Factors associated with behavioral intention of free and self-paid COVID-19 vaccination based on the social cognitive theory among nurses and doctors in China.

She, Rui; Chen, Xi; Li, Liping; Li, Lijuan; Huang, Zepeng; Lau, Joseph T F

OBJECTIVE To examine the associations between factors based on the Social Cognitive Theory (SCT) and behavioral intention of free and self-paid (600 RMB or 91 USD) COVID-19 vaccination of 80% effectiveness and rare mild side effects among doctors and nurses in China. DESIGN Cross-sectional study. SETTING Public hospitals. PARTICIPANTS 362 doctors and 1702 nurses in major departments of five hospitals of three Chinese provinces. METHODS An anonymous online survey was conducted from October to November 2020, facilitated by hospital administrators through online WeChat/QQ working groups. Data on outcome expectations, self-efficacy, norms, and COVID-19-related work experiences were collected. Multivariate logistic regression models were used for data analysis. RESULTS The logistic regression analysis showed that physical (e.g., protective effect of vaccination) and self-evaluative outcome expectations (e.g., anticipated regret), self-efficacy, norms (e.g., descriptive norm, subjective norm, professional norm, and moral norm), and job satisfaction were significantly and positively associated with the free and self-paid COVID-19 vaccination intention outcomes among doctors and nurses, adjusted for background variables. Doctors who had engaged in COVID-19-related work reported higher self-paid vaccination intention. CONCLUSIONS Health promotion is needed to improve the uptake of COVID-19 vaccination among healthcare workers. Such interventions may consider modifying the identified factors of vaccination intention, including strengthening perceived efficacy, positive feelings about vaccination, the need to avoid future regret, self-efficacy, and social norms. Future studies should examine the actual behavior patterns of COVID-19 vaccination and testing the efficacy of promotion intervention through randomized controlled studies.