Theory of Planned Behavior Constructs for Covid-19 Booster Dose Vaccination Among Malaysian Adults’ Population: An Exploratory Analysis
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Abstract
Introduction: The Theory of Planned Behavior (TPB) construct is recommended by the World Health Organization to assess intention for vaccination; however, there is yet a validated instrument in the context of booster dose Covid-19 vaccination in Malaysia. The purpose of the present study is to translate and investigate the factorial validity and internal reliability of the TPB construct for booster dose Covid-19 vaccination (TPB-BDV) questionnaire in Malaysia. Materials and methods: In the pre-testing of the study, five experts and 40 Malaysian adults respectively rated the content and validity index of all 11 items of the translated questionnaire in Malay version. Next, 160 Malaysian adults completed the Malay version of Theory of Planned Behavior- Booster Dose Vaccination (TPB-BDV) questionnaire via online. Results: In the pre-testing phase, Content Validity and Face Validity Index for 10 items in Malay version of TPB-BDV achieved cutoff mean score >3.0 for relevancy, clarity, ambiguity, and simplicity. Meanwhile, Item 8 scored low on relevancy. In the main study, exploratory factor analysis suggested three factors consisting of a final 10 items (without Item 8) which accounted for 74.0% of the total variance. The three factors were Attitude (5 items), Subjective Norms (3 items), and Perceived Behavioral Control (2 items). The internal reliability ranged from a = 0.83 to a = 0.93, with an overall value of a = 0.90. Conclusion: The findings suggest that the 10-items Malay version of TPB-BDV is valid and reliable to measure the individual decision in taking the Covid-19 booster-dose vaccine among Malaysian adult population.
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World Health Organization. “Coronavirus disease (Covid-19) pandemic.” https://www.who.int/europe/emergencies/situations/Covid-19. Accessed Jan 28, 2023.
Murphy J, Vallières F, Bentall RP, et al. Psychological characteristics associated with Covid-19 vaccine hesitancy and resistance in Ireland and the United Kingdom. Nature Communications. 2021; 12:29. doi: 10.1038/s41467-020-20226-9
Assistant Secretary for Public Affairs (ASPA). “Covid-19 vaccines” HHS.gov. https://www.hhs.gov/coronavirus/Covid-19-vaccines/index.html. Accessed May 20, 2023.
Ministry of Health Malaysia. “Latest Malaysia Covid-19 vaccination policy.” https://mysejahtera.moh.gov.my/en/Covid-19/latest-malaysia-Covid-19-vaccination-policy. Accessed May 28, 2023.
Ministry of Communications and Digital. “Ensure public transport users are fully vaxxed, operators told.” https://www.kkd.gov.my/en/public/news/20434-ensure-public-transport-users-are-fully-vaxxed-operators-told. Accessed Jan 20, 2023.
Ministry of Health Malaysia. “Covid-19 Malaysia updates.” https://Covid-19.moh.gov.my/vaksin-Covid-19/pick-dos-penggalak. Accessed May 28, 2023.
Ministry of Health Malaysia. “Second Covid-19 Booster Dose available to all above 60 years and for high-risk adults and adolescents.” https://Covid-19.moh.gov.my/vaksin-Covid-19/pick-dos-penggalak/semasa/2022/05/dos-penggalak-Covid-19-kedua-untuk-semua-individu-berumur-60-tahun-ke-atas-dan-sewasa-serta-remaja-berisiko-tinggi. Accessed Jan 20, 2023.
Ministry of Health Malaysia. “Vaccinations in Malaysia.” https://Covidnow.moh.gov.my/vaccinations. Accessed May 20, 2023.
Abdelmoneim SA, Sallam M, Hafez DM, et al. Covid-19 vaccine booster dose acceptance: Systematic review and meta-analysis. Tropical Medicine and Infectious Disease. 2022;7(10):298. doi: 10.3390/tropicalmed7100298 https://doi.org/10.3390/tropicalmed7100298
Wong LP, Alias H, Siaw YL, Muslimin M, Lai LL, Lin Y, Hu Z. Intention to receive a Covid-19 vaccine booster dose and associated factors in Malaysia. Human Vaccines & Immunotherapeutics. 2022;18(5):2078634. doi: 10.1080/21645515.2022.2078634
Betsch C, Schmid P, Heinemeier D, Korn L, Holtmann C, Böhm R. Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination. PLOS ONE. 2018;13(12):e0208601. doi: 10.1371/journal.pone.0208601
Schmid P, Rauber D, Betsch C, Lidolt G, Denker ML. Barriers of influenza vaccination intention and behavior–a systematic review of influenza vaccine hesitancy, 2005–2016. PLOS ONE. 2017;12(1):e0170550. doi: 10.1371/journal.pone.0170550
Ajzen I. Attitudes, personality, and behavior. Berkshire, UK: McGraw-Hill Education; 2005.
