Group-based trajectory modeling to identify health beliefs of COVID-19 vaccination and its predictors: A cohort study in China

Figures & data

Figure 1. Study design.

Table 1. Participants’ baseline characteristics (N = 1129).

Variable	Summary statistics
Sex, N (%)
Men	761	(67.4)
Women	368	(32.6)
Age group, y, N (%)
12-17	352	(31.2)
18-28	259	(22.9)
29-39	354	(31.4)
≥40	164	(14.5)
Marital status, N (%)
Unmarried	709	(62.8)
Married	369	(35.1)
Other	24	(2.1)
Education level, N (%)
Junior high school or below	477	(42.2)
Senior high school	446	(39.5)
College Degree	113	(10.0)
Bachelor degree or above	93	(8.2)
Occupation post, N (%)
Personnel of public institutions	67	(5.9)
Students	356	(31.5)
Farmers and industrial workers	451	(39.9)
Enterprise staffs	116	(10.3)
Other	139	(12.3)
Health insurance, N (%)
No	174	(15.4)
Yes	955	(84.6)
Chronic disease, N (%)
No	1047	(92.7)
Yes	82	(7.3)
Type of vaccine, N (%)
Sinovac	517	(45.8)
Sinopharm	416	(36.8)
KCONVAC	196	(17.4)
Adverse reactions foreboding, N (%)
No	907	(80.3)
Yes	222	(19.7)
PCS, M (SD)	92.3	(10.0)
MCS, M (SD)	85.9	(13.4)
Health beliefs, M (SD)	73.8	(10.2)
Perceived susceptibility, M (SD)	7.4	(2.1)
Perceived severity, M (SD)	8.4	(4.1)
Perceived benefits, M (SD)	11.8	(3.2)
Perceived barriers, M (SD)	20.5	(3.4)
Cues to action, M (SD)	25.6	(4.1)

M: Mean; SD: Standard deviation; PCS: Physical Component Summary; MCS: Mental Component Summary.

Figure 2. (a) the four-group health beliefs trajectory (group 1: Very low-stable; group 2: Low-stable; group 3: Medium-stable; group 4: High-stable). (b) the two-group perceived susceptibility trajectory (group 1: Low-stable; group 2: High-stable). (c) the three-group perceived severity trajectory (group 1: Low-stable; group 2: Medium-stable; group 3: High-stable). (d) the two-group perceived benefits trajectory (group 1: Low-stable; group 2: High-stable). (e) the three-group perceived barriers trajectory (group 1: Low-stable; group 2: Medium-stable; group 3: High-stable). (f) the three-group cues to action trajectory (group 1: Low-stable; group 2: Medium-stable; group 3: High-stable).

Figure 3. (a) the three-group physical component summary trajectory (group 1: Low-declining; group 2: Medium-stable; group 3: High-slow increasing-stable). (b) the three-group mental component summary trajectory (group 1: Low-declining; group 2: Medium-stable; group 3: High-stable).

Table 2. Summary of group-based trajectory analysis.

Trajectory group	BIC (N=3387)	BIC (N=1129)	AvePP	Group Membership Probabilities (%)
Health beliefs	− 11993.93	− 11987.33
Very low-stable			0.86	182 (16.1)
Low-stable			0.78	341 (30.2)
Medium-stable			0.86	515 (45.6)
High-stable			0.86	91 (8.1)
Perceived susceptibility	−6911.56	6908.26
Low-stable			0.99	1042 (92.3)
High-stable			0.85	87 (7.7)
Perceived severity	−8973.29	−8968.35
Low-stable			0.92	436 (38.6)
Medium-stable			0.83	467 (41.4)
High-stable			0.90	226 (20.0)
Perceived benefits	−8343.26	−8339.96
Low-stable			0.88	410 (36.3)
High-stable			0.94	719 (63.7)
Perceived barriers	−8412.27	−8407.33
Low-stable			0.86	227 (20.1)
Medium-stable			0.78	418 (37.0)
High-stable			0.89	484 (42.9)
Cues to action	−9034.97	−9030.03
Low-stable			0.88	159 (14.1)
Medium-stable			0.83	349 (30.9)
High-stable			0.92	621 (55.0)
Physical component summary	−8822.98	−8817.49
Low-declining			0.86	66 (5.8)
Medium-stable			0.95	721 (63.9)
High-slow increasing-stable			0.86	342 (30.3)
Mental component summary	− 11127.32	− 11122.37
Low-declining			0.85	155 (13.7)
Medium-stable			0.89	686 (60.8)
High-stable			0.88	288 (25.5)

BIC: Bayesian Information Criterion; AvePP: Average Posterior Probability.

Table 3. Multinomial logistic regression to assess predictors associated with global health beliefs trajectory.

