April 7-9, 2022 • Hyatt Regency • Lexington, KY
Communication Strategies to Promote Comprehensive Well-being
Communication Strategies to Promote Comprehensive Well-being
Abstract: Demographic and Psychosocial Correlates of COVID-19 Vaccine Uptake Among US Adults: Application of the Theory of Planned Behavior
Context: COVID-19 vaccine hesitancy and resistance presents major challenges to public health mitigation efforts. Identifying primary motivation factors can help improve messaging aimed at increasing vaccine uptake. The Theory of Planned Behavior (TPB) posits that attitudes, social norms, and perceived behavioral control (self-efficacy) affect behavioral intentions. Identifying which of these factors is most related to vaccine uptake, as well as the demographic and ideological factors, can help tailor health communication messaging. True access in addition to perceived self-efficacy has been debated as major causes of hesitancy in the early phases of vaccine rollout. Objective: This study examines the ideological, demographic, and psychosocial correlates of COVID-19 vaccine uptake, including perceived norms, attitude toward vaccination, and perceived behavioral control over vaccination. Design: This online, cross-sectional survey was designed to measure demographic and ideological characteristics likely to be related to perceptions of COVID-19 vaccination (e.g., political affiliation; prior COVID-19 diagnosis), as well as TPB cognitions about COVID-19 vaccination (i.e., utilizing a 7-point Likert scale, in accordance with TPB theory). Through linear and logistic regressions, analyses examine demographic and ideological predictors of psychosocial (TPB) constructs, as well as demographic, ideological, and psychosocial predictors of vaccine uptake. The final sample included 1048 US adults, recruited through Amazon’s Mechanical Turk. Of the full sample, 693 had received at least 1 dose of a COVID-19 vaccine. Results: Having an official COVID-19 diagnosis was the strongest consistent predictor of COVID-19 vaccine uptake and findings suggest a suppression relationship wherein official diagnosis gains strength with the TPB constructs added to the model. Indeed, participants who had been previously diagnosed with COVID-19 tended to have less favorable attitudes toward vaccination (despite reporting higher rates of vaccination). Attitudes and perceived control appear to suppress the relationship between one’s own perceived risk of severe outcomes and vaccine uptake. Perceived behavioral control did not relate to vaccine uptake when controlling for other TPB constructs. Additionally, having an acquaintance that had a severe outcome for COVID-19 predicted vaccine uptake. Social norms and attitude were also strong positive predictors of vaccine uptake. Among demographic and ideological factors, identifying as politically independent or Republican were associated with lower rates of vaccine uptake. Women and African-Americans were also less likely to be vaccinated, compared to men and White/nonHispanic participants. Conclusions: Public health messaging emphasizing positive outcomes of vaccination may increase vaccination uptake, particularly relative to self-efficacy messages. Medical experiences when receiving a COVID-19 diagnosis and treatment should be further studied, given the unexpected observed inverse relationships with attitudes and uptake. Additionally, increasing vaccine uptake in the African-American population is critical, and follow-up research should examine if perceived control may influence uptake in this population. Self-efficacy may have waned over time as a driver of vaccination in the general population. The impact of having a family member at risk for severe outcome from COVID-19 appeared to be partially mediated by attitudes toward vaccination; public health messages that use attitudinal appeals about loved ones may be particularly effective at motivating vaccine uptake.