A psychometric assessment of a novel scale for evaluating vaccination attitudes amidst a major public health crisis

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Abstract

Despite abundant scientific evidence supporting immunization benefits, vaccine hesitancy remains a significant global health concern, particularly during public health crises. Exploring public attitudes towards vaccination is crucial. This study aimed to develop and validate a tailored Public Vaccination Attitudes Scale specifically under the unique circumstances of a public health crisis. A psychometric evaluation was conducted using a cross-sectional study during the peak of a major public health crisis. The scale was developed and its psychometric properties validated using three approaches: (1) generating the item pool through literature research and focus group discussions; (2) assessing the items through expert consultation; and (3) evaluating construct validity, content validity, and internal consistency reliability through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Data from a total of 3921 respondents were randomly divided into two subsets, one for EFA (n = 1935) and the other for CFA (n = 1986). A 22-item draft scale with five factors was created after literature research and focus group discussion. The content validity of this scale ranged between 0.88 and 1.00. EFA showed a 17-item scale with four factors (Cronbach’s α > 0.7) accounting for 68.044% of the total variance. CFA showed that the values of the fit indices, including convergent validity and discriminant validity, were excellent or acceptable. The overall Cronbach’s α was 0.874, and each factor ranged from 0.726 to 0.885. This study introduces a valuable tool for assessing vaccination attitudes during public health crises, aiding researchers, policymakers, and nurses in combating vaccine hesitancy. Emphasizing the importance of fostering vaccine acceptance, it enhances disease control during emergencies, contributing to the knowledge needed for more effective public health strategies and crisis responses

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Is the CVI an acceptable indicator of content validity? Appraisal and recommendations.

Denise Polit, Cheryl Beck, Steven Owen (2007)

Nurse researchers typically provide evidence of content validity for instruments by computing a content validity index (CVI), based on experts' ratings of item relevance. We compared the CVI to alternative indexes and concluded that the widely-used CVI has advantages with regard to ease of computation, understandability, focus on agreement of relevance rather than agreement per se, focus on consensus rather than consistency, and provision of both item and scale information. One weakness is its failure to adjust for chance agreement. We solved this by translating item-level CVIs (I-CVIs) into values of a modified kappa statistic. Our translation suggests that items with an I-CVI of .78 or higher for three or more experts could be considered evidence of good content validity.

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COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries

Julio Solís Arce, Shana Warren, Niccoló F. Meriggi … (2021)

Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs. Survey data collected across ten low-income and middle-income countries (LMICs) in Asia, Africa and South America compared with surveys from Russia and the United States reveal heterogeneity in vaccine confidence in LMICs, with healthcare providers being trusted sources of information, as well as greater levels of vaccine acceptance in these countries than in Russia and the United States.

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A Proactive Approach for Managing COVID-19: The Importance of Understanding the Motivational Roots of Vaccination Hesitancy for SARS-CoV2

Steven W Taylor, Caeleigh Landry, Michelle M. Paluszek … (2020)

Importance Vaccination hesitancy—the reluctance or refusal to be vaccinated—is a leading global health threat (World Health Organization, 2019). It is imperative to identify the prevalence of vaccination hesitancy for SARS-CoV2 in order to understand the scope of the problem and to identify its motivational roots in order to proactively prepare to address the problem when a vaccine eventually becomes available. Objective To identify (1) the prevalence of vaccination hesitancy for a SARS-CoV2 vaccine, (2) the motivational roots of this hesitancy, and (3) the most promising incentives for improving the likelihood of vaccination uptake when a vaccine does become available. Design, Setting, and Participants A cross-sectional sample of 3,674 American and Canadian adults assessed during the COVID-19 pandemic in May 2020. Main Outcomes Measures of vaccination intention (i.e., “If a vaccine for COVID-19 was available, would you get vaccinated?”), attitudes toward vaccines in general and specific to SARS-CoV2 using the Vaccination Attitudes Examination Scale, and incentives for getting vaccinated for those who reported they would not get vaccinated. Results Many American (25%) and Canadian (20%) respondents said that they would not get vaccinated against SARS-CoV2 if a vaccine was available. Non-adherence rates of this magnitude would make it difficult or impossible to achieve herd immunity. Vaccine rejection was most strongly correlated with mistrust of vaccine benefit, and also correlated with worry about unforeseen future effects, concerns about commercial profiteering from pharmaceutical companies, and preferences for natural immunity. When asked about incentives for getting vaccinated, respondents were most likely to report that evidence for rigorous testing and safety of the vaccine were of greatest importance. Conclusions and Relevance Vaccination hesitancy is a major looming problem for COVID-19. To improve vaccine uptake, it is imperative that the vaccine is demonstrated to the public to be rigorously tested and not perceived as rushed or premature in its dissemination.

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Author and article information

Contributors

Fengying Zhang: zhangfengying2020@163.com

Journal

Journal ID (nlm-ta): Sci Rep

Journal ID (iso-abbrev): Sci Rep

Title: Scientific Reports

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2045-2322

Publication date (Electronic): 4 May 2024

Publication date PMC-release: 4 May 2024

Publication date Collection: 2024

Volume: 14

Electronic Location Identifier: 10250

Affiliations

[1 ]GRID grid.263761.7, ISNI 0000 0001 0198 0694, School of Nursing, , Soochow University, ; Suzhou, Jiangsu China

[2 ]West China Hospital/West China School of Nursing, Sichuan University, ( https://ror.org/011ashp19) No.37, Guoxue Alley, Chengdu, 610041 China

[3 ]Law School of Southwest Minzu University, ( https://ror.org/04gaexw88) Chengdu, Sichuan China

[4 ]GRID grid.412901.f, ISNI 0000 0004 1770 1022, Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, , West China Hospital, ; Chengdu, Sichuan China

Article

Publisher ID: 61028

DOI: 10.1038/s41598-024-61028-z

PMC ID: 11069544

PubMed ID: 38704420

SO-VID: ad411def-100e-4bb3-85a3-06901388d21d

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Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 8 November 2023

Date accepted : 30 April 2024

Funding

Funded by: the National Natural Science Foundation of China

Award ID: 71871147

Award Recipient : Fengying Zhang

Funded by: the Science and Technology Department of Sichuan Province Project

Award ID: 2021YJ0013

Award Recipient : Fengying Zhang

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ScienceOpen disciplines: Uncategorized

Keywords: acceptance attitudes,immunization,vaccination attitudes,public health crisis,health care,medical research,risk factors

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ScienceOpen disciplines: Uncategorized

Keywords: acceptance attitudes, immunization, vaccination attitudes, public health crisis, health care, medical research, risk factors

A psychometric assessment of a novel scale for evaluating vaccination attitudes amidst a major public health crisis

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Abstract

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Cardiovascular Innovations and Applications

Most cited references 41

Is the CVI an acceptable indicator of content validity? Appraisal and recommendations.

COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries

A Proactive Approach for Managing COVID-19: The Importance of Understanding the Motivational Roots of Vaccination Hesitancy for SARS-CoV2

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