Variable	Low-stable vs. Very low-stable				Medium-stable vs. Very low-stable				High-stable vs. Very low-stable
	P	OR	95%CI		P	OR	95%CI		P	OR	95%CI
Age group (12–17 vs. 40 and older)	0.152	0.516	0.209	1.275	0.878	0.933	0.386	2.256	0.222	0.416	0.102	1.702
Age group (18–28 vs. 40 and older)	0.404	0.752	0.386	1.468	0.978	0.991	0.514	1.910	0.730	1.182	0.457	3.062
Age group (29–39 vs. 40 and older)	0.189	0.667	0.364	1.221	0.219	0.686	0.376	1.251	0.754	1.144	0.492	2.660
Occupation post (Other vs. Personnel of public institutions)	0.859	0.922	0.376	2.263	0.086	2.162	0.896	5.215	0.391	1.862	0.449	7.716
Occupation post (Enterprise staffs vs. Personnel of public institutions)	0.954	0.980	0.501	1.919	0.001	5.532	1.939	15.783	0.189	2.951	0.588	14.820
Occupation post (Farmers and industrial workers vs. Personnel of public institutions)	0.218	0.683	0.372	1.254	0.501	1.286	0.618	2.678	0.174	2.330	0.688	7.887
Occupation post (Students vs. Personnel of public institutions)	0.086	2.161	0.896	5.214	0.576	1.329	0.490	3.606	0.418	1.957	0.386	9.930
PCS (Low-declining vs. High-slow increasing-stable)	0.236	1.609	0.733	3.530	0.118	0.491	0.201	1.198	0.941	1.057	0.245	4.554
PCS (Medium-stable vs. High-slow increasing-stable)	0.470	1.194	0.738	1.932	0.130	0.708	0.453	1.107	0.011	0.450	0.242	0.836
MCS (Low-declining vs. High-stable)	<0.001	0.274	0.136	0.552	<0.001	0.067	0.033	0.135	<0.001	0.006	0.001	0.051
MCS (Medium-stable vs. High-stable)	0.182	0.661	0.360	1.214	0.001	0.376	0.214	0.659	<0.001	0.191	0.095	0.385

PCS: Physical Component Summary; MCS: Mental Component Summary.

Table 4. Multinomial logistic regression to assess predictors associated with perceived susceptibility and perceived severity trajectory.

	Perceived susceptibility trajectory				Perceived severity trajectory
	High-stable vs. Low-stable				Medium-stable vs. Low-stable				High-stable vs. Low-stable
	P	OR	95%CI		P	OR	95%CI		P	OR	95%CI
Sex (Men vs. Women)	/	/	/	/	0.424	1.128	0.840	1.516	0.035	1.524	1.030	2.256
Age group (12–17 vs. 40 and older)	0.066	0.362	0.123	1.069	0.324	0.718	0.372	1.386	0.809	0.902	0.392	2.077
Age group (18–28 vs. 40 and older)	0.278	0.684	0.344	1.359	0.329	0.792	0.497	1.264	0.374	1.286	0.738	2.239
Age group (29–39 vs. 40 and older)	0.098	0.595	0.322	1.100	0.609	1.120	0.726	1.728	0.154	1.457	0.869	2.442
Education level (Junior high school or below vs. Bachelor degree or above)	0.661	1.217	0.507	2.923	/	/	/	/	/	/	/	/
Education level (Senior high school vs. Bachelor degree or above)	0.333	0.638	0.257	1.585	/	/	/	/	/	/	/	/
Education level (College Degree vs. Bachelor degree or above)	0.061	0.266	0.067	1.063	/	/	/	/	/	/	/	/
Occupation post (Other vs. Personnel of public institutions)	0.801	1.173	0.340	4.046	0.787	1.097	0.560	2.147	0.943	1.032	0.436	2.443
Occupation post (Enterprise staffs vs. Personnel of public institutions)	0.758	1.220	0.345	4.320	0.075	0.533	0.266	1.065	0.385	0.680	0.285	1.625
Occupation post (Farmers and industrial workers vs. Personnel of public institutions)	0.253	1.883	0.636	5.573	0.313	0.735	0.404	1.337	0.319	1.464	0.691	3.101
Occupation post (Students vs. Personnel of public institutions)	0.570	1.509	0.365	6.242	0.978	1.011	0.465	2.197	0.608	0.770	0.283	2.092
Adverse reactions foreboding (No vs. Yes)	/	/	/	/	0.041	0.691	0.484	0.986	0.001	0.501	0.329	0.763
PCS (Low-declining vs. High-slow increasing-stable)	0.011	2.623	1.247	5.516	<0.001	5.782	2.617	12.776	0.012	3.339	1.300	8.577
PCS (Medium-stable vs. High-slow increasing-stable)	0.191	0.717	0.435	1.180	<0.001	1.911	1.381	2.644	0.702	0.929	0.635	1.358
MCS (Low-declining vs. High-stable)	/	/	/	/	0.197	1.388	0.843	2.285	0.232	0.662	0.336	1.302
MCS (Medium-stable vs. High-stable)	/	/	/	/	0.510	1.121	0.798	1.574	0.548	1.134	0.752	1.710

/: Variables with P > 0.05 in univariate analysis and didn’t be examined in the multinomial logistic regression analysis.

