The influence of attitude, subjective norms, and perceived behavioral control on vaccination intention among teachers: The moderating role of perceived policy effectiveness
DOI:
https://doi.org/10.24200/jonus.vol9iss1pp224-244Abstract
Background and Purpose: This study explores teachers' influence on families' vaccination decisions and the role of schools in health education. It aims to identify factors shaping teachers' attitudes toward vaccines and their decision-making when vaccinating their children. Using the Theory of Planned Behavior, the research examines educators' attitudes, subjective norms, and perceived behavior control about vaccination choices.
Methodology: A quantitative approach was employed to analyze the data in this study. Questionnaires were distributed to teachers in three states in Malaysia, namely Pahang, Terengganu, and Kelantan. Out of the total 400 questionnaires distributed, only 326 were found suitable for analysis after the screening process. The data were then analyzed using the partial least square structural equation modeling (PLS-SEM) method.
Findings: The study reveals a significant link between teachers' attitudes toward vaccinating children and a connection between subjective norms and parents' vaccination intentions. These findings support previous research, underscoring the influence of attitudes and subjective norms on vaccination decisions. However, no significant relationship was found between perceived behavior control and parents' intention to vaccinate, suggesting that parents' beliefs about accessing vaccines or overcoming barriers have a limited impact on their vaccination intentions. In addition, Perceived policy effectiveness positively influenced parents' vaccination intentions.
Contributions: This study enhances understanding teachers' vaccination intentions, informing evidence-based policies to promote vaccination and address barriers. Recognizing the factors influencing teachers' decision-making, targeted interventions can enhance vaccination rates and improve public health outcomes.
Keywords: Vaccine acceptance, teachers' vaccination intentions, attitude, subjective norms, perceived behaviour control.
References
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Adiyoso, W., Wilopo, W., Nurbaiti, B., & Suprapto, F. A. (2023). The use of Health Belief Model (HBM) to explain factors underlying people to take the COVID-19 vaccine in Indonesia. Vaccine: X, 14(1), 100297.
Ajibike, W. A., Adeleke, A. Q., Mohamad, F., Bamgbade, J. A., Nawi, M. N. M., & Moshood, T. D. (2021). An evaluation of environmental sustainability performance via attitudes, social responsibility, and culture: A mediated analysis.
Environmental Challenges, 4(1), 100161.
Anderson, J. C., & Gerbing, D. W. (1988). Structural equation modeling in practice: A review and recommended two-step approach. Psychological Bulletin, 103(3), 411-423.
Barattucci, M., Pagliaro, S., Ballone, C., Teresi, M., Consoli, C., Garofalo, A., De Giorgio, A., & Ramaci, T. (2022). Trust in science as a possible mediator between different antecedents and COVID-19 booster vaccination intention: An
integration of health belief model (HBM) and theory of planned behavior (TPB). Vaccines, 10(7), 1099.
Betsch, C., Böhm, R., & Chapman, G. B. (2015). Using behavioral insights to increase vaccination policy effectiveness. Policy Insights from the Behavioral and Brain Sciences, 2(1), 61-73.
Britt, R. K., & Englebert, A. M. (2018). Behavioral determinants for vaccine acceptability among rurally located college students. Health Psychology and Behavioral Medicine, 6(1), 262-276.
Cahapay, M. B. (2022). To get or not to get: Examining the intentions of Philippine teachers to vaccinate against COVID-19. Journal of Human Behavior in the Social Environment, 32(3), 325-335.
Camoens, A. (2021, September 15). Action to be taken against 2,500 teachers who refused Covid-19 vaccines. The Star. https://www.thestar.com.my/news/nation/2021/09/15/action-to-be-taken-against-2500-teachers-who-refused-
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Danks, N. P., & Ray, S. (2018). Predictions from partial least squares models. In Ali, F., Rasoolimanesh, S.M. and Cobanoglu, C. (Eds.), Applying partial least squares in tourism and hospitality research (pp. 35-52). Emerald Publishing
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Diamantopoulos, A., & Siguaw, J. A. (2006). Formative versus reflective indicators in organizational measure development: A comparison and empirical illustration. British Journal of Management, 17(4), 263-282.
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Hair, J. F., Hult, G. T. M., Ringle, C. M., & Sarstedt, M. (2017a). A primer on partial least squares structural equation modeling (PLS-SEM). SAGE Publications, Inc.
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Halimi, F. F., Gabarre, S., Rahi, S., Al-Gasawneh, J. A., & Ngah, A. H. (2022). Modelling Muslims' revisit intention of non-halal certified restaurants in Malaysia. Journal of Islamic Marketing, 13(11), 2437-2461.
