University of Colorado School of Medicine, Department of Pediatrics, Aurora, CO, United States; University of Colorado, Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, CO, United States.
University of Colorado, Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, CO, United States.
Vaccine. 2019 Sep 10;37(38):5688-5697. doi: 10.1016/j.vaccine.2019.08.009. Epub 2019 Aug 14.
Evidence-based strategies to address vaccine hesitancy are lacking. Personal values are a measurable psychological construct that could be used to deliver personalized messages to influence vaccine hesitancy and behavior. Our objectives were to develop a valid, reliable self-report survey instrument to measure vaccine values based on the Schwartz theory of basic human values, and to test the hypothesis that vaccine values are distinct from vaccine attitudes and are related to vaccine hesitancy and behavior.
Parental Vaccine Values (PVV) scale items were generated using formative qualitative research and expert input, yielding 24 items for testing. 295 parents of children aged 14-30 months completed a self-report survey with measures of Schwartz's global values, the PVV, vaccine attitudes, and vaccine hesitancy. Factor analysis was used to determine vaccine values factor structure. Associations between vaccine values, vaccine attitudes, vaccine hesitancy, and vaccination behavior were assessed using linear and logistic regression models. Late vaccination was assessed from electronic medical records.
A six-factor structure for vaccine values was determined with good fit (RMSEA = 0.07, Bentler's CFI = 0.91) with subscales for Conformity, Universalism, Tradition, Self-Direction, Security- Disease Prevention, and Security- Vaccine Risk. Vaccine values were moderately associated with Schwartz global values and vaccine attitudes, indicating discriminant validity from these constructs. Multivariable linear regression showed vaccine hesitancy was associated with vaccine values Conformity (partial R = 0.10) and Universalism (0.04) and vaccine attitudes Vaccine Safety (0.52) and Vaccine Benefit (0.16). Multivariable logistic regression showed that late vaccination was associated with vaccine value Self-direction (OR = 1.80, 95% CI: 1.26-2.65) and vaccine attitude of Vaccine Benefit (OR = 0.44, 95% CI: 0.32-0.60).
The PVV scale had good psychometric properties and appears related to but distinct from Schwartz global values and vaccine attitudes. Vaccine values are associated with vaccine hesitancy and late vaccination and may be useful in tailoring future interventions.
目前缺乏解决疫苗犹豫的循证策略。个人价值观是一种可衡量的心理结构，可以用来传递个性化信息，以影响疫苗犹豫和行为。我们的目标是开发一种基于 Schwartz 基本人类价值观理论的有效、可靠的自我报告测量工具，以测量疫苗价值观，并检验疫苗价值观与疫苗态度不同且与疫苗犹豫和行为相关的假设。
使用形成性定性研究和专家意见生成了父母疫苗价值观（PVV）量表项目，共生成 24 个测试项目。295 名 14-30 月龄儿童的父母完成了一份自我报告调查，内容包括 Schwartz 全球价值观、PVV、疫苗态度和疫苗犹豫。使用因子分析确定疫苗价值观的因子结构。使用线性和逻辑回归模型评估疫苗价值观、疫苗态度、疫苗犹豫和疫苗接种行为之间的关联。从电子病历评估延迟接种情况。
确定了疫苗价值观的六因素结构，拟合度良好（RMSEA=0.07，Bentler 的 CFI=0.91），包括顺从、普世主义、传统、自我导向、疾病预防安全和疫苗风险安全子量表。疫苗价值观与 Schwartz 全球价值观和疫苗态度中度相关，表明与这些结构具有区分效度。多变量线性回归显示，疫苗犹豫与疫苗价值观的顺从（部分 R=0.10）和普世主义（0.04）以及疫苗态度的疫苗安全性（0.52）和疫苗效益（0.16）相关。多变量逻辑回归显示，延迟接种与疫苗价值观的自我导向（OR=1.80，95%CI：1.26-2.65）和疫苗态度的疫苗效益（OR=0.44，95%CI：0.32-0.60）相关。
PVV 量表具有良好的心理测量学特性，似乎与 Schwartz 全球价值观和疫苗态度相关，但又不同。疫苗价值观与疫苗犹豫和延迟接种有关，可能有助于为未来的干预措施提供信息。
