an iterative process and representative verbatim quotes were chosen to illustrate the themes. Results: Of 4683 survey responses (cancer 3560, diabetes 842, and MS 281), 1604 (34.3%) included free-text comments for qualitative analysis. Participants who provided these were significantly less likely to have received a COVID-19 vaccination than those who did not comment (72.4% and 86.2%, respectively). People with diabetes were significantly less likely to provide free-text comments than those with cancer or MS (29.0%, 35.1% and 39.9%, respectively). Four key themes were identified from qualitative analysis, which were similar across disease states: (1) having a chronic disease heightened perceived susceptibility to and perceived severity of COVID-19; (2) perceived impact of vaccination on chronic disease management and disease-related safety; (3) uncertain benefits of COVID-19 vaccine; and (4) overwhelming information overload disempowering patients. Conclusions: This qualitative analysis highlights an additional layer of complexity related to COVID-19 vaccination decision making in people with underlying health conditions. Appreciation of higher susceptibility to severe COVID-19 outcomes appears to be weighed against uncertain impacts of the vaccine on the progression and management of the comorbid disease. Interactions by clinicians addressing individual factors may alleviate concerns and maximise vaccine uptake in people with significant underlying health conditions.

Application of behavioral change theory and models on COVID-19 preventive behaviors, worldwide: A systematic review

Objective:

This systematic review aimed to assess the global application of behavioral change theory and models on COVID-19 preventive behaviors.

Methods:

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedure. Databases such as PubMed/MIDLINE, Web of Science, Scopus, EMB ASE, World Health Organization libraries, and Google Scholar were used to search all published articles in the area of application of behavioral change theory and model on COVID-19 preventive behavior until October 1, 2022. Studies published in another language other than English were excluded. Two independent reviewers did the article selection and quality check. A third reviewer asked if any disagreement were found.

Result:

Seventeen thousand four hundred thirty-six total articles were retrieved from all sources after the removal of duplicated articles and those not evaluating the outcome of interest were excluded. Finally, 82 articles done using behavioral change theory and model on COVID-19 preventive behaviors were included. The health belief model (HBM) and theory of planned behavior (TPB) were most commonly used in COVID-19 preventive behaviors. The constructs of most behavioral theories and models were significantly associated with COVID-19 preventive behaviors such as hand washing, face mask use, vaccine uptake, social isolation, self-quarantine, social distance, and use of sanitizers.

Conclusion:

This systematic review summarizes comprehensive evidence on the application of behavioral change theory and model on COVID-19 preventive behaviors globally. A total of seven behavioral change theories and models were included. The HBM and TPBs were most commonly used for COVID-19 preventive behaviors. Therefore, the application of behavioral change theory and models is recommended for developing behavioral change interventional strategies.

Predicting Vaccination Intention against COVID-19 Using Theory of Planned Behavior: A Systematic Review and Meta-Analysis

This study systematically analyzed the literature using the theory of planned behavior (TPB) as a theoretical framework to examine the influence of its constructs on vaccination intention against COVID-19. Quantitative studies were searched in PubMed, CINAHL, Web of Science, and Google Scholar following the PRISMA guidelines. The average rate of COVID-19 vaccination intention was 73.19%, ranging from 31% to 88.86%. Attitude had the strongest association with vaccination intention (r₊ = 0.487, 95% CI: 0.368-0.590), followed by subjective norms (r₊ = 0.409, 95% CI: 0.300-0.507), and perceived behavioral control (r₊ = 0.286, 95% CI: 0.198-0.369). Subgroup analyses showed that the pooled effect sizes of TPB constructs on vaccination intention varied across geographic regions and study populations. Attitude had large effect sizes in Asia, Europe, and Oceania, especially among the adult general population, parents, and patients. Subjective norms had large effect sizes in Asia and Oceania, especially among parents and patients. Perceived behavioral control was the most dominant predictor of vaccination acceptance in Africa among patients. These findings suggest that TPB provides a useful framework for predicting intention to receive a COVID-19 vaccine. Hence, public awareness and educational programs aimed at promoting COVID-19 vaccination intention should consider using TPB as a framework to achieve the goal.

