Gap between cognitions and behaviors among children’s guardians of influenza vaccination: The role of social influence and vaccine-related knowledge

Figures & data

Table 1. Demographic profiles and vaccination behavior.

		History of vaccination		Total	χ^2	p	aOR (95 CI%)	p
		N	%
Socio-demographic characteristics
Gender	Female	396	40.74	972	4.43	.035	1.00
	Male	202	46.76	432			1.28(1.01–1.63)	.04
Age group(year)	<30^#	200	39.92	501	8.90	.012	1.00	.01
	30-40	361	42.93	841			1.32(1.04–1.67)	.02
	≥40	37	59.68	62			2.22(1.28–3.85)	< .001
Residence	Urban^#	301	42.04	716	0.18	.669
	Rural	297	43.17	688
Education level	Middle school or lower^#	232	50.22	462	19.37	< .001	1.00
	Junior college	331	39.88	830			0.67(0.52–0.87)	< .001
	Bachelor or higher	35	31.25	112			0.47(0.29–0.76)	< .001
Annual income (RMB)	<50K	218	48.12	453	12.29	.002	1.00	.16
	<100K	180	43.58	413			0.44(0.67–1.19)	.44
	<200K	200	37.17	538			0.75(0.56–1.01)	.06
Vaccine hesitancy	High	108	33.13	326	18.53	< .001	1.00	.35
	Moderate	221	42.75	517			1.27(0.92–1.75)	.15
	Low	269	47.95	561			1.23(0.80–1.91)	.34
Perceived risk	No^#	182	39.22	464	3.22	.073	1.00	.31
	Yes	416	44.26	940			1.15(0.88–1.51)
Perceived benefit	No^#	250	35.77	699	26.54	< .001	1.00	< .001
	Yes	348	49.36	705			1.64(1.21–2.24)
Perceived barrier	No^#	215	41.19	522	0.67	.413
	Yes	383	43.42	882
Total		598	42.59	1404

Note: (i) Subjects who had never heard of the influenza vaccine were not included in the analysis; (ii) The guardians of children aged less than six months were not included; (iii) aOR: adjusted odds ratio (adjustment for confounders); vaccine hesitancy and socio-demographic characteristics including gender, age, residence, education level, and annual household income); 95%CI: 95% confidence interval.

Table 2. Vaccine hesitancy and actual uptake stratified by demographic profiles.

			History of vaccination		χ^2	p
			N	%
		Vaccine hesitancy
Gender	Female	High	61	29.05	17.28	< .001
		Moderate	148	41.23
		Low	187	46.40
	Male	High	47	40.52	3.51	.173
		Moderate	73	46.20
		Low	72	48.65
Age	<30	High	35	30.97	11.06	.004
		Moderate	65	35.91
		Low	100	48.31
	<40	High	67	33.84	9.44	.009
		Moderate	136	44.01
		Low	158	47.31
	≥40	High	6	40.00	4.93	.085
		Moderate	20	74.07
		Low	11	55.00
Residence	Urban	High	51	32.28	9.49	.009
		Moderate	111	42.05
		Low	139	47.28
	Rural	High	57	33.93	9.17	.010
		Moderate	110	43.48
		Low	130	48.69
Education	High/secondary school	High	49	42.61	10.55	.005
		Moderate	89	46.35
		Low	94	60.65
	Junior college	High	52	27.96	14.64	.001
		Moderate	119	41.90
		Low	160	44.44
	Bachelor or higher	High	7	28.00	0.17	.920
		Moderate	13	31.71
		Low	15	32.61
Annual income (RMB)	<50K	High	45	39.47	7.42	.024
		Moderate	80	46.51
		Low	93	55.69
	<100K	High	28	30.77	15.14	.001
		oderate	63	39.62
		Low	89	54.60
	<200K	High	35	28.93	5.35	.069
		Moderate	78	41.94
		Low	87	37.66

Note: (i) Subjects who had never heard of the influenza vaccine were not included in the analysis; (ii) The guardians of children aged less than six months were not included.

Table 3. Perceived risk, perceived benefit and actual uptake stratified by demographic profiles.

