Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 22, 2021
Date Accepted: Apr 29, 2021
Date Submitted to PubMed: May 3, 2021
Understanding Behavioral Intentions Toward COVID-19 Vaccines: A Theory-based Content Analysis of Tweets
ABSTRACT
Background:
Acceptance rates of COVID-19 vaccines still have not reached the threshold for herd immunity. Understanding why some people are willing to be vaccinated and others are not is a critical step to develop efficient implementation strategies to promote COVID-19 vaccines.
Objective:
We conducted a theory-based content analysis based on the Capability, Opportunity, Motivation-Behavior (COM-B) Model to characterize the factors influencing behavioral intentions for COVID-19 vaccines mentioned on the Twitter platform.
Methods:
We collected English tweets posted from 2020.11.01 to 2020.11.22, using the combination of relevant keywords and hashtags. After excluding retweets, we randomly selected 5,000 tweets for manual coding and content analysis. We performed a content analysis informed by the adapted COM-B model.
Results:
Of the 5,000 COVID-19 vaccine-related tweets were coded, these tweets were posted by 4,796 unique users. 97 tweets carried positive behavioral intent, while 182 tweets contained negative behavioral intent. Of these, 28 tweets were mapped with capability factors; 155 tweets were related to motivation; 23 tweets were related to opportunities, and 74 tweets did not contain any useful information about reasons of their behavioral intentions (kappa 0.73). Some tweets mentioned two or more constructs at the same time. Tweets that mentioned capability (p<0.001), motivation (P<0.001), and opportunity (P=0.033) are more likely to have negative behavioral intentions.
Conclusions:
Most behavioral intentions regarding COVID-19 vaccines were related to the motivation construct. The themes identified in this study could be used to inform theory-based and evidence-based interventions to improve acceptance of COVID-19 vaccines.
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