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Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination.
PLoS One. 2018; 13(12):e0208601.Plos

Abstract

BACKGROUND

Monitoring 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 FINDINGS

Three 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 sub-scales 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 3). The present studies are limited to the concurrent validity of the scales.

CONCLUSIONS

The 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.

Links

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Authors+Show Affiliations

Betsch C
CEREB - Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany. Media and Communication Science, University of Erfurt, Erfurt, Germany.
Schmid P
CEREB - Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany. Media and Communication Science, University of Erfurt, Erfurt, Germany.
Heinemeier D
CEREB - Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany. Media and Communication Science, University of Erfurt, Erfurt, Germany.
Korn L
CEREB - Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany. Media and Communication Science, University of Erfurt, Erfurt, Germany.
Holtmann C
CEREB - Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany.
Böhm R
School of Business and Economics, RWTH Aachen University, Aachen, Germany.

MeSH

Cross-Sectional StudiesHealth Knowledge, Attitudes, PracticeHumansPatient Acceptance of Health CareRisk AssessmentVaccination

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30532274

Citation

Betsch, Cornelia, et al. "Beyond Confidence: Development of a Measure Assessing the 5C Psychological Antecedents of Vaccination." PloS One, vol. 13, no. 12, 2018, pp. e0208601.
Betsch C, Schmid P, Heinemeier D, et al. Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination. PLoS One. 2018;13(12):e0208601.
Betsch, C., Schmid, P., Heinemeier, D., Korn, L., Holtmann, C., & Böhm, R. (2018). Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination. PloS One, 13(12), e0208601. https://doi.org/10.1371/journal.pone.0208601
Betsch C, et al. Beyond Confidence: Development of a Measure Assessing the 5C Psychological Antecedents of Vaccination. PLoS One. 2018;13(12):e0208601. PubMed PMID: 30532274.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination. AU - Betsch,Cornelia, AU - Schmid,Philipp, AU - Heinemeier,Dorothee, AU - Korn,Lars, AU - Holtmann,Cindy, AU - Böhm,Robert, Y1 - 2018/12/07/ PY - 2018/08/16/received PY - 2018/11/20/accepted PY - 2018/12/12/entrez PY - 2018/12/12/pubmed PY - 2019/5/6/medline SP - e0208601 EP - e0208601 JF - PloS one JO - PLoS One VL - 13 IS - 12 N2 - BACKGROUND: Monitoring 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 FINDINGS: Three 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 sub-scales 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 3). The present studies are limited to the concurrent validity of the scales. CONCLUSIONS: The 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. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/30532274/Beyond_confidence:_Development_of_a_measure_assessing_the_5C_psychological_antecedents_of_vaccination_ DB - PRIME DP - Unbound Medicine ER -