			History of vaccination		χ^2	p		History of vaccination		χ^2	p
			N	%				N	%
		Perceived risk					Perceived benefit
Gender	Female	No^#	63	42.00	1.55	.213	No^#	158	33.47	20.01	< .001
		Yes	139	49.29			Yes	238	47.60
	Male	No^#	119	37.90	2.09	.148	No^#	92	40.53	7.46	.006
		Yes	277	42.10			Yes	110	53.66
Age	<30	No^#	64	38.10	0.35	.554	No^#	70	29.17	22.21	< .001
		Yes	136	40.84			Yes	130	49.81
	<40	No^#	105	38.89	0.64	.104	No^#	161	37.53	10.41	.001
		Yes	256	44.83			Yes	200	48.54
	≥40	No^#	13	50.00	1.74	.187	No^#	19	63.33	0.32	.570
		Yes	24	66.67			Yes	18	56.25
Residence	Urban	No^#	73	36.68	3.24	.072	No^#	126	35.80	11.08	.001
		Yes	228	44.10			Yes	175	48.08
	Rural	No^#	109	41.13	0.73	.393	No^#	124	35.73	15.77	< .001
		Yes	188	44.44			Yes	173	50.73
Education	High/secondary school	No^#	102	50.00	0.01	.934	No^#	100	40.98	17.63	< .001
		Yes	130	50.39			Yes	132	60.55
	Junior college	No^#	74	31.62	9.26	.002	No^#	133	33.93	10.97	.001
		Yes	257	43.12			Yes	198	45.21
	Bachelor or higher	No^#	6	23.08	1.05	.305	No^#	17	26.98	1.22	.269
		Yes	29	33.72			Yes	18	36.73
Annual income (RMB)	<50K	No^#	80	47.62	0.03	.869	No^#	95	41.30	8.70	.003
		Yes	138	48.42			Yes	123	55.16
	<100K	No^#	48	38.71	1.71	.191	No^#	69	33.50	17.01	< .001
		Yes	132	45.67			Yes	111	53.62
	<200K	No^#	54	31.40	3.62	.057	No^#	86	32.70	4.41	.036
		Yes	146	39.89			Yes	114	41.45

Note: (i) Subjects who had never heard of the influenza vaccine were not included in the analysis; (ii) The guardians of children aged less than six months were not included.

Table 4. Indexes of model fitness for the structural equation model.

	GFI	AGFI	CFI	PNFI	RMSEA
Fitting value	0.933	0.912	0.890	0.729	0.060
Reference value	>0.9	>0.9	>0.8	>0.5	<0.08

Note: *GFI, goodness-of-fit index; AGFI, adjusted goodness-of-fit index; CFI, comparative fit index; PNFI, parsimony normed fit index; RMSEA, root mean square error of approximation. Fitting values suggested that the structural equation model had a good fitting effect.

Figure 1. Knowledge on influenza and influenza vaccination (p < .001).

Note: ^aSubjects who had never heard of the influenza vaccine were not included in the analysis; ^bThe guardians of children aged less than six months were not included.

Figure 2. Social influence on influenza vaccination (p < .001).

Note: ^aSubjects who had never heard of the influenza vaccine were not included in the analysis; ^bThe guardians of children aged less than six months were not included.

Figure 3. The effects of social influence and relative knowledge on influenza vaccination (p＜.001).

Table 5. Path diagram of knowledge, social influence, perceived benefit, perceived risk, perceived barrier, vaccine hesitancy and influenza vaccination.

	C.R.	p-value	Standard regression coefficient
Relative knowledge ← Social influence	4.63	< .001	0.07
Perceived benefit ←Social influence	21.91	< .001	1.99
Perceived risk ← Social influence	10.72	< .001	0.77
Perceived barrier ← Social influence	−8.76	< .001	−0.66
Vaccine hesitancy ← Relative knowledge	−21.26	< .001	−2.14
Vaccine hesitancy ← Social influence	−2.16	< .001	−1.09
Influenza vaccination ← Vaccine hesitancy	−3.52	< .001	−0.11
Influenza vaccination ← Social influence	6.87	< .001	0.61

Note: C.R., critical ratio.