Confidents, Waiters, and Non-Intenders: Estimating and Validating a Segmentation Analysis of COVID-19 Attitudes, Beliefs, and Behaviors in Early 2021 (Preprint)

Abstract

Background: The COVID-19 pandemic prompted the launch of the ANONYMIZED national campaign to boost vaccine confidence and uptake among adults, as vaccines are key to preventing severe illness and death.

Past segmentation research relevant to COVID-19 behavior has found important differences in attitudes, sociodemographics, and subsequent COVID-19 prevention behaviors across population segments. This study extends prior work by incorporating a more comprehensive set of attitudes, behaviors, and sociodemographic variables to identify population segments by differing levels of COVID-19 vaccine confidence and evaluate differences in their subsequent uptake of COVID-19 prevention behaviors.

Data were obtained from five waves of a longitudinal, probability-based panel of U.S. adults (N = 4,398). Latent class cluster analysis estimated segments of respondents based on over 40 COVID-19 attitudes, beliefs, behaviors, and sociodemographics as reported in Wave 1. Survey-weighted cross-tabulations and bivariate regression analyses assessed differences in COVID-19 vaccine uptake, booster uptake, mask use, and social distancing in all segments across all five survey waves.

Six segments (Hardline Non-Intenders, Prevention-Compliant Non-Intenders, Burned-Out Waiters, Anxious Waiters, Skeptical Confidents, Ready Confidents) were identified that differed by their COVID-19 vaccine confidence, prevention-related attitudes and behaviors, and sociodemographics. Cross-tabulations and regression results indicated significant segment membership differences in COVID-19 vaccine and booster timing, mask use, and social distancing. Results from survey-weighted cross-tabulations comparing COVID-19 vaccine and booster uptake across segments indicate statistically significant differences in these outcomes across the six segments (P < .001). Results were statistically significant for each segment (P < .01 for booster uptake among Burned-Out Waiters; P < .001 for all other coefficients), indicating that, on average, respondents in segments with lower intentions to vaccinate reported later receipt of COVID-19 vaccines and boosters relative to the timing of vaccine and booster uptake among Ready Confidents.

Results extend previous research by showing that initial beliefs and behaviors relevant to COVID-19 vaccination, mask use, and social distancing are important for understanding differences in subsequent compliance with recommended COVID-19 prevention measures. Results highlight the utility of a comprehensive list of attitudes, behaviors, and other individual-level characteristics that can serve as a basis for future segmentation efforts relevant to COVID-19 and other infectious diseases.