Using the Health Belief Model to Predict Vaccination Intention Among COVID-19 Unvaccinated People in Thai Communities

Abstract

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has become one of the biggest challenges to individual health and the public health system worldwide. COVID-19 morbidity and mortality are increasing, impacting almost every country including Thailand. This study used the Health Belief Model (HBM) as a framework to examine the intention of unvaccinated people living in northern Thailand to receive COVID-19 vaccines.MethodsThis cross-sectional study was conducted during October and November 2021. A total of 1,024 participants who are currently living in four northern provinces of Thailand, Chiang Mai, Chiang Rai, Lamphun, and Phayao, were recruited to participate in the study. The questionnaire was developed using an HBM structure to obtain information about the perceived severity, perceived susceptibility, self-efficacy, perceived benefits and barriers, cues to action, and preventive behaviors relating to COVID-19 vaccination and the decision to become vaccinated. Multiple linear regression was used to analyze the data.ResultsThe unvaccinated participants were an average of 44.45 ± 16.63 years of age and more than half were women (54.5%). The COVID-19 preventive behavior score used perceived severity (B = 0.26), self-efficacy (B = 0.51), perceived benefits and barriers (B = 0.11), and cues to action (B = 0.18) after adjusting for age, underlying disease, and body mass index (R2 = 42.5%). The COVID-19 vaccination decision score was positively correlated with perceived severity (B = 0.13), perceived susceptibility (B = 0.25), perceived benefits and barriers (B = 0.21), and cues to action (B = 0.27) after adjusting for underlying disease (R2 = 38.7%).DiscussionThe results demonstrated the usefulness of using the HBM structure to understand individual intention to receive a COVID-19 vaccine. Communities should consider a COVID-19 health campaign and programs that use the HBM model as a framework for altering perceptions and beliefs about the COVID-19 vaccine and improving vaccination rates among unvaccinated people in rural northern Thailand.

Application of behavioral change theory and models on COVID-19 preventive behaviors, worldwide: A systematic review

“…The most typical preventive behaviors such as planning to get vaccinated, accepting vaccinations, wearing a face mask, keeping social distance, washing hands with soap and water, using hand sanitizer, self-quarantining, staying at home, not touching one’s face, and not going to public meetings. In this review, COVID-19 vaccine acceptance was positively correlated with all HBM constructs (perceived susceptibility, perceived severity, perceived barrier, perceived benefit, cues to action, and self-efficacy), 23 , 28 – 32 and constructs were also correlated with behavioral intention to engage in COVID-19 preventive behavior. 24 , 33 – 37 …”

“…The most typical preventive behaviors such as planning to get vaccinated, accepting vaccinations, wearing a face mask, keeping social distance, washing hands with soap and water, using hand sanitizer, self-quarantining, staying at home, not touching one's face, and not going to public meetings. In this review, COVID-19 vaccine acceptance was positively correlated with all HBM constructs (perceived susceptibility, perceived severity, perceived barrier, perceived benefit, cues to action, and self-efficacy), 23,[28][29][30][31][32] and constructs were also correlated with behavioral intention to engage in COVID-19 preventive behavior. 24,[33][34][35][36][37] The application of TPB to COVID-19 preventive behaviors is based on 27 articles included in this systematic review, and the dimensions of TPB (attitude, social norm, and perceived behavioral control) were significantly associated with COVID-19 preventive behaviors.…”

“…According to a review of 38 articles based on HBMs conducted in various nations, acceptability of the COVID-19 vaccine ranges from 37.2% to 77.4% with the highest acceptance recorded in China among pregnant women. 24,[28][29][30][31]33,45,46 This difference might be the use of diverse assessment instruments, and the heterogeneous study participants from various nations with distinct cultures, norms, and beliefs may be the likely causes of the variation in variance explained by HBM components.…”

“…22 Individual level higher scores of COVID-19 fear, knowledge, age, and personal attitudes, at the interpersonal level COVID-19 information sharing, cultural norms and household income, and better evaluation of the national government policies about COVID-19 at the policy level were positively associated with COVID-19 preventive behaviors. [23][24][25][26] Therefore, the purpose of this systematic review was to assess the applicability of behavioral change theory and models on COVID-19 preventive behavior globally.…”

Interrogating Changes in COVID-19 Vaccine Intent During the National Vaccine Rollout in the Philippines

“…Moreover, several studies have shown that the HBM constructs can serve as an important predictor of influenza vaccination uptake (Brewer et al, 2007; Shahrabani, Benzion & Yom Din, 2009; Shahrabani & Benzion, 2010; Tsutsui, Benzion & Shahrabani, 2012; Alsuwailem et al, 2023). During the COVID-19 pandemic, the HBM was used to assess the root causes of COVID-19 vaccine hesitancy in the Asia-Pacific region and beyond (Kabir et al, 2021; Alobaidi, 2021; Huynh et al, 2021; Zilhadia et al, 2022; Jian Ng et al, 2022; Shah et al, 2022; Seangpraw et al, 2022b,a; Limbu, Gautam & Pham, 2022b; Ghazy et al, 2022; Hidayana et al, 2022; Qin et al, 2022; Harutyunyan et al, 2023; Berger et al, 2023; Toledo-López et al, 2023).…”