An instrument to measure psychosocial determinants of health care professionals’ vaccination behavior: Validation of the Pro-VC-Be questionnaire

ABSTRACT

Objectives

The lack of validated instruments assessing vaccine hesitancy/confidence among health care professionals (HCPs) for themselves, and their patients led us to develop and validate the Pro-VC-Be instrument to measure vaccine confidence and other psychosocial determinants of HCPs’ vaccination behavior among diverse HCPs in different countries.

Methods

Cross-sectional survey in October-November 2020 among 1,249 GPs in France, 432 GPs in French-speaking parts of Belgium, and 1,055 nurses in Quebec (Canada), all participating in general population immunization. Exploratory and confirmatory factor analyses evaluated the instrument’s construct validity. We used HCPs’ self-reported vaccine recommendations to patients, general immunization activity, self-vaccination, and future COVID-19 vaccine acceptance to test criterion validity.

Results

The final results indicated a 6-factor structure with good fit: vaccine confidence (combining complacency, perceived vaccine risks, perceived benefit-risk balance, perceived collective responsibility), trust in authorities, perceived constraints, proactive efficacy (combining commitment to vaccination and self-efficacy), reluctant trust, and openness to patients. The instrument showed good convergent and criterion validity and adequate discriminant validity.

Conclusions

This study found that the Pro-VC-Be is a valid instrument for measuring psychosocial determinants of HCPs’ vaccination behaviors in different settings. Its validation is currently underway in Europe among various HCPs in different languages.

KEYWORDS:

• Health care professionals
• questionnaire validation
• vaccination behaviors
• vaccine confidence
• vaccine hesitancy

Acknowledgments

We warmly thank the following experts for their invaluable advice on the first version of the Pro-VC-Be questionnaire: C Betsch, M Deml, KB Habersaat, J Leask, and JK Ward. We also thank the survey participants, as well as Jo Ann Cahn who revised the English of the manuscript. We have these experts’ permission to mention their names in the manuscript for publication.

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.

Authors contributions

PV, ED, and AG were involved in the conception and design of the Pro-VC-Be. PV, ED, and ND were involved in the organization and implementation of data collection. LF and PV were involved in the statistical analysis, interpretation of the data and drafting of the paper. AG, ED, ND, AF, LK, 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.

Reviewer disclosures

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

Ethical approval

Our work was conducted with the approval of an institutional ethics committee in each of the participating countries: the details of this have been included in the manuscript (paragraph 2.4.2 data collection procedure).

As the survey was conducted exclusively via the Internet in Quebec and Belgium, and via the Internet or telephone in France, the ethics committees approved that the completion of a questionnaire constituted consent by the health professionals and that written consent was not required.

Supplemental data

Supplemental data for this article can be accessed here.

Additional information

Funding

This work was funded by the Direction de la Recherche, des Etudes, de l’Evaluation et des Statistiques, French Ministry of Health, under Grant number 2102173353; and by the European Union’s Horizon 2020 research and innovation program under Grant agreement number 964728 (JITSUVAX).