Henseler, J., Ringle, C. M., & Sarstedt, M. (2015). A new criterion for assessing discriminant validity in variance-based structural equation modelling. Journal of the Academy of Marketing Science, 43(1), 115-135.
Himelboim, I., Xiao, X., Lee, D. K. L., Wang, M. Y., & Borah, P. (2020). A social networks approach to understanding vaccine conversations on Twitter: Network clusters, sentiment, and certainty in HPV social networks. Health
Communication, 35(5), 607-615.
Johnson, C., & Ogletree, R. (2017). Knowledge and behavioral intention related to HPV vaccination among male college students. American Journal of Health Education, 48(5), 320-330.
Kim, J. H. (2019). Multicollinearity and misleading statistical results. Korean Journal of Anesthesiology, 72(6), 558-569.
Kock, N. (2015). Common method bias in PLS-SEM: A full collinearity assessment approach. International Journal of e-Collaboration, 11(4), 1-10.
Li, J. B., Lau, E. Y. H., & Chan, D. K. C. (2022). Why do Hong Kong parents have low intention to vaccinate their children against COVID-19? Testing health belief model and theory of planned behavior in a large-scale survey, Vaccine,
40(19), 2772-2780.
Liu, R., Zhang, Y., Nicholas, S., Leng, A., Maitland, E., & Wang, J. (2021). COVID-19 vaccination willingness among Chinese adults under the free vaccination policy. Vaccines, 9(3), 292.
Manganello, J. A., Chiang, S. C., Cowlin, H., Kearney, M., & Massey, P. (2022). HPV and COVID-19 vaccines: Social media use, confidence, and intentions among parents living in different community types in the United States. Journal of
Behavioral Medicine, 46(1–2), 212–228.
Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory. McGraw-Hill.
Podsakoff, P. M., MacKenzie, S. B., & Podsakoff, N. P. (2012). Sources of method bias in social science research and recommendations on how to control it. Annual Review of Psychology, 63(1), 539-569.
Quinn, S. C., Jamison, A., Freimuth, V. S., An, J., Hancock, G. R., & Musa, D. (2017). Exploring racial influences on flu vaccine attitudes and behavior: Results of a national survey of White and African American adults. Vaccine, 35(8), 1167-
1174.
Riccó, M., Vezzosi, L., Gualerzi, G., Balzarini, F., Mezzoiuso, A. G., Odone, A., & Signorelli, C. (2018). Measles vaccine in the school settings: A cross-sectional study about knowledge, personal beliefs, attitudes and practices of school
teachers in northern Italy. Minerva Pediatrica, 75(3), 367-375.
Shmueli, G., Ray, S., Velasquez Estrada, J. M., & Chatla, S. B. (2016). The elephant in the room: Predictive performance of PLS models. Journal of Business Research, 69(10), 4552-4564.
Shmueli, G., Sarstedt, M., Hair, J. F., Cheah, J. H., Ting, H., Vaithilingam, S., & Ringle, C. M. (2019). Predictive model assessment in PLS-SEM: Guidelines for using PLS predict. European Journal of Marketing, 53(11), 2322-2347.
Vrdelja, M., Učakar, V., & Kraigher, A. (2020). From mandatory to voluntary vaccination: Intention to vaccinate in the case of policy changes. Public Health, 180(1), 57-63.
Wang, H., Li, J., Mangmeechai, A., & Su, J. (2021). Linking perceived policy effectiveness and proenvironmental behavior: The influence of attitude, implementation intention, and knowledge. International Journal of Environmental
Research and Public Health, 18(6), 2910.
Xiao, X. (2019). Follow the heart or the mind? Examining cognitive and affective attitude on HPV vaccination intention. Atlantic Journal of Communication, 29(2), 93-105.
Xiao, X., & Wong, R. M. (2020). Vaccine hesitancy and perceived behavioral control: Meta analysis. Vaccine, 38(33), 5131-5138.
Xu, L., Ling, M., Lu, Y., & Shen, M. (2017). Understanding household waste separation behaviour: Testing the roles of moral, past experience, and perceived policy effectiveness within the theory of planned behaviour. Sustainability,
9(4), 625.
Xu, R., Shi, G., Zheng, S., Tung, T. H., & Zhang, M. (2023). COVID-19 vaccine hesitancy between family decision-makers and non-decision-makers among college teachers. Annals of Medicine, 55(1), 292-304.
Zhang, L., Yang, J., Cao, Y., & Kang, W. (2022). Sociocultural–psychological predictors influencing parents' decision-making regarding HPV vaccination for their adolescent daughters in mainland China: An extended TPB model.