Juraskova I, O’Brien M, Mullan B, Bari R, Laidsaar-Powell R, McCaffery K. HPV vaccination and the effect of information framing on intentions and behavior: An application of the theory of planned behavior and moral norm. International Journal of Behavioral Medicine. 2012; 19:518-25. doi: 10.1007/s12529-011-9182-5
Nie H, Vasseur V, Fan Y, Xu J. Exploring reasons behind careful-use, energy-saving behaviors in residential sector based on the theory of planned behavior: Evidence from Changchun, China. Journal of Cleaner Production. 2019; 230:29-37. doi: 10.1016/j.jclepro.2019.05.101
Chiu YL, Chou YC, Chang YW, Chu CM, Lin FG, Lai CH, Hwang SL, Fang WH, Kao S. Using an extended theory of planned behavior to predict smoking cessation counselors’ intentions to offer smoking cessation support in the Taiwanese military: a cross-sectional study. BMJ open. 2019;9(5): e026203. doi: 10.5061/dryad.798d8m6
Der AD, Anaman-Torgbor JA, Charles-Unadike VO, Tarkang EE. Predictors of intention to use modern contraceptives among female senior secondary school students in the Kpando Municipality, Ghana. African Health Sciences. 2021;21(3):1375-84. doi: 10.4314/ahs.v21i3.49
Breslin G, Dempster M, Berry E, Cavanagh M, Armstrong NC. Covid-19 vaccine uptake and hesitancy survey in Northern Ireland and Republic of Ireland: Applying the theory of planned behavior. PLOS ONE. 2021;16(11): e0259381. doi: 10.1371/journal.pone.0259381
Wong MC, Wong EL, Huang J, Cheung AW, Law K, Chong MK, Ng RW, Lai CK, Boon SS, Lau JT, Chen Z. Acceptance of the Covid-19 vaccine based on the health belief model: A population-based survey in Hong Kong. Vaccine. 2021;39(7):1148-56. doi: 10.1016/j.vaccine.2020.12.083
Kyaw TM, Kurrummiah B, Varathappan N, et al. Factors influencing the acceptance of Covid-19 booster dose in Malaysia. Journal of Education and Community Health. 2022;9(2):69-79. doi: 10.34172/jech.2022.11
Yusoff MSB, Arifin WN, Hadie SNH. ABC of Questionnaire Development and Validation for Survey Research. Education in Medicine Journal. 2021 Mar 31;13(1):97–108. DOI: https://doi.org/10.21315/eimj2021.13.1.10
Sapnas KG, Zeller RA. Minimizing sample size when using exploratory factor analysis for measurement. Journal of nursing measurement. 2002 Sep 1;10(2):135-54. DOI: https://doi.org/10.1891/jnum.10.2.135.52552
Yaghmaie F. Content validity and its estimation. Journal of Medical Education. 2003;3(1): e105015. doi: 10.22037/jme.v3i1.870
Kaiser HF. A second-generation little jiffy. Psychometrika. 1970; 35(4): 401-415. doi: 10.1007/BF02291817
Bartlett MS. Tests of significance in factor analysis. British Journal of Psychology. 1950; 3:77–85. DOI: https://doi.org/10.1111/j.2044-8317.1950.tb00285.x
Tabachnick BG, Fidell LS. Using multivariate statistics (5th ed). New York, NY: Allyn and Bacon; 2007.
Hair JF, Black WC, Babin BJ, Anderson RE, Tatham RL. Multivariate data analysis (6th ed.). Upper Saddle River, NJ: Pearson Prentice Hall; 2006.
Leach M, Hennessy M, Fishbein M. Perception of easy–difficult: Attitude or self-efficacy? Journal of Applied Social Psychology. 2001;31(1):1-20. doi: 10.1111/j.1559-1816.2001.tb02478.x
Shi J, Hye Kyung Kim, Salmon CT, Tandoc EC, Zhang Hao Goh. Cultural tightness–looseness and normative social influence in eight Asian countries: Associations of individual and collective norms with vaccination intentions. Social Science & Medicine. 2024 Jan 1; 340:116431–1. DOI: https://doi.org/10.1016/j.socscimed.2023.116431