Health Belief Model, Theory of Planned Behavior, or Psychological Antecedents: What Predicts COVID-19 Vaccine Hesitancy Better Among the Bangladeshi Adults?

Abstract

This study aimed to determine the prevalence and investigate the constellations of psychological determinants of the COVID-19 vaccine hesitancy among the Bangladeshi adult population utilizing the health belief model-HBM (perceived susceptibility to and severity of COVID-19, perceived benefits of and barriers to COVID-19 vaccination, and cues to action), the theory of planned behavior-TPB (attitude toward COVID-19 vaccine, subjective norm, perceived behavioral control, and anticipated regret), and the 5C psychological antecedents (confidence, constraints, complacency, calculation, and collective responsibility). We compared the predictability of these theoretical frameworks to see which framework explains the highest variance in COVID-19 vaccine hesitancy. This study adopted a cross-sectional research design. We collected data from a nationally representative sample of 1,497 respondents through both online and face-to-face interviews. We employed multiple linear regression analysis to assess the predictability of each model of COVID-19 vaccine hesitancy. We found a 41.1% prevalence of COVID-19 vaccine hesitancy among our study respondents. After controlling the effects of socio-economic, demographic, and other COVID-19 related covariates, we found that the TPB has the highest predictive power (adjusted R2 = 0.43), followed by the 5C psychological antecedents of vaccination (adjusted R2 = 0.32) and the HBM (adjusted R2 = 0.31) in terms of explaining total variance in the COVID-19 vaccine hesitancy among the adults of Bangladesh. This study provides evidence that theoretical frameworks like the HBM, the TPB, and the 5C psychological antecedents can be used to explore the psychological determinants of vaccine hesitancy, where the TPB has the highest predictability. Our findings can be used to design targeted interventions to reduce vaccine hesitancy and increase vaccine uptake to prevent COVID-19.

Using Integrative Behavior Model to Predict COVID-19 Vaccination Intention among Health Care Workers in Indonesia: A Nationwide Survey

“…To predict intention to vaccinate against COVID-19, published research generally employed HBM or TPB theories, which are the foundation of IBM constructs [ 6 , 15 , 16 , 17 ]. Thus far, a study utilizing IBM to predict COVID-19 vaccine intention have not yet become available.…”

Vaccine Hesitancy Drives Low Human Papillomavirus Vaccination Coverage in Girls Attending Public Schools in South Africa

“…The 5C model has subsequently become an important tool for measuring the determinants of vaccine hesitancy, and has been used for this purpose on various populations in different countries, including Hong Kong nurses ( 11 ); USA patients ( 12 ); German physicians ( 13 , 14 ); Bangladeshi adults ( 15 ); Swiss university students ( 16 ); and adults in Egypt, United Arab Emirates and Jordan ( 17 ). Although South Africa is yet to validate a tool for measuring the extent and determinants of vaccine hesitancy, there is evidence from South Africa that the 5C tool may be appropriate for investigating HPV vaccine hesitancy in this setting ( 8 ).…”

The coronavirus disease 2019 (COVID-19) vaccination psychological antecedent assessment using the Arabic 5c validated tool: An online survey in 13 Arab countries

“…These antecedents are now being widely used as the framework to assess VH in high-income countries to determine the possible COVID-19 vaccine take up rates [ 26 ]. Many studies had used the 5C scale to assess COVID-19 vaccine psychological antecedants [ 27 – 29 ], however, there is no any studies conducted among arab population using the validated arabic version of the 5C scale.…”