Factors associated with parental acceptance of influenza vaccination for their children: the evidence from four cities of China

Figures & data

Figure 1. Theoretical model

Table 1. Summary of construct with measurement items

Constructs	Items Item in questionnaire		Mean (scale range: 1 to 7)	Std. Deviation	Sources
Knowledge (KN)	KN1	The most effective way to prevent influenza is to get a flu shot.	5.10	1.295	(Venkatesh et al., 2003; Venkatesh et al., 2012)
	KN2	New flu vaccines are needed every year to effectively prevent the flu.	5.23	1.282
	KN3	Even with the flu shot, susceptible people should not to go to crowded places.	5.16	1.229
	KN4	The immunity of influenza vaccines from different countries is similarly equivalent.	4.98	1.231
	KN5	Influenza vaccination can greatly reduce the severity of the flu.	5.17	1.317
Social Influence (SI)	SI1	People who are important to me think: My kids should get the flu shot.	5.24	1.397	(Jewer, 2018; Morosan & DeFranco, 2016; Venkatesh et al., 2012)
	SI2	People who influence my behavior believe that my children should be vaccinated against the flu.	4.95	1.375
	SI3	Parents who have vaccinated their children against flu are considered health conscious.	5.06	1.412
Performance Expectancy (PE)	PE1	After flu vaccination, children will be healthier.	4.55	1.439	(Herrero et al., 2017; Kwame et al., 2019)
	PE2	Vaccination against influenza is cost-effective.	4.52	1.458
	PE3	Children will not get the flu easily after the flu vaccination.	4.37	1.412
	PE4	Getting a flu shot will improve children’s quality of life.	4.56	1.574
Effort Expectancy (EE)	EE1	It is convenient to get the flu vaccine.	4.89	1.540	(Venkatesh et al., 2003)
	EE2	The financial burden of influenza vaccination is affordable.	5.05	1.561
	EE3	It is easy to master the knowledge of influenza vaccines.	4.69	1.487
Perceived Risk (PR)	PR1	The safety of the flu vaccine is worrying me.	3.92	1.640	(Venkatesh et al., 2012)
	PR2	The vaccine crisis in China makes me nervous.	3.81	1.878
	PR3	Reactions to the vaccine (such as fever) make me uncomfortable.	4.00	1.664
	PR4	Children need to get flu shots every year, which makes me feel stressed.	3.78	1.617
Behavioral Intention (BI)	BI1	I would like to get my children vaccinated against the flu.	5.21	1.556	(Wang et al., 2016)
	BI2	I plan to get my children vaccinated in the future.	5.03	1.451
	BI3	I would like to recommend flu vaccination to relatives and friends.	4.48	1.624
	BI4	I will introduce the benefits of flu shots to others.	4.75	1.544

Table 2. Sample demographics (N = 462)

Items	n	%	Mean	Std. Deviation
Gender			1.52	0.50
male (1)	224	48.5
female (2)	238	51.5
Age			3.22	1.13
20–25 years old (1)	30	6.5
26–30 years old (2)	97	21.0
30–35 years old (3)	143	31.0
36–40 years old (4)	126	27.3
41+ years old (5)	66	14.3
Education			2.06	0.78
High school education or below (1)	127	27.5
Vocational college degree (2)	179	38.7
Bachelor degree and above (3)	156	33.8
Income (Annual household income)			2.46	1.07
Below $ 10,000 (1)	101	21.9
$ 10,000 – $ 20,000 (2)	149	32.3
$ 20,000 – $ 30,000 (3)	109	23.6
Over $ 30,000 (4)	103	22.3
KidsNum (Number of Kids)			1.4	0.49
1kid (1)	276	59.7
2 or more kids (2)	186	40.3
KidsGender (Kids’ Gender)			1.76	0.71
All boy(s) (1)	183	39.6
All girl(s) (2)	205	44.4
Both boy(s) and girl(s) (3)	74	16.0
City (Data collection city)			/	/
Changsha (1)	117	25.3
Guangzhou (2)	131	28.4
Wuhan (3)	100	21.6
Beijing (4)	114	24.7

Table 3. Composite reliability and convergent validity of the measurements

Constructs	Variables	Loadings	C.R	Cronbach’s Alpha	AVE
KN	KN1	0.778	0.89	0.890	0.618
	KN2	0.766
	KN3	0.766
	KN4	0.803
	KN5	0.817
SI	SI1	0.846	0.87	0.869	0.692
	SI2	0.863
	SI3	0.784
PE	PE1	0.860	0.89	0.884	0.659
	PE2	0.753
	PE3	0.851
	PE4	0.778
EE	EE1	0.784	0.82	0.824	0.61
	EE2	0.779
	EE3	0.780
PR	PR1	0.837	0.93	0.923	0.757
	PR2	0.875
	PR3	0.832
	PR4	0.933
BI	BI1	0.824	0.92	0.918	0.74
	BI2	0.867
	BI3	0.882
	BI4	0.866

Loading: standardized factor loading; CR: Composite Reliability; AVE: Average Variance Extracted.

Table 4. Hypothesis testing

Hypotheses	Paths			t	β	p	Comments ^h
H1	PE ^b	< –	KN ^a	4.376	0.228	***	Supported
H2	EE ^c	< –	KN	4.012	0.227	***	Supported
H3	PR ^d	< –	KN	−2.418	−0.138	*0.016	Supported
H4	PE	< –	SI ^e	8.034	0.437	***	Supported
H5	EE	< –	SI	6.541	0.386	***	Supported
H6	PR	< –	SI	−2.993	−0.172	**0.003	Supported
H7	BI ^f	< –	PE	8.739	0.402	***	Supported
H8	BI	< –	EE	7.158	0.343	***	Supported
H9	BI	< –	PR	−5.961	−0.244	***	Supported

^a-fKN, knowledge; SI, social influence; PE, performance expectancy; EE, effort expectancy; PR, perceived risk; BI, behavioral intention.

^hN = 4000 bootstrap samples, Maximum Likelihood Estimates, Significant at p < 0.05.

Table 5. Moderating effects of control variables

Paths Demographic variables	BI < – PE	BI < – EE	BI < – PR
Gender
male (1)	0.29 ^a	0.28	−0.33
female (2)	0.48	0.23	−0.13
Z-value	−1.428	0.981	−3.178*
Age
20–30 years old (1 + 2)	0.34	0.34	−0.21
36+ years old (4 + 5)	0.32	0.34	−0.20
Z-value	0.066	−0.345	−0.061
Education
High school education or below (1)	0.17	0.27	−0.33
Bachelor degree and above (3)	0.53	0.25	−0.11
Z-value	−3.213*	0.898	−3.080*
Income (Annual household income)
Below $ 10,000 (1)	0.23	0.35	−0.33
Over $ 30,000 (4)	0.35	0.32	−0.27
Z-value	−0.887	0.151	−0.526
KidsNum (Number of Kids)
1kid (1)	0.32	0.25	−0.26
2 or more kids (2)	0.41	0.29	−0.18
Z-value	−1.492	−0.849	−0.370
KidsGender (Kids’ Gender)
All boy(s) (1)	0.70	0.11	−0.16
All girl(s) (2)	0.21	0.32	−0.28
Z-value	5.854*	−2.910*	2.051*

^aStandardized Coefficients Beta; ^b: Significant at α level of 0.05.