Predicting COVID-19 Vaccination Intentions to Inform Evidence-Based Messaging for Building Vaccine Confidence Among Rural Americans

• Published in: American journal of health promotion 2024-09, Vol.38 (7), p.1004-1013
• Main Authors: Totzkay, Daniel, Fraustino, Julia Daisy, Smith, Brittany T., Jarrett, Traci, Dino, Geri A., Costello, Lisa M., Kristjansson, Alfgeir L.
• Format: Article
• Language: English
• Subjects: Attitudes; Behavioral sciences; COVID-19; COVID-19 vaccines; Health promotion; Immunization; Negative emotions; Norms; Perceived control; Psychosocial factors; Response rates; Self-efficacy; Social norms; Susceptibility
• ISSN: 0890-1171; 2168-6602; 2168-6602
• DOI: 10.1177/08901171241249281

Purpose Examine possible message topics to promote rural vaccination using psychosocial antecedents of vaccination. Design Cross-sectional survey administered by Research America, Inc. Setting West Virginia (WV). Sample 756 WV adults via convenience sample (n = 370; ∼2% response rate from online panel of ∼20 000 WV residents), and random digit dial of landlines (n = 174; ∼1% response rate from 18 432 numbers) and cellphones (n = 212; ∼1% response rate from 20 486 numbers). Measures Outcome measures included self-reported vaccination intention and behavior. Predictor measures, rooted in theories of social and behavioral science that have been found to be predictive of vaccination outcomes (i.e., Reasoned Action Approach, Extended Parallel Process Model), included perceived severity and susceptibility, negative affect, instrumental and affective attitudes, social norms, self-efficacy, response efficacy, and perceived control. Analysis Multivariate linear regression for intention and logistic regression for behavior. Results Intention was positively predicted by affective attitude, β = .30, P < .05, instrumental attitude, β = .19, P < .05, response efficacy, β = .19, P < .05, negative affect, β = .16, P < .05, self-efficacy, β = .13, P < .05, and subjective norm, β = .13, P < .05, F(10, 267) = 30.12, Adj. R2 = .53. Vaccination status was predicted by instrumental attitude, exp(B) = 2.09, and subjective norm, exp(B) = 2.00, Pseudo R2 = .29, log likelihood = 125.11, χ2(10) = 38.34, P < .05. Promising message targets were instrumental attitude, M = 3.21, SD = 1.46, and subjective norms, M = 3.76, SD = 1.71. Conclusion COVID-19 vaccine confidence messages should address (1) positive feelings and safety perceptions, (2) vaccination’s effectiveness in preventing serious COVID-19, and (3) subjective vaccination norms.