Open AccessHealth Belief Model Perspective on the Control of COVID-19 Vaccine Hesitancy and the Promotion of Vaccination in China: Web-Based Cross-sectional Study
Author(s) -
Hao Chen,
Xiaomei Li,
Junling Gao,
Xiaoxi Liu,
Yimeng Mao,
Ruru Wang,
Pinpin Zheng,
Qianyi Xiao,
Yingnan Jia,
Hua Fu,
Jianghong Dai
Publication year - 2021
Publication title -
jmir. journal of medical internet research/journal of medical internet research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.446
H-Index - 142
eISSN - 1439-4456
pISSN - 1438-8871
DOI - 10.2196/29329
Subject(s) - vaccination , medicine , logistic regression , health belief model , odds ratio , cross sectional study , demography , family medicine , psychological intervention , health promotion , environmental health , immunology , public health , nursing , pathology , sociology
Background The control of vaccine hesitancy and the promotion of vaccination are key protective measures against COVID-19. Objective This study assesses the prevalence of vaccine hesitancy and the vaccination rate and examines the association between factors of the health belief model (HBM) and vaccination. Methods A convenience sample of 2531 valid participants from 31 provinces and autonomous regions of mainland China were enrolled in this online survey study from January 1 to 24, 2021. Multivariable logistic regression was used to identify the associations of the vaccination rate and HBM factors with the prevalence of vaccine hesitancy after other covariates were controlled. Results The prevalence of vaccine hesitancy was 44.3% (95% CI 42.3%-46.2%), and the vaccination rate was 10.4% (9.2%-11.6%). The factors that directly promoted vaccination behavior were a lack of vaccine hesitancy (odds ratio [OR] 7.75, 95% CI 5.03-11.93), agreement with recommendations from friends or family for vaccination (OR 3.11, 95% CI 1.75-5.52), and absence of perceived barriers to COVID-19 vaccination (OR 0.51, 95% CI 0.35-0.75). The factors that were directly associated with a higher vaccine hesitancy rate were a high level of perceived barriers (OR 1.63, 95% CI 1.36-1.95) and perceived benefits (OR 0.51, 95% CI 0.32-0.79). A mediating effect of self-efficacy, influenced by perceived barriers (standardized structure coefficient [SSC]=−0.71, P <.001), perceived benefits (SSC=0.58, P <.001), agreement with recommendations from authorities (SSC=0.27, P <.001), and agreement with recommendations from friends or family (SSC=0.31, P <.001), was negatively associated with vaccination (SSC=−0.45, P <.001) via vaccine hesitancy (SSC=−0.32, P <.001). Conclusions It may be possible to increase the vaccination rate by reducing vaccine hesitancy and perceived barriers to vaccination and by encouraging volunteers to advocate for vaccination to their friends and family members. It is also important to reduce vaccine hesitancy by enhancing self-efficacy for vaccination, due to its crucial mediating function.