April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: "The Influence of Information Environments and Behavioral Beliefs on Continued COVID-19 Vaccination Among U.S. Young Adults: A Longitudinal Study Informed by Participatory Research"
Background: Innovative approaches are needed to examine today’s complex information environment and its influence on youth health. In particular, exposure to COVID-19 vaccine information and misinformation across expert and non-expert sources may uniquely impact young adults, who are active media users[1] and vaccinated at lower rates[2]. Trusted sources may support or discourage vaccination, and their effects may depend on behavioral beliefs[3]. Understanding how these interacting influences impact young adults can inform vaccine communication with this population.
Youth offer valuable expertise on information sources and beliefs in their peer communities[4]. Yet, no prior study has integrated youth participatory action research (YPAR)—a framework that elevates youth as collaborators throughout the research process[5]—with established survey development practices to capture these constructs and measure their effects. To fill this gap, the current longitudinal survey study includes novel measures of young adult vaccine information environments (“EVT”) and behavior-specific beliefs, derived from YPAR and standard elicitation research. Based on the reasoned action approach (RAA)[6] and prior work[3], it was hypothesized (https://aspredicted.org/FWC_F61) that baseline vaccine behavioral beliefs (H1) and EVT (H2) would each predict follow up COVID-19 bivalent booster uptake, and that EVT effects would be lower among those with strong behavioral beliefs (H3).
Methods: Survey measures were developed in two formative research phases. First, in a university-assisted YPAR program in Philadelphia, twelve diverse youth (15-22 years; eight co-authors here) generated lists of potential peer COVID-19 vaccination beliefs and information sources. This process also informed a local survey and youth-created campaign messages. Second, an online elicitation questionnaire, administered to a national sample of young adults (18-22 years; n=38), gathered additional belief and source items.
A final online survey was administered to U.S. young adults (18-22 years) in Nov/Dec 2022 (T1; n=1094) and 12 weeks later in Feb/Mar 2023 (T2; n=762). To capture information environments, each respondent was assigned an EVT score—the mean product of exposure to, valence of, and trust in each of twelve vaccine information sources identified in formative research (α=0.83). A behavioral belief scale averaged agreement with the 19 belief items identified in formative research (α=0.93). Analyses included respondents eligible for the bivalent booster between T1 and T2 (n=584). Using binary logistic regressions, T2 booster uptake was regressed on T1 behavioral beliefs, T1 EVT, and the interaction.
Results: Supporting main effects hypotheses, T1 behavioral beliefs (H1) and EVT (H2) significantly predicted T2 booster uptake (behavioral beliefs OR=3.10, 95% CI=1.95, 4.94; EVT OR=1.34, 95% CI=1.18,1.52). The interaction between behavioral beliefs and EVT was in the hypothesized direction (H3), but not statistically significant (OR=0.86; CI=0.64,1.15; p=.20).
Conclusion: This study advances the vaccine communication literature by applying participatory approaches to developing comprehensive, youth-specific, and timely measures of communication variables and examining these variables’ effects on behavior overtime. We illustrate how YPAR can inform both local and population-level research. Youth contributed to novel measures of EVT and behavioral beliefs; both predicted booster uptake. Despite competing information sources, strengthening youth confidence in vaccine benefits and safety through trusted channels is likely to encourage continued vaccination in this age group.
Youth offer valuable expertise on information sources and beliefs in their peer communities[4]. Yet, no prior study has integrated youth participatory action research (YPAR)—a framework that elevates youth as collaborators throughout the research process[5]—with established survey development practices to capture these constructs and measure their effects. To fill this gap, the current longitudinal survey study includes novel measures of young adult vaccine information environments (“EVT”) and behavior-specific beliefs, derived from YPAR and standard elicitation research. Based on the reasoned action approach (RAA)[6] and prior work[3], it was hypothesized (https://aspredicted.org/FWC_F61) that baseline vaccine behavioral beliefs (H1) and EVT (H2) would each predict follow up COVID-19 bivalent booster uptake, and that EVT effects would be lower among those with strong behavioral beliefs (H3).
Methods: Survey measures were developed in two formative research phases. First, in a university-assisted YPAR program in Philadelphia, twelve diverse youth (15-22 years; eight co-authors here) generated lists of potential peer COVID-19 vaccination beliefs and information sources. This process also informed a local survey and youth-created campaign messages. Second, an online elicitation questionnaire, administered to a national sample of young adults (18-22 years; n=38), gathered additional belief and source items.
A final online survey was administered to U.S. young adults (18-22 years) in Nov/Dec 2022 (T1; n=1094) and 12 weeks later in Feb/Mar 2023 (T2; n=762). To capture information environments, each respondent was assigned an EVT score—the mean product of exposure to, valence of, and trust in each of twelve vaccine information sources identified in formative research (α=0.83). A behavioral belief scale averaged agreement with the 19 belief items identified in formative research (α=0.93). Analyses included respondents eligible for the bivalent booster between T1 and T2 (n=584). Using binary logistic regressions, T2 booster uptake was regressed on T1 behavioral beliefs, T1 EVT, and the interaction.
Results: Supporting main effects hypotheses, T1 behavioral beliefs (H1) and EVT (H2) significantly predicted T2 booster uptake (behavioral beliefs OR=3.10, 95% CI=1.95, 4.94; EVT OR=1.34, 95% CI=1.18,1.52). The interaction between behavioral beliefs and EVT was in the hypothesized direction (H3), but not statistically significant (OR=0.86; CI=0.64,1.15; p=.20).
Conclusion: This study advances the vaccine communication literature by applying participatory approaches to developing comprehensive, youth-specific, and timely measures of communication variables and examining these variables’ effects on behavior overtime. We illustrate how YPAR can inform both local and population-level research. Youth contributed to novel measures of EVT and behavioral beliefs; both predicted booster uptake. Despite competing information sources, strengthening youth confidence in vaccine benefits and safety through trusted channels is likely to encourage continued vaccination in this age group.