基于理论的美国非裔美国人对新冠疫苗犹豫态度分析:最新证据
A Theory-Based Analysis of COVID-19 Vaccine Hesitancy among African Americans in the United States: A Recent Evidence.
作者信息
Sharma Manoj, Batra Kavita, Batra Ravi
机构信息
Department of Environmental and Occupational Health, University of Nevada, Las Vegas, NV 89119, USA.
Office of Research, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89102, USA.
出版信息
Healthcare (Basel). 2021 Sep 27;9(10):1273. doi: 10.3390/healthcare9101273.
African Americans have been disproportionately vaccinated at lower rates, which warrants the development of theory-based interventions to reduce vaccine hesitancy in this group. The fourth-generation theories, e.g., multi-theory model (MTM) of health behavior change, are vital in developing behavioral interventions. Therefore, the current study aims to determine recent trends in COVID-19 vaccination rates and to test the MTM model in predicting the initiation of COVID-19 vaccines among vaccine-hesitant Blacks. A sample of 428 unvaccinated African Americans were recruited through a web-based survey using a 28-item psychometric valid questionnaire. Chi-square, independent-samples-t-test or Welch's t test, and Pearson's correlation tests were utilized for the analyses. Hierarchical regression modelling was performed to determine the increment in variation accounted for through addition of predictors over a set of models. Nearly 48% of unvaccinated Blacks reported being vaccine-hesitant. The vaccine-hesitant group was relatively younger (40.5 years ± 15.8 vs. 46.2 years ± 17.4, < 0.001), were Republicans (22.1% vs. 10.0%, < 0.001), lived in the North-East region (26.0% vs. 11.4%, < 0.001) and had religious affiliations other than Christianity (21.2% vs. 13.6%, = 0.04). The mean scores of perceived advantages ((9.01 ± 3.10 vs. 7.07 ± 3.60, < 0.001) and behavioral confidence (8.84 ± 3.76 vs. 5.67 ± 4.09, < 0.001) were higher among vaccine non-hesitant group as opposed to the hesitant ones. In a final regression model, all MTM constructs) predicted nearly 65% of variance in initiating COVID-19 vaccination behavior among the vaccine-hesitant group (adjusted R = 0.649, F = 32.944, < 0.001). With each unit increment in MTM constructs (e.g., participatory dialogue and behavior confidence), the initiation of COVID-19 vaccination among vaccine-hesitant Blacks increased by 0.106 and 0.166 units, respectively. Based on the findings of this study a m-health educational intervention to promote COVID-19 vaccine uptake behavior among Blacks is proposed.
非裔美国人接种疫苗的比例一直相对较低,这就需要制定基于理论的干预措施,以减少该群体对疫苗的犹豫态度。第四代理论,例如健康行为改变的多理论模型(MTM),对于制定行为干预措施至关重要。因此,本研究旨在确定新冠疫苗接种率的近期趋势,并检验MTM模型在预测对疫苗犹豫的黑人接种新冠疫苗方面的效果。通过一项基于网络的调查,使用一份包含28个条目的心理测量有效问卷,招募了428名未接种疫苗的非裔美国人作为样本。分析采用卡方检验、独立样本t检验或韦尔奇t检验以及皮尔逊相关检验。进行分层回归建模,以确定通过在一组模型中添加预测变量所解释的变异增量。近48%未接种疫苗的黑人表示对疫苗持犹豫态度。对疫苗犹豫的群体相对更年轻(40.5岁±15.8岁对46.2岁±17.4岁,P<0.001),是共和党人(22.1%对10.0%,P<0.001),居住在东北地区(26.0%对11.4%,P<0.001),并且有基督教以外的宗教信仰(21.2%对13.6%,P = 0.04)。与对疫苗犹豫的群体相比,不犹豫群体在感知优势((9.01±3.10对7.07±3.60,P<0.001)和行为信心(8.84±3.76对5.67±4.09,P<0.001)方面的平均得分更高。在最终的回归模型中,所有MTM构建因素预测了对疫苗犹豫群体中近65%的新冠疫苗接种行为变异(调整后R = 0.649,F = 32.944,P<0.001)。随着MTM构建因素(例如参与性对话和行为信心)每增加一个单位,对疫苗犹豫的黑人接种新冠疫苗的行为分别增加0.106和0.166个单位。基于本研究的结果,提出了一项移动健康(m-health)教育干预措施,以促进黑人的新冠疫苗接种行为。