Vaccine · 2025
Psychometric validation of the COVID-19 vaccine hesitancy scale for primary and booster doses among university students: A cross-sectional study.
СтатьяВалидационное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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AlShurman Bara' Abdallah, Majowicz Shannon E, Grindrod Kelly, Goh Joslin, Butt Zahid Ahmad
Аннотация
BACKGROUND: Vaccine hesitancy (VH) continues to impede COVID-19 vaccine coverage. Booster dose uptake lags behind primary dose uptake, especially among younger adults. Unlike most studies that focus on initial stages of VH, the aim of this study was to validate the COVID-19 Vaccine Hesitancy Scale (CVHS) for both primary and booster doses among University of Waterloo (UW) students.
METHODS: An online survey was conducted among UW students in Ontario, Canada, between March and May 2024. The CVHS items were adapted for primary and booster doses. Exploratory (EFA) and confirmatory factor analyses (CFA) assessed the factor structure and model fit. Reliability was evaluated using Cronbach's alpha and composite reliability (CR). Convergent and discriminant validity were assessed through average variance extracted (AVE). Significant differences between primary and booster dose hesitancy were determined via 95 % Confidence Interval.
RESULTS: A total of 4453 students participated. Respondents were predominantly female (57.2 %), aged 18-22 years (84.0 %), and undergraduates (94.8 %). EFA and CFA confirmed a three-factor structure for both primary and booster dose scales. Both scales had high reliability (Cronbach's alpha >0.60, CR >0.7). CFA results indicated a good model fit (Comparative Fit Index = 0.94; Root Mean Square Error of Approximation = 0.07), and demonstrated adequate convergent, discriminant, and criterion validity. Known-group validity was supported by significant differences in VH scores across gender and academic level, with men and undergraduate students reporting higher hesitancy than women and graduate students (p < 0.001). VH was higher for booster doses (33.4 %) than primary doses (19.3 %) with more students delaying (32.1 %) or refusing boosters (29.3 %) than delaying (11.5 %) or refusing (6.2 %) primary doses.
CONCLUSION: Our adapted scales performed well psychometrically to measure VH across different COVID-19 vaccine phases. These scales can help in identifying key barriers of VH to understand shifting trajectories over time, thereby informing targeted interventions to promote vaccination uptake among younger adults.
METHODS: An online survey was conducted among UW students in Ontario, Canada, between March and May 2024. The CVHS items were adapted for primary and booster doses. Exploratory (EFA) and confirmatory factor analyses (CFA) assessed the factor structure and model fit. Reliability was evaluated using Cronbach's alpha and composite reliability (CR). Convergent and discriminant validity were assessed through average variance extracted (AVE). Significant differences between primary and booster dose hesitancy were determined via 95 % Confidence Interval.
RESULTS: A total of 4453 students participated. Respondents were predominantly female (57.2 %), aged 18-22 years (84.0 %), and undergraduates (94.8 %). EFA and CFA confirmed a three-factor structure for both primary and booster dose scales. Both scales had high reliability (Cronbach's alpha >0.60, CR >0.7). CFA results indicated a good model fit (Comparative Fit Index = 0.94; Root Mean Square Error of Approximation = 0.07), and demonstrated adequate convergent, discriminant, and criterion validity. Known-group validity was supported by significant differences in VH scores across gender and academic level, with men and undergraduate students reporting higher hesitancy than women and graduate students (p < 0.001). VH was higher for booster doses (33.4 %) than primary doses (19.3 %) with more students delaying (32.1 %) or refusing boosters (29.3 %) than delaying (11.5 %) or refusing (6.2 %) primary doses.
CONCLUSION: Our adapted scales performed well psychometrically to measure VH across different COVID-19 vaccine phases. These scales can help in identifying key barriers of VH to understand shifting trajectories over time, thereby informing targeted interventions to promote vaccination uptake among younger adults.