JMIR Publications

ABSTRACT

Background:

Background:

The COVID-19 pandemic prompted the launch of the ANONYMIZED national campaign to boost vaccine confidence and uptake among adults, as vaccines are key to preventing severe illness and death.

Objective:

Past segmentation research relevant to COVID-19 behavior has found important differences in attitudes, sociodemographics, and subsequent COVID-19 prevention behaviors across population segments. This study extends prior work by incorporating a more comprehensive set of attitudes, behaviors, and sociodemographic variables to identify population segments by differing levels of COVID-19 vaccine confidence and evaluate differences in their subsequent uptake of COVID-19 prevention behaviors.

Methods:

Data were obtained from five waves of a longitudinal, probability-based panel of U.S. adults (N = 4,398). Latent class cluster analysis estimated segments of respondents based on over 40 COVID-19 attitudes, beliefs, behaviors, and sociodemographics as reported in Wave 1. Survey-weighted cross-tabulations and bivariate regression analyses assessed differences in COVID-19 vaccine uptake, booster uptake, mask use, and social distancing in all segments across all five survey waves.

Results:

Six segments (Hardline Non-Intenders, Prevention-Compliant Non-Intenders, Burned-Out Waiters, Anxious Waiters, Skeptical Confidents, Ready Confidents) were identified that differed by their COVID-19 vaccine confidence, prevention-related attitudes and behaviors, and sociodemographics. Cross-tabulations and regression results indicated significant segment membership differences in COVID-19 vaccine and booster timing, mask use, and social distancing. Results from survey-weighted cross-tabulations comparing COVID-19 vaccine and booster uptake across segments indicate statistically significant differences in these outcomes across the six segments (P < .001). Results were statistically significant for each segment (P < .01 for booster uptake among Burned-Out Waiters; P < .001 for all other coefficients), indicating that, on average, respondents in segments with lower intentions to vaccinate reported later receipt of COVID-19 vaccines and boosters relative to the timing of vaccine and booster uptake among Ready Confidents.

Conclusions:

Results extend previous research by showing that initial beliefs and behaviors relevant to COVID-19 vaccination, mask use, and social distancing are important for understanding differences in subsequent compliance with recommended COVID-19 prevention measures. Results highlight the utility of a comprehensive list of attitudes, behaviors, and other individual-level characteristics that can serve as a basis for future segmentation efforts relevant to COVID-19 and other infectious diseases.