Health Belief Model, Theory of Planned Behavior, or Psychological Antecedents: What Predicts COVID-19 Vaccine Hesitancy Better Among the Bangladeshi Adults?

  1. Mohammad Bellal Hossain
  2. Md. Zakiul Alam
  3. Md. Syful Islam
  4. Shafayat Sultan
  5. Md. Mahir Faysal
  6. Sharmin Rima
  7. Md. Anwer Hossain
  8. Abdullah Al Mamun

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Abstract

This study aimed to determine the prevalence and investigate the constellations of psychological determinants of the COVID-19 vaccine hesitancy among the Bangladeshi adult population utilizing the health belief model-HBM (perceived susceptibility to and severity of COVID-19, perceived benefits of and barriers to COVID-19 vaccination, and cues to action), the theory of planned behavior-TPB (attitude toward COVID-19 vaccine, subjective norm, perceived behavioral control, and anticipated regret), and the 5C psychological antecedents (confidence, constraints, complacency, calculation, and collective responsibility). We compared the predictability of these theoretical frameworks to see which framework explains the highest variance in COVID-19 vaccine hesitancy. This study adopted a cross-sectional research design. We collected data from a nationally representative sample of 1,497 respondents through both online and face-to-face interviews. We employed multiple linear regression analysis to assess the predictability of each model of COVID-19 vaccine hesitancy. We found a 41.1% prevalence of COVID-19 vaccine hesitancy among our study respondents. After controlling the effects of socio-economic, demographic, and other COVID-19 related covariates, we found that the TPB has the highest predictive power (adjusted R 2 = 0.43), followed by the 5C psychological antecedents of vaccination (adjusted R 2 = 0.32) and the HBM (adjusted R 2 = 0.31) in terms of explaining total variance in the COVID-19 vaccine hesitancy among the adults of Bangladesh. This study provides evidence that theoretical frameworks like the HBM, the TPB, and the 5C psychological antecedents can be used to explore the psychological determinants of vaccine hesitancy, where the TPB has the highest predictability. Our findings can be used to design targeted interventions to reduce vaccine hesitancy and increase vaccine uptake to prevent COVID-19.

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  1. Version published to 10.3389/fpubh.2021.711066
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    SciScore for 10.1101/2021.04.19.21255578: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and Limitations of the Study: This study is the first to explore the COVID-19 vaccine hesitancy among Bangladeshi adults, adopting a large and diversified representative sample. Moreover, this study also explored many psychological antecedents of the COVID-19 vaccine hesitancy utilizing three of the most widely used theoretical tools-the HBM, the TPB, and the 5C psychological antecedents, and used multivariate modeling to identify the most salient predictors. Therefore, this study’s findings can help design targeted intervention to reduce the COVID-19 vaccine hesitancy, which will help the Government of Bangladesh attain the target of 80% vaccination coverage for the COVID-19 vaccine. Another strength of the study is that our study provides the findings on the prevalence of the COVID-19 vaccine hesitancy and its predictors while the COVID-19 vaccine was publicly available in Bangladesh. Finally, in terms of theoretical contribution of the study in the field of vaccination behavior, this study contributes evidence from a non-WEIRD country that, at one hand, assess the predictive validity of the novel 5C psychological antecedents of vaccination10 and, on the other hand, validates the theoretical supremacy of the TPB over the HBM and the 5C model in predicting the COVID-19 vaccine hesitancy among the adult population in Bangladesh. However, our study also has some limitations. This study could not use probability sampling completely. We tried to draw our sample followi...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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  3. Version published to 10.1101/2021.04.19.21255578v2 on medRxiv
  4. Version published to 10.1101/2021.04.19.21255578v1 on medRxiv