Department of Epidemiology and Health Statistic, School of Public Health, Southeast University, Nanjing, China.
Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China.
JMIR Public Health Surveill. 2022 Jun 20;8(6):e34666. doi: 10.2196/34666.
Promoting vaccination and eliminating vaccine hesitancy are key measures for controlling vaccine-preventable diseases.
We aimed to understand the beliefs surrounding and drivers of vaccination behavior, and their relationships with and influence on vaccination intention and practices.
We conducted a web-based survey in 31 provinces in mainland China from May 24, 2021 to June 15, 2021, with questions pertaining to vaccination in 5 dimensions: attitude, subjective norms, perceived behavioral control, intention, and behavior. We performed hierarchical regression analysis and structural equation modeling based on the theory of planned behavior-in which, the variables attitude, subjective norms, and intention each affect the variable intention; the variable intention mediates the relationships of attitude and subjective norms with behavior, and the variable perceived behavioral control moderates the strength of this mediation-to test the validity of the theoretical framework.
A total of 9924 participants, aged 18 to 59 years, were included in this study. Vaccination intention mediated the relationships of attitude and subjective norms with vaccination behavior. The indirect effect of attitude on vaccination behavior was 0.164 and that of subjective norms was 0.255, and the difference was statistically significant (P<.001). The moderated mediation analysis further indicated that perceived behavioral control would affect the mediation when used as moderator, and the interaction terms for attitude (β=-0.052, P<.001) and subjective norms (β=-0.028, P=.006) with perceived behavioral control were significant.
Subjective norms have stronger positive influences on vaccination practices than attitudes. Perceived behavioral control, as a moderator, has a substitution relationship with attitudes and subjective norms and weakens their positive effects on vaccination behavior.
推动疫苗接种和消除疫苗犹豫是控制疫苗可预防疾病的关键措施。
本研究旨在了解疫苗接种行为的信念和驱动因素，以及它们与疫苗接种意向和实践的关系及其影响。
我们于 2021 年 5 月 24 日至 6 月 15 日在中国大陆 31 个省进行了一项基于网络的调查，内容涉及疫苗接种的 5 个维度：态度、主观规范、感知行为控制、意向和行为。我们基于计划行为理论进行了层次回归分析和结构方程建模——其中，态度、主观规范和意向这 3 个变量分别影响意向变量；意向变量介导了态度和主观规范与行为的关系，感知行为控制变量调节了这种中介关系的强度。
共纳入 9924 名年龄在 18 至 59 岁之间的参与者。疫苗接种意向介导了态度和主观规范与疫苗接种行为之间的关系。态度对疫苗接种行为的间接影响为 0.164，主观规范的间接影响为 0.255，差异具有统计学意义（P<0.001）。调节中介分析进一步表明，当使用感知行为控制作为调节变量时，感知行为控制会影响中介，态度（β=-0.052，P<0.001）和主观规范（β=-0.028，P=.006）与感知行为控制的交互项具有统计学意义。
主观规范对疫苗接种实践的正向影响强于态度。感知行为控制作为一个调节变量，与态度和主观规范具有替代关系，削弱了它们对疫苗接种行为的正向影响。