COVID-19 Vaccine Hesitancy in Australian Patients with Solid Organ Cancers

Background: Vaccination is the cornerstone of the global public health response to the COVID-19 pandemic. Excess morbidity and mortality of COVID-19 infection is seen in people with cancer. COVID-19 vaccine hesitancy has been observed in this medically vulnerable population, although associated attitudes and beliefs remain poorly understood. Methods: An online cross-sectional survey of people with solid organ cancers was conducted through nine health services across Australia. Demographics, cancer-related characteristics and vaccine uptake were collected. Perceptions and beliefs regarding COVID-19 vaccination were assessed using the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale and the Disease Influenced Vaccine Acceptance Scale-6. Results: Between June and October 2021, 2691 people with solid organ cancers completed the survey. The median age was 62.5 years (SD = 11.8; range 19–95), 40.9% were male, 71.3% lived in metropolitan areas and 90.3% spoke English as their first language. The commonest cancer diagnoses were breast (36.6%), genitourinary (18.6%) and gastrointestinal (18.3%); 59.2% had localized disease and 56.0% were receiving anti-cancer therapy. Most participants (79.7%) had at least one COVID-19 vaccine dose. Vaccine uptake was higher in people who were older, male, metropolitan, spoke English as a first language and had a cancer diagnosis for more than six months. Vaccine hesitancy was higher in people who were younger, female, spoke English as a non-dominant language and lived in a regional location, and lower in people with genitourinary cancer. Vaccinated respondents were more concerned about being infected with COVID-19 and less concerned about vaccine safety and efficacy. Conclusions: People with cancer have concerns about acquiring COVID-19, which they balance against vaccine-related concerns about the potential impact on their disease progress and/or treatment. Detailed exploration of concerns in cancer patients provides valuable insights, both for discussions with individual patients and public health messaging for this vulnerable population.

COVID-19 vaccine uptake among family caregivers of people with dementia: The role of attitudes toward vaccination, perceived social support and personality traits

People with dementia have an increased risk of contracting severe forms of COVID-19. Although in worldwide vaccination programs priority has been given to older people, having taken the vaccine does not totally eliminate the risk of contracting COVID-19 when one is in close contact with unvaccinated people. Thus, family caregivers’ choices to remain unvaccinated against COVID-19 could have potentially lethal consequences for their relatives. To our knowledge, this study represents the first attempt within the international literature to analyze COVID-19 vaccine uptake among family caregivers of people with dementia and to identify some of the psychological factors, related to COVID-19 and vaccination behavior, that could facilitate or hinder vaccine uptake. Contact information for family caregivers was obtained from five different centers and associations throughout the Italian territory. Data were collected from 179 respondents during July-September 2021 using a cross-sectional web-based survey design. More than 75% of the respondents indicated that had been vaccinated against COVID-19 and reported receiving vaccine information mainly from print or electronic newspapers (86%), followed by TV (81%) and families (64.2%). In multivariable logistic regression analyses, worries about unforeseen future effects was significantly related to COVID-19 vaccine uptake, indicating that family caregivers concerned about potential side effects of vaccines were less likely to have been vaccinated against COVID-19 (OR = 0.60, CI = 0.40-0.89). Openness to experience was also related to COVID-19 vaccine uptake, with family caregivers higher on this trait being less likely to have been vaccinated against COVID-19 (OR = 0.83, CI = 0.71-0.98). Implications for targeting of vaccine-related messages are discussed.

A Study of Pandemic Prevention Health Behavior in Adults

Following the outbreak of COVID-19, the World Health Organization recommended prevention measures to minimize the spread of the pandemic. However, strict compliance with prevention measures requires positive health behavior practices, especially among adults. Therefore, this study investigated adults’ health behaviors in relation to pandemic prevention based on the health belief model (HBM) and the theory of planned behavior (TPB). This study used a structural model, applying the HBM and the TPB to explain and predict pandemic prevention behaviors in adults. The data obtained were statistically analyzed using SPSS 25.0 and AMOS 25.0. The results revealed that, in total, 341 adults (age: 20–64 years; males: 167, females: 174; single: 167; married: 164; divorced: 8) participated in this study. Of the 341 participants, 339 had use of the internet and a smartphone. Furthermore, the results revealed that attitudes, subjective norms, and perceived behavioral control in relation to pandemic prevention behaviors directly affected people’s intentions to adopt pandemic prevention behaviors. Perceived severity and perceived disability had significant indirect effects on the intention to prevent pandemics; pandemic prevention behavior and perceived behavioral control had a significant effect on pandemic prevention intention. The pandemic prevention education programs suggested in this study have the potential to improve adults’ health behavior in relation to pandemic prevention.