Theory of planned behavior explains males' and females' intention to receive COVID-19 vaccines differently

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.

Factors affecting lung cancer patients' intention to perform early postoperative exercise: a qualitative study based on theory of planned behavior

BACKGROUND

Early postoperative exercise is effective in improving the prognosis of postoperative lung cancer patients, but compliance was lower than expected. Factors affecting lung cancer patients' intention to perform early postoperative exercise were unclear.

PURPOSE

To discuss the factors affecting lung cancer patients' intention to perform early postoperative exercise based on the Theory of Planned Behavior.

METHODS

This was a qualitative study. Twenty-five lung cancer patients were recruited using purposive sampling, and semi-structured face-to-face interviews were performed. The reflexive intuitive thematic analysis method was used, and triangulation was employed to ensure the credibility of the study.

RESULTS

Results of this study identified 8 themes from 3 aspects. For behavioral attitudes, two themes emerged: (1) Aware of the benefits of postoperative exercise, (2) Underestimate the importance of postoperative exercise. For subjective norms, four themes emerged: (1) Influence of caregiver support on carrying out postoperative exercise, (2) Short-term supervision of medical staff, (3) Positive driving effect from other patients, and (4) Motivation due to family responsibility. For perceived behavior control, two themes and six sub-themes emerged: (1) Obstacles before actual exercise (Lack of adequate knowledge of postoperative pulmonary exercise, Less active in seeking related knowledge about rehabilitation exercise, and Misconceptions about rehabilitation exercise); (2) Unpleasant experiences during exercise (Physical discomfort, Limited space and depressive atmosphere, and Psychological burden).

CONCLUSIONS

Several factors could affect lung cancer patients' early postoperative exercise behavior. Healthcare professionals should fully understand these factors from patients' perspectives. Special interventions should be designed for the patients and their caregivers to correct cognitive bias, reduce obstacles, and promote compliance with exercise.

Examining health sciences students' intention to uptake COVID-19 vaccination using the theory of planned behavior

To examine the association between the theory of planned behavior (TPB) constructs and Health Sciences students' intentions to receive COVID-19 vaccination. A cross-sectional study was conducted in Saudi Arabia by recruiting Health Sciences students as participants. Using Structural Equation Modeling (SEM), the proposed TPB model was evaluated. The sample of 505 individuals consisted of more males (n = 275; 54.5%) than females and was relatively young (88% were between the ages of 18 and 30). The suggested TPB model explained 78.2% of the variation in intention to get COVID-19 immunization. We found that greater levels of perceived behavioral control (β = 1.58, p < .001) and attitude (β = .44, p < .001) strongly predicted increased vaccination intentions. The subjective norm construct was not a significant predictor of vaccination intentions (β = 0.06, p = .34). The findings of this study indicate that the TPB can be utilized effectively to obtain insight into the factors associated with COVID-19 adherence and help in the development of effective COVID-19 intervention strategies.

Non-commuting intentions during COVID-19 in Nanjing, China: A hybrid latent class modeling approach

Non-commuting travel is essential for people to meet daily demands and regulate mental health, which is greatly disrupted due to the COVID-19 pandemic. To explore non-commuting intentions during COVID-19 across different groups of residents, this paper uses online survey data in Nanjing and constructs a hybrid latent class choice model that combines sociodemographic characteristics and psychological factors. Results showed that the respondents can be divided into two groups: the "cautious" group versus the "fearless" group. The "cautious" group with lower willingness to travel tend to be older, higher-income, higher-educated, female and full-time employees. Furthermore, the "cautious" group with higher perceived susceptibility is more obedient to government policies. In contrast, the "fearless" group is significantly affected by perceived severity and is more inclined to turn to personal protection against the pandemic. These results suggested that non-commuting trips were influenced not only by individual characteristics but also by psychological factors. Finally, the paper provides implications for the government to formulate COVID-19 management measures for the heterogeneity of different groups.

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.