PCS: Physical Component Summary; MCS: Mental Component Summary.

Table 5. Multinomial logistic regression to assess predictors associated with perceived benefits, perceived barriers and cues to action trajectory.

Variable	Perceived benefits trajectory				Perceived barriers trajectory								Cues to action trajectory
	High-stable vs. Low-stable				Medium-stable vs. Low-stable				High-stable vs. Low-stable				Medium-stable vs. Low-stable				High-stable vs. Low-stable
	P	OR	95%CI		P	OR	95%CI		P	OR	95%CI		P	OR	95%CI		P	OR	95%CI
Sex (Men vs. Women)	0.088	1.274	0.964	1.683	/	/	/	/	/	/	/	/	/	/	/	/	/	/	/	/
Age group (12–17 vs. 40 and older)	/	/	/	/	0.513	1.312	0.582	2.957	0.256	1.647	0.696	3.895	/	/	/	/	/	/	/	/
Age group (18–28 vs. 40 and older)	/	/	/	/	0.804	1.075	0.608	1.901	0.645	1.151	0.632	2.098	/	/	/	/	/	/	/	/
Age group (29–39 vs. 40 and older)	/	/	/	/	0.235	0.732	0.437	1.225	0.545	0.846	0.493	1.453	/	/	/	/	/	/	/	/
Education level (Junior high school or below vs. Bachelor degree or above)	0.206	0.705	0.410	1.212	/	/	/	/	/	/	/	/	/	/	/	/	/	/	/	/
Education level (Senior high school vs. Bachelor degree or above)	0.336	0.765	0.443	1.320	/	/	/	/	/	/	/	/	/	/	/	/	/	/	/	/
Education level (College Degree vs. Bachelor degree or above)	0.908	1.038	0.546	1.975	/	/	/	/	/	/	/	/	/	/	/	/	/	/	/	/
Occupation post (Other vs. Personnel of public institutions)	0.037	1.986	1.044	3.777	0.408	1.399	0.632	3.096	0.234	1.677	0.715	3.930	0.096	2.204	0.870	5.584	0.202	1.781	0.733	4.327
Occupation post (Enterprise staffs vs. Personnel of public institutions)	0.369	1.350	0.701	2.600	0.015	2.938	1.228	7.032	0.039	2.705	1.051	6.961	0.013	3.871	1.336	11.210	0.012	3.756	1.340	10.528
Occupation post (Farmers and industrial workers vs. Personnel of public institutions)	0.438	1.244	0.717	2.159	0.772	0.905	0.463	1.772	0.801	1.098	0.529	2.280	0.181	1.688	0.784	3.634	0.703	1.152	0.556	2.385
Occupation post (Students vs. Personnel of public institutions)	0.639	1.146	0.649	2.023	0.846	0.912	0.361	2.304	0.833	1.112	0.413	2.991	0.218	1.652	0.743	3.671	0.419	1.365	0.642	2.902
Health insurance (No vs. Yes)	/	/	/	/	/	/	/	/	/	/	/	/	0.199	0.720	0.435	1.189	0.408	0.813	0.498	1.328
Adverse reactions foreboding (No vs. Yes)	/	/	/	/	0.674	0.919	0.622	1.359	0.010	1.792	1.152	2.789	/	/	/	/	/	/	/	/
PCS (Low-declining vs. High-slow increasing-stable)	0.021	0.483	0.260	0.897	0.446	0.762	0.379	1.533	0.003	0.229	0.087	0.603	0.105	0.529	0.245	1.142	<0.001	0.197	0.083	0.470
PCS (Medium-stable vs. High-slow increasing-stable)	0.036	0.716	0.525	0.978	0.553	1.141	0.738	1.762	0.033	0.634	0.417	0.965	0.808	0.938	0.557	1.577	0.034	0.589	0.361	0.961
MCS (Low-declining vs. High-stable)	<0.001	0.202	0.125	0.327	<0.001	0.286	0.149	0.550	<0.001	0.038	0.018	0.081	0.006	0.364	0.176	0.753	<0.001	0.057	0.027	0.119
MCS (Medium-stable vs. High-stable)	<0.001	0.507	0.358	0.718	0.045	0.564	0.321	0.988	<0.001	0.261	0.154	0.443	0.340	0.730	0.382	1.395	0.002	0.387	0.212	0.705

/: Variables with P > 0.05 in univariate analysis and didn’t be examined in the multinomial logistic regression analysis.

PCS: Physical Component Summary; MCS: Mental Component Summary.

Table

COVID-19	Coronavirus disease 2019
SARS-CoV-2	severe acute respiratory syndrome coronavirus 2
GBTM	Group-based trajectory model
SF-12	12-item short-form
PCS	physical component summary
MCS	mental component summary
AvePP	Average Posterior Probability
BIC	Bayesian Information Criterion