Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination
Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination
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DOI：
10.1371/journal.pone.0208601
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发表时间：
2018-12-07
期刊：
影响因子：
3.7
通讯作者：
Boehm, Robert
中科院分区：
文献类型：
--
作者：
Betsch, Cornelia;Schmid, Philipp;Boehm, Robert
背景监测相当数量的人没有接受推荐疫苗接种的原因可以识别随着时间的推移而出现的重要趋势，并设计和评估应对疫苗迟疑和增加疫苗接种率的策略。评估疫苗犹豫不决的现有有效措施主要集中在对疫苗和提供疫苗的系统的信心上。然而，经验和理论工作表明，自满(不认为疾病是高风险的)、限制(结构和心理障碍)、计算(参与广泛的信息搜索)以及与集体责任有关的方面(保护他人的意愿)也在解释疫苗接种行为方面发挥作用。因此，我们的目标是开发一个有效的测量这些5C心理接种疫苗的先行因素。方法和发现三个横断面研究。研究一采用因子分析的方法编制了初量表，并评估了各分量表的收敛效度、判别效度和同时效度(N=1,445，两个德国便利样本)。在研究2中，德国人口(N=1,003)的年龄和性别抽样代表完成了一般疫苗接种和特定疫苗接种的措施，以评估是否有可能需要一个针对疫苗具体项目的措辞。研究3将新量表的性能与现有的六种疫苗迟疑指标(N=350，美国方便样本)进行了比较。作为结果，编制了长(15个条目)和短(5个条目)5C量表，作为信心、自满、约束、计算和集体责任的可靠和有效指标。5C子量表与相关心理概念相关，如态度(自信)、感知的个人健康状况和坚不可摧(自满)、自我控制(约束)、倾向于深思熟虑(计算)和公共取向(集体责任)等。新的量表在以一般方式与疫苗特定方式制定时提供了类似的结果(研究2)。在七项指标的比较中，5C量表始终是解释单次疫苗接种预测分析中最大方差的量表之一(研究2)。结论5C量表为监测预防接种的心理因素提供了一种新的工具，有助于诊断、干预设计和评估。其简短版本适用于现场环境和对相关疫苗接种前兆的定期全球监测。
BackgroundMonitoring the reasons why a considerable number of people do not receive recommended vaccinations allows identification of important trends over time, and designing and evaluating strategies to address vaccine hesitancy and increase vaccine uptake. Existing validated measures assessing vaccine hesitancy focus primarily on confidence in vaccines and the system that delivers them. However, empirical and theoretical work has stated that complacency (not perceiving diseases as high risk), constraints (structural and psychological barriers), calculation (engagement in extensive information searching), and aspects pertaining to collective responsibility (willingness to protect others) also play a role in explaining vaccination behavior. The objective was therefore to develop a validated measure of these 5C psychological antecedents of vaccination.Methods and findingsThree cross-sectional studies were conducted. Study 1 uses factor analysis to develop an initial scale and assesses the sub-scales' convergent, discriminant, and concurrent validity (N = 1,445, two German convenience-samples). In Study 2, a sample representative regarding age and gender for the German population (N = 1,003) completed the measure for vaccination in general and for specific vaccinations to assess the potential need for a vaccine-specific wording of items. Study 3 compared the novel scale's performance with six existing measures of vaccine hesitancy (N= 350, US convenience-sample). As an outcome, a long (15-item) and short (5-item) 5C scale were developed as reliable and valid indicators of confidence, complacency, constraints, calculation, and collective responsibility. The 5C subscales correlated with relevant psychological concepts, such as attitude (confidence), perceived personal health status and invulnerability (complacency), self-control (constraints), preference for deliberation (calculation), and communal orientation (collective responsibility), among others. The new scale provided similar results when formulated in a general vs. vaccine-specific way (study 2). In a comparison of seven measures the 5C scale was constantly among the scales that explained the highest amounts of variance in analyses predicting single vaccinations (between 20% and 40%; study 2). The present studies are limited to the concurrent validity of the scales.ConclusionsThe 5C scale provides a novel tool to monitor psychological antecedents of vaccination and facilitates diagnosis, intervention design and evaluation. Its short version is suitable for field settings and regular global monitoring of relevant antecedents of vaccination.