Measuring Motivation for COVID-19 Vaccination: An Application of the Transtheoretical Model

• Published in: American journal of health promotion Vol. 37; no. 8; pp. 1109 - 1120
• Main Authors: Sacco, Allegra, Robbins, Mark L., Paiva, Andrea L., Monahan, Kathleen, Lindsey, Hayley, Reyes, Cheyenne, Rusnock, Andrea
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-11-2023; American Journal of Health Promotion
• Subjects: Barriers; Change agents; Confirmatory factor analysis; COVID-19; COVID-19 vaccines; Exploratory factor analysis; Health promotion; Immunization; Matrices; Measurement; Motivation; Mythology; Principal components analysis; Self-efficacy; Transtheoretical model; United States > US; COVID-19; vaccine confidence; transtheoretical model; health behaviors; decision making; vaccination
• ISSN: 0890-1171; 2168-6602
• DOI: 10.1177/08901171231197899

Purpose
In the United States (US), individuals vary widely in their readiness to get vaccinated for COVID-19. The present study developed measures based on the transtheoretical model (TTM) to better understand readiness, decisional balance (DCBL; pros and cons), self-efficacy (SE), as well as other motivators for change such as myths and barriers for COVID-19 vaccination.
Design
Cross-sectional measurement development.
Setting
Online survey.
Sample
528 US adults ages 18-75.
Measures
Demographics, stage of change (SOC), DCBL, SE, myths, and barriers.
Analysis
The sample was randomly split into halves for exploratory factor analysis using principal components analysis (EFA/PCA), followed by confirmatory factor analyses (CFA) to test measurement models. Correlation matrices were assessed and multivariate analyses examined relationships between constructs and sub-constructs.
Results
For DCBL, EFA/PCA revealed three correlated factors (one pros, two cons) (n
1
= 8, α = .97; n
2
= 5, α = .93; n
3
= 4, α = .84). For SE, two correlated factors were revealed (n
1
= 12, α = .96; n
2
= 3, α = .89). Single-factor solutions for Myths (n = 13, α = .94) and Barriers (n = 6, α = .82) were revealed. CFA confirmed models from EFAs/PCAs. Follow-up analyses of variance aligned with past theoretical predictions of the relationships between SOC, pros, cons, and SE, and the predicted relationships with myths and barriers.
Conclusion
This study produced reliable and valid measures of TTM constructs, myths, and barriers to understand motivation to receive COVID-19 vaccination that can be used in future research.