Theories-based determinants analysis of Hib-combined vaccine hesitancy in China: A multi-group structural equation modeling

Abstract

ABSTRACT Objectives To explore determinants of Hib-combined vaccine hesitancy in Chinese parents, and to provide scientific intervention measures to tackle vaccine hesitancy. Methods 2,531 parents were recruited from local healthcare centers in Zhejiang Province by accidental sampling, and completed the self-developed online questionnaire with voluntary participation. Health Belief Model and Model of Determinants of Vaccine Hesitancy were applied to construct the framework of research. Multi-group Structural Equation Modeling was performed to explore the effects of determinants of vaccine hesitancy across various socio-economic status (SES). Results Hib-combined vaccine hesitancy for total sample was 2.184 ± 0.777 (95%CI: 2.153–2.214), and most of them were in low (n = 1436, 56.7%) level. Low SES group (2.335 ± 0.763, 95%CI: 2.271–2.400) had significantly highest vaccine hesitancy. For total sample, Self-Efficacy and Cues to Action presented −0.517 and −0.437 of standard total effect on Vaccine Hesitancy, respectively. The Multi-group Structural Equation Model with satisfying goodness of fit in SES groups ( = 1616.074, df = 314, /df = 5.147, CFI = 0.973, TLI = 0.966, SRMR = 0.027, RMSEA = 0.041) showed that Cues to Action imposed −0.621 (95%CI: −0.867–0.389, p < .001) of major standard total effect on Vaccine Hesitancy in low SES group, while Self-Efficacy imposed −0.560 (95%CI: −0.668–0.444, p < .001) and −0.685 (95%CI: −0.841–0.454, p < .001) of principal standard total effect on Vaccine Hesitancy in middle and high SES groups, respectively. Conclusions Hib-combined vaccine hesitancy in Chinese parents was low, and the lower the SES, the higher the vaccine hesitancy. Cues to Action and Self-Efficacy played primary role in declining vaccine hesitancy for parents at low SES, and at middle and high SES, respectively.