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Accepted for/Published in: JMIR Public Health and Surveillance

Date Submitted: Nov 3, 2021
Date Accepted: Apr 26, 2022

The final, peer-reviewed published version of this preprint can be found here:

Vaccination Intention and Behavior of the General Public in China: Cross-sectional Survey and Moderated Mediation Model Analysis

Yang L, Ji L, Wang Q, Xu Y, Yang G, Cui T, Shi N, Zhu L, Xiu S, Jin H, Zhen S

Vaccination Intention and Behavior of the General Public in China: Cross-sectional Survey and Moderated Mediation Model Analysis

JMIR Public Health Surveill 2022;8(6):e34666

DOI: 10.2196/34666

PMID: 35723904

PMCID: 9253970

The Moderated Mediation Model of Vaccination Intention and Behavior: Evidence from the Theory of Planned Behavior

  • Liuqing Yang; 
  • Lili Ji; 
  • Qiang Wang; 
  • Yan Xu; 
  • Guoping Yang; 
  • Tingting Cui; 
  • Naiyang Shi; 
  • Lin Zhu; 
  • Shixin Xiu; 
  • Hui Jin; 
  • Shiqi Zhen

ABSTRACT

Background:

Background:

Promoting vaccination and eliminating vaccine hesitancy are key measures for controlling vaccine-preventable diseases.

Objective:

Objective:

To understand the beliefs and drivers of vaccination behavior and explore the relationship between each dimension of the theory of planned behavior (TPB), with vaccination intention and practices.

Methods:

Methods:

An online survey was conducted in 34 provinces in mainland China from May 24, 2021 to June 15, 2021, to test the TPB model. This model is influenced by the mediating role of vaccination intention and connects attitudes (ATT) and subjective norms (SNs), with vaccination behavior and the moderating role of perceived behavioral control (PBC), in influencing mediation. Hierarchical regression analysis and structural equation modeling were performed, to test the validity of the TPB theoretical framework.

Results:

Results:

A total of 9924 participants, aged 18-59 years, were included in this study. Vaccination intention plays a mediating role in the relationship between ATT and SN, and vaccination practices. The indirect effect of ATT on vaccination behavior was 0.164 and that of SN was 0.255, and the difference was statistically significant (P < .001). The moderated mediation analysis further indicated that PBC would affect the mediation when used as moderator, ATT * PBC (β = -0.052, P < 0.001) and SN * PBC (β = -0.028, P = .006), respectively.

Conclusions:

Conclusions:

SNs have a stronger influence than ATT on vaccination behavior. PBC, when affecting the entire model as a moderator, would have an alternative relationship with ATT and SN and would inversely inhibit the implementation of vaccination practices.


 Citation

Please cite as:

Yang L, Ji L, Wang Q, Xu Y, Yang G, Cui T, Shi N, Zhu L, Xiu S, Jin H, Zhen S

Vaccination Intention and Behavior of the General Public in China: Cross-sectional Survey and Moderated Mediation Model Analysis

JMIR Public Health Surveill 2022;8(6):e34666

DOI: 10.2196/34666

PMID: 35723904

PMCID: 9253970

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