The choice of Taiwanese college students to vaccinate against severe special infectious pneumonia COVID-19 based on the integrated theory of planning behavior

Taiwan's coronavirus (COVID-19) vaccine procurement was delayed until October 2021. With the vaccine's introduction in Taiwan, the public will have an opportunity to choose vaccination. Choosing to vaccinate involves considerations regarding the trade-off between the protective power of the vaccine and its side effects, which is a planned behavior. College students have considered high-risk objects for COVID-19 outbreaks given their lifestyle, and their efficient vaccination may help reduce mutual infection between college students and the general public. This study obtained 707 valid questionnaires from Taiwan college students (20 years old and above). We investigated several factors during our college students' survey regarding vaccination. Among this integrated TPB model, "Attitude," "Subjective Norm," "Perceived Behavioral Control," and "COVID-19 Information Asymmetry" had a positive impact on vaccination "Behavioral Intention." COVID-19 information asymmetry positively and significantly affected behavioral intention through perceived behavioral control, while perceived behavioral control had a mediating effect. To promote the behavioral intention of college students to choose COVID-19 vaccination, public and private departments for epidemic prevention must aim to overcome the self-efficacy barriers of perceived behavioral control and promote the primary group influence effect of subjective norm and the self-interest factor of attitude. Governments and NGOs should also ensure prompt and accurate transmission of epidemic and vaccine information and actively investigate and prohibit misleading details from unknown sources and no scientific basis. Such a policy will generate trust, effectively increasing the vaccination rate and reducing cluster infection.

Challenges and opportunities in current vaccine technology and administration: A comprehensive survey examining oral vaccine potential in the United States

This study provides a snapshot of the current vaccine business ecosystem, including practices, challenges, beliefs, and expectations of vaccine providers. Our team focused on providers' firsthand experience with administering vaccines to determine if an oral vaccine (e.g. pill or oral-drop) would be well-received. We interviewed 135 healthcare providers and vaccine specialists across the US, focusing questions on routine vaccinations, not COVID-19 vaccines. Improving workflow efficiency is a top concern among vaccine providers due to shrinking reimbursement rates-determined by pharmacy benefit managers (PBMs)-and the time-intensiveness of injectable vaccines. Administering injectable vaccines takes 23 minutes/patient on average, while dispensing pills takes only 5 minutes/patient. An average of 24% of patients express needle-fear, which further lengthens the processing time. Misaligned incentives between providers and PBMs could reduce the quality and availability of vaccine-related care. The unavailability of single-dose orders prevents some rural providers from offering certain vaccines. Most interviewees (74%) believe an oral vaccine would improve patient-provider experience, patient-compliance, and workflow efficiency, while detractors (26%) worry about the taste, vaccine absorption, and efficacy. Additional research could investigate whether currently non-vaccinating pharmacies would be willing to offer oral vaccines, and the impact of oral vaccines on vaccine acceptance.

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.

A Scoping Review of Three Dimensions for Long-Term COVID-19 Vaccination Models: Hybrid Immunity, Individual Drivers of Vaccinal Choice, and Human Errors

The virus that causes COVID-19 changes over time, occasionally leading to Variants of Interest (VOIs) and Variants of Concern (VOCs) that can behave differently with respect to detection kits, treatments, or vaccines. For instance, two vaccination doses were 61% effective against the BA.1 predominant variant, but only 24% effective when BA.2 became predominant. While doses still confer protection against severe disease outcomes, the BA.5 variant demonstrates the possibility that individuals who have received a few doses built for previous variants can still be infected with newer variants. As previous vaccines become less effective, new ones will be released to target specific variants and the whole process of vaccinating the population will restart. While previous models have detailed logistical aspects and disease progression, there are three additional key elements to model COVID-19 vaccination coverage in the long term. First, the willingness of the population to participate in regular vaccination campaigns is essential for long-term effective COVID-19 vaccination coverage. Previous research has shown that several categories of variables drive vaccination status: sociodemographic, health-related, psychological, and information-related constructs. However, the inclusion of these categories in future models raises questions about the identification of specific factors (e.g., which sociodemographic aspects?) and their operationalization (e.g., how to initialize agents with a plausible combination of factors?). While previous models separately accounted for natural- and vaccine-induced immunity, the reality is that a significant fraction of individuals will be both vaccinated and infected over the coming years. Modeling the decay in immunity with respect to new VOCs will thus need to account for hybrid immunity. Finally, models rarely assume that individuals make mistakes, even though this over-reliance on perfectly rational individuals can miss essential dynamics. Using the U.S. as a guiding example, our scoping review summarizes these aspects (vaccinal choice, immunity, and errors) through ten recommendations to support the modeling community in developing long-term COVID-19 vaccination models.