International adaptation and validation of the Pro-VC-Be: measuring the psychosocial determinants of vaccine confidence in healthcare professionals in European countries

ABSTRACT

Background

Healthcare professionals (HCPs) play an important role in vaccination; those with low confidence in vaccines are less likely to recommend them to their patients and to be vaccinated themselves. The study’s purpose was to adapt and validate long- and short-form versions of the International Professionals’ Vaccine Confidence and Behaviors (I-Pro-VC-Be) questionnaire to measure psychosocial determinants of HCPs’ vaccine confidence and their associations with vaccination behaviors in European countries.

Research design and methods

After the original French-language Pro-VC-Be was culturally adapted and translated, HCPs involved in vaccination (mainly GPs and pediatricians) across Germany, Finland, France, and Portugal completed a cross-sectional online survey in 2022. A 10-factor multigroup confirmatory factor analysis (MG-CFA) of the long-form (10 factors comprising 34 items) tested for measurement invariance across countries. Modified multiple Poisson regressions tested the criterion validity of both versions.

Results

2,748 HCPs participated. The 10-factor structure fit was acceptable to good everywhere. The final MG-CFA model confirmed strong factorial invariance and showed very good fit. The long- and short-form I-Pro-VC-Be had good criterion validity with vaccination behaviors.

Conclusion

This study validates the I-Pro-VC-Be among HCPs in four European countries; including long- and short-form tools for use in research and public health.

KEYWORDS:

• Europe
• healthcare professionals
• international tool: vaccines
• vaccine confidence
• vaccine hesitancy

Acknowledgments

We thank the following experts for their advice on the original version of the Pro-VC-Be questionnaire: C Betsch, M Deml, KB Habersaat, J Leask, and JK Ward. We also thank all partners within the JITSUVAX project (Jiu Jitsu with Misinformation in the Age of Covid) and the survey participants in all participating countries. We thank the various networks in each country from which participants were recruited for their involvement: the National Institute for Health Research’s (NIHR) Clinical Research Network (CRN) in the UK, the Schlesinger Group Germany provider in Germany; the Portuguese Society of Pediatricians and the Portuguese Association of General Practice and Family Medicine in Portugal; the National College of General Practice Teachers (CNGE acronym in French) in France; and The Finnish Medical Association in Finland. We thank Jo Ann Cahn for her English proofreading of the revised version of this article.

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

PV, ED, and AG were involved in the conception and design of the original, long-form Pro-VC-Be. AmG, LK, AF, FR, PS, FT, DH, SL, PN, EA, AS, and PV were involved in the international adaptation of the original tool; including translation, cognitive interviews, and the pilot study. PV, AS, LK, and AmG were involved in the organization and implementation of data collection in the international populations. LF, PV, and AmG were involved in the statistical analysis, interpretation of the data, and initial drafting of the paper. AG, ED, AF, LK, FR, FT, DH, PN, EA, SL, AS, and PS were involved in the interpretation of the data and revising the paper critically for intellectual content; they approved it for publication. All authors agree to be accountable for all aspects of the work.

Ethical Considerations

The ethics boards of the University of Aix-Marseille (reference 16 December 2021-01), the Health Care Division of the Ethics Committee for Human Sciences at the University of Turku (1/2022), the advisory board on ethical issues of the University of Erfurt (20210713), the Ethics Committee of the Faculty of Medicine of the University of Coimbra (093-CE-2021), and the School of Psychological Sciences Research Ethics Committee (SREC) of the University of Bristol (119594) approved the original study protocol and questionnaires in their respective countries. The survey was conducted exclusively online, participants were asked to give consent before being directed to the platform where the survey took place in each country.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14760584.2023.2242479.

Additional information

Funding

This manuscript and the entire JITSUVAX project was funded by the European Union’s Horizon 2020 research and innovation program under Grant agreement number 964728 (JITSUVAX).