Frontiers in Public Health, 10(1), 1035658.
Abd Rahman, N. A. S., Razali, J. R., & Rozaimy, M. (2022b). Examining the factors influencing Malaysian parents' intention toward Human Papillomavirus Vaccination (HPV) for children. International Journal of Academic Research in
Business and Social Sciences, 12(5), 1809-1820.
Adiyoso, W., Wilopo, W., Nurbaiti, B., & Suprapto, F. A. (2023). The use of Health Belief Model (HBM) to explain factors underlying people to take the COVID-19 vaccine in Indonesia. Vaccine: X, 14(1), 100297.
Ajibike, W. A., Adeleke, A. Q., Mohamad, F., Bamgbade, J. A., Nawi, M. N. M., & Moshood, T. D. (2021). An evaluation of environmental sustainability performance via attitudes, social responsibility, and culture: A mediated analysis.
Environmental Challenges, 4(1), 100161.
Anderson, J. C., & Gerbing, D. W. (1988). Structural equation modeling in practice: A review and recommended two-step approach. Psychological Bulletin, 103(3), 411-423.
Barattucci, M., Pagliaro, S., Ballone, C., Teresi, M., Consoli, C., Garofalo, A., De Giorgio, A., & Ramaci, T. (2022). Trust in science as a possible mediator between different antecedents and COVID-19 booster vaccination intention: An
integration of health belief model (HBM) and theory of planned behavior (TPB). Vaccines, 10(7), 1099.
Betsch, C., Böhm, R., & Chapman, G. B. (2015). Using behavioral insights to increase vaccination policy effectiveness. Policy Insights from the Behavioral and Brain Sciences, 2(1), 61-73.
Britt, R. K., & Englebert, A. M. (2018). Behavioral determinants for vaccine acceptability among rurally located college students. Health Psychology and Behavioral Medicine, 6(1), 262-276.
Cahapay, M. B. (2022). To get or not to get: Examining the intentions of Philippine teachers to vaccinate against COVID-19. Journal of Human Behavior in the Social Environment, 32(3), 325-335.
Camoens, A. (2021, September 15). Action to be taken against 2,500 teachers who refused Covid-19 vaccines. The Star. https://www.thestar.com.my/news/nation/2021/09/15/action-to-be-taken-against-2500-teachers-who-refused-
covid-19-vaccines
Chang, S. J., Van Witteloostuijn, A., & Eden, L. (2010). From the editors: Common method variance in international business research. Journal of International Business Studies, 41(2), 178-184.
Cohen, J. (1988). Statistical power for the social sciences. Laurence Erlbaum and Associates.
Danks, N. P., & Ray, S. (2018). Predictions from partial least squares models. In Ali, F., Rasoolimanesh, S.M. and Cobanoglu, C. (Eds.), Applying partial least squares in tourism and hospitality research (pp. 35-52). Emerald Publishing
Limited.
Diamantopoulos, A., & Siguaw, J. A. (2006). Formative versus reflective indicators in organizational measure development: A comparison and empirical illustration. British Journal of Management, 17(4), 263-282.
Fishbein, M., Jaccard, J., Davidson, A. R., Ajzen, I., & Loken, B. (1980). Predicting and understanding family planning behaviors. In I. Ajzen, & M. Fishbein (Eds.), Understanding attitudes and predicting social behavior. Prentice Hall.
Hair, J. F., Risher, J. J., Sarstedt, M., & Ringle, C. M. (2019). When to use and how to report the results of PLS-SEM. European Business Review, 31(1), 2-24.
Hair, J. F., Hult, G. T. M., Ringle, C. M., & Sarstedt, M. (2017a). A primer on partial least squares structural equation modeling (PLS-SEM). SAGE Publications, Inc.
Hair, J., Hollingsworth, C. L., Randolph, A. B., & Chong, A. Y. L. (2017b). An updated and expanded assessment of PLS-SEM in information systems research. Industrial Management & Data Systems, 117(3), 442-458.
Halimi, F. F., Gabarre, S., Rahi, S., Al-Gasawneh, J. A., & Ngah, A. H. (2022). Modelling Muslims' revisit intention of non-halal certified restaurants in Malaysia. Journal of Islamic Marketing, 13(11), 2437-2461.
Henseler, J., Ringle, C. M., & Sarstedt, M. (2015). A new criterion for assessing discriminant validity in variance-based structural equation modelling. Journal of the Academy of Marketing Science, 43(1), 115-135.
Himelboim, I., Xiao, X., Lee, D. K. L., Wang, M. Y., & Borah, P. (2020). A social networks approach to understanding vaccine conversations on Twitter: Network clusters, sentiment, and certainty in HPV social networks. Health
Communication, 35(5), 607-615.
