Deepening Our Understanding of COVID-19 Vaccine Decision-Making amongst Healthcare Workers in Southwest Virginia, USA Using Exploratory and Confirmatory Factor Analysis

Abstract

Vaccine hesitancy amongst healthcare workers (HCWs) has been a major challenge throughout the COVID-19 pandemic. While many studies have identified HCW characteristics and specific attitudes associated with COVID-19 vaccine hesitancy, researchers are still working towards developing a holistic understanding of the psychological constructs that influence COVID-19 vaccine decision-making in this population. Between 15 March and 29 March 2021, we distributed an online survey assessing individual characteristics and vaccine-related perceptions to employees of a not-for-profit healthcare system in Southwest Virginia (N = 2459). We then performed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to describe patterns of vaccine-related thought amongst HCWs and identify latent psychometric constructs involved in vaccine decision-making. The goodness of model fit was assessed using the Tucker–Lewis Index (TLI), the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RMSEA). Internal consistency and reliability of each factor were assessed using Cronbach’s alpha. EFA identified four latent psychometric constructs: Lack of trust in the COVID-19 vaccine; Anti-science sentiment; Adverse side-effects; and Situational risk assessment. The goodness of EFA model fit was adequate (TLI > 0.90, RMSEA ≤ 0.08) with acceptable internal consistency and reliability for three of four factors (Cronbach’s alpha > 0.70). The CFA model also had adequate goodness of fit (CFI > 0.90, RMSEA ≤ 0.08). We believe the psychometric constructs identified in this study can provide a useful framework for interventions to improve vaccine uptake amongst this critical population.

Modelling the Interplay between Responsive Individual Vaccination Decisions and the Spread of SARS-CoV-2

“…4 This is partially due to vaccine hesitancy -a complex phenomenon related to concerns about the safety, efficacy, and necessity of these vaccines. 5,6 Encouraging higher vaccine uptake by addressing vaccine hesitancy is crucial, but the effects of vaccine promotion interventions can be difficult to predict since decisions on whether and when to receive a vaccine dose are influenced by a multitude of factors -including fear of illness, 7 altruism, 7,8 social conformity, 9,10 and information spread via social contacts, news outlets, or social media. 11,12 Mathematical models can compare counterfactual scenarios and represent complex individual-and community-level behaviours, providing insight into the optimal formulation and timing of such interventions.…”