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

Am J Health Promot. 2023 Nov;37(8):1109-1120. doi: 10.1177/08901171231197899. Epub 2023 Aug 23.

Abstract

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) (n1 = 8, α = .97; n2 = 5, α = .93; n3 = 4, α = .84). For SE, two correlated factors were revealed (n1 = 12, α = .96; n2 = 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.

Keywords: COVID-19; decision making; health behaviors; transtheoretical model; vaccination; vaccine confidence.

MeSH terms

  • Adult
  • COVID-19 Vaccines*
  • COVID-19* / prevention & control
  • Cross-Sectional Studies
  • Decision Making
  • Humans
  • Motivation
  • Self Efficacy
  • Surveys and Questionnaires
  • Transtheoretical Model
  • United States
  • Vaccination

Substances

  • COVID-19 Vaccines