Johnson, C., & Ogletree, R. (2017). Knowledge and behavioral intention related to HPV vaccination among male college students. American Journal of Health Education, 48(5), 320-330.
Kim, J. H. (2019). Multicollinearity and misleading statistical results. Korean Journal of Anesthesiology, 72(6), 558-569.
Kock, N. (2015). Common method bias in PLS-SEM: A full collinearity assessment approach. International Journal of e-Collaboration, 11(4), 1-10.
Li, J. B., Lau, E. Y. H., & Chan, D. K. C. (2022). Why do Hong Kong parents have low intention to vaccinate their children against COVID-19? Testing health belief model and theory of planned behavior in a large-scale survey, Vaccine,
40(19), 2772-2780.
Liu, R., Zhang, Y., Nicholas, S., Leng, A., Maitland, E., & Wang, J. (2021). COVID-19 vaccination willingness among Chinese adults under the free vaccination policy. Vaccines, 9(3), 292.
Manganello, J. A., Chiang, S. C., Cowlin, H., Kearney, M., & Massey, P. (2022). HPV and COVID-19 vaccines: Social media use, confidence, and intentions among parents living in different community types in the United States. Journal of
Behavioral Medicine, 46(1–2), 212–228.
Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory. McGraw-Hill.
Podsakoff, P. M., MacKenzie, S. B., & Podsakoff, N. P. (2012). Sources of method bias in social science research and recommendations on how to control it. Annual Review of Psychology, 63(1), 539-569.
Quinn, S. C., Jamison, A., Freimuth, V. S., An, J., Hancock, G. R., & Musa, D. (2017). Exploring racial influences on flu vaccine attitudes and behavior: Results of a national survey of White and African American adults. Vaccine, 35(8), 1167-
1174.
Riccó, M., Vezzosi, L., Gualerzi, G., Balzarini, F., Mezzoiuso, A. G., Odone, A., & Signorelli, C. (2018). Measles vaccine in the school settings: A cross-sectional study about knowledge, personal beliefs, attitudes and practices of school
teachers in northern Italy. Minerva Pediatrica, 75(3), 367-375.
Shmueli, G., Ray, S., Velasquez Estrada, J. M., & Chatla, S. B. (2016). The elephant in the room: Predictive performance of PLS models. Journal of Business Research, 69(10), 4552-4564.
Shmueli, G., Sarstedt, M., Hair, J. F., Cheah, J. H., Ting, H., Vaithilingam, S., & Ringle, C. M. (2019). Predictive model assessment in PLS-SEM: Guidelines for using PLS predict. European Journal of Marketing, 53(11), 2322-2347.
Vrdelja, M., Učakar, V., & Kraigher, A. (2020). From mandatory to voluntary vaccination: Intention to vaccinate in the case of policy changes. Public Health, 180(1), 57-63.
Wang, H., Li, J., Mangmeechai, A., & Su, J. (2021). Linking perceived policy effectiveness and proenvironmental behavior: The influence of attitude, implementation intention, and knowledge. International Journal of Environmental
Research and Public Health, 18(6), 2910.
Xiao, X. (2019). Follow the heart or the mind? Examining cognitive and affective attitude on HPV vaccination intention. Atlantic Journal of Communication, 29(2), 93-105.
Xiao, X., & Wong, R. M. (2020). Vaccine hesitancy and perceived behavioral control: Meta analysis. Vaccine, 38(33), 5131-5138.
Xu, L., Ling, M., Lu, Y., & Shen, M. (2017). Understanding household waste separation behaviour: Testing the roles of moral, past experience, and perceived policy effectiveness within the theory of planned behaviour. Sustainability,
9(4), 625.
Xu, R., Shi, G., Zheng, S., Tung, T. H., & Zhang, M. (2023). COVID-19 vaccine hesitancy between family decision-makers and non-decision-makers among college teachers. Annals of Medicine, 55(1), 292-304.
Zhang, L., Yang, J., Cao, Y., & Kang, W. (2022). Sociocultural–psychological predictors influencing parents' decision-making regarding HPV vaccination for their adolescent daughters in mainland China: An extended TPB model.
Frontiers in Public Health, 10(1), 1035658.
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2024-02-29
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The influence of attitude, subjective norms, and perceived behavioral control on vaccination intention among teachers: The moderating role of perceived policy effectiveness. (2024). Journal of Nusantara Studies (JONUS), 9(1), 224-244. https://doi.org/10.24200/jonus.vol9iss1pp224-244
