Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination

Abstract

BackgroundMonitoring the reasons why a considerable number of people do not receive recommended vaccinations allows identification of important trends over time, and designing and evaluating strategies to address vaccine hesitancy and increase vaccine uptake. Existing validated measures assessing vaccine hesitancy focus primarily on confidence in vaccines and the system that delivers them. However, empirical and theoretical work has stated that complacency (not perceiving diseases as high risk), constraints (structural and psychological barriers), calculation (engagement in extensive information searching), and aspects pertaining to collective responsibility (willingness to protect others) also play a role in explaining vaccination behavior. The objective was therefore to develop a validated measure of these 5C psychological antecedents of vaccination. Methods and FindingsThree cross-sectional studies were conducted. Study 1 uses factor analysis to develop an initial scale and assesses the sub-scales’ convergent, discriminant, and concurrent validity (N = 1,445, two German convenience-samples). In Study 2, a sample representative regarding age and gender for the German population (N = 1,003) completed the measure for vaccination in general and for specific vaccinations to assess the potential need for a vaccine-specific wording of items. Study 3 compared the novel scale’s performance with six existing measures of vaccine hesitancy (N = 350, US convenience-sample). As an outcome, a long (15-item) and short (5-item) 5C scale were developed as reliable and valid indicators of confidence, complacency, constraints, calculation, and collective responsibility. The 5C sub-scales correlated with relevant psychological concepts, such as attitude (confidence), perceived personal health status and invulnerability (complacency), self-control (constraints), preference for deliberation (calculation), and communal orientation (collective responsibility), among others. The new scale provided similar results when formulated in a general vs. vaccine-specific way (Study 2). In a comparison of seven measures the 5C scale was constantly among the scales that explained the highest amounts of variance in analyses predicting single vaccinations (between 20% and 40%; Study 3). The present studies are limited to the concurrent validity of the scales. ConclusionsThe 5C scale provides a novel tool to monitor psychological antecedents of vaccination and facilitates diagnosis, intervention design and evaluation. Its short version is suitable for field settings and regular global monitoring of relevant antecedents of vaccination.

Knowledge, Attitudes, Practices (KAP) of Italian Occupational Physicians towards Tick Borne Encephalitis

“…Again, we cannot rule out that some of the items assessed through the knowledge test may be affected by a significant social desirability bias, with participants reporting the “socially appropriated” rather than their authentic behaviors, so that our results could have ultimately overstated the share of occupational physicians having an effective understanding of TBE associated issues [ 14 , 44 , 45 ].…”

The role of health determinants in the influenza vaccination uptake among older adults (65+): a scope review

“…This framework has become known as the 5C model, which builds on and extends the previous general (e.g., health belief model [62]) and vaccine-speci c (e.g., 3C model [60]; 5A model [63]) health models/theories. It provides a novel tool to monitor the psychological antecedents of vaccination and facilitates diagnosis, intervention design, and evaluation [64]. Given the gaps detected in our scope review for comprehensive interventions to overcome VH for seasonal in uenza, it becomes clear there is an urgent need to implement these models and evaluate their success on a public health level also with other citizens.…”

Individual preferences for voluntary vs. mandatory vaccination policies: an experimental analysis

“…Note, however, that the I-Vax game models the incentives of real-world vaccination decisions 21 and that its external validity has been established in previous research, for example, by showing a positive correlation between the participants' general vaccination attitude and their vaccine uptake in the vaccination game. 21,25,26,33 Additionally, several factors that have been shown to affect individual vaccination behaviour, such as time constraints, 34 PREFERENCES FOR VACCINATION POLICIES 14 moral values, 35,36 and others, 37 have not been explicitly considered in this research. Such attitudes and opinions may have an additional impact or interact with the effects obtained in the present study.…”