Measuring Motivation for COVID-19 Vaccination: An Application of the Transtheoretical Model

Abstract

Purpose In the United States (US), individuals vary widely in their readiness to get vaccinated for COVID-19. The present study developed measures based on the transtheoretical model (TTM) to better understand readiness, decisional balance (DCBL; pros and cons), self-efficacy (SE), as well as other motivators for change such as myths and barriers for COVID-19 vaccination. Design Cross-sectional measurement development. Setting Online survey. Sample 528 US adults ages 18-75. Measures Demographics, stage of change (SOC), DCBL, SE, myths, and barriers. Analysis The sample was randomly split into halves for exploratory factor analysis using principal components analysis (EFA/PCA), followed by confirmatory factor analyses (CFA) to test measurement models. Correlation matrices were assessed and multivariate analyses examined relationships between constructs and sub-constructs. Results For DCBL, EFA/PCA revealed three correlated factors (one pros, two cons) ( n 1 = 8, α = .97; n 2 = 5, α = .93; n 3 = 4, α = .84). For SE, two correlated factors were revealed ( n 1 = 12, α = .96; n 2 = 3, α = .89). Single-factor solutions for Myths ( n = 13, α = .94) and Barriers ( n = 6, α = .82) were revealed. CFA confirmed models from EFAs/PCAs. Follow-up analyses of variance aligned with past theoretical predictions of the relationships between SOC, pros, cons, and SE, and the predicted relationships with myths and barriers. Conclusion This study produced reliable and valid measures of TTM constructs, myths, and barriers to understand motivation to receive COVID-19 vaccination that can be used in future research.