Background

Theories of health behavior change are being inadequately adopted to understand the reasons behind low influenza vaccination rates among healthcare workers (HCWs). The Theory of Planned Behavior (TPB) is being used to predict intention-behavior relationship while the Health Belief Model (HBM) is being employed to predict actual behavior. The purpose of this study was to test a conceptual model based on the HBM’s constructs to predict Jordanian HCWs’ intentions for influenza vaccine uptake as an alternative to the TPB.

Method

A cross-sectional questionnaire-based study was conducted in 2016 in a tertiary teaching hospital in Amman-Jordan including a convenience sample of 477 HCWs with direct patient contact. The study instrument was tested for validity and reliability. A conceptual regression model was proposed incorporating the constructs of the primary HBM with some modifications in the threat construct as well as an additional variable about explicit past vaccination behavior (in the past year and/or any previous history of influenza vaccine uptake).

Results

Almost all the constructs of the HBM demonstrated significant differences between participants intending and those who did not intend to vaccinate against influenza. After adjusting for the confounding variables in the final conceptual regression model, past vaccination behavior (OR= 4.50, 95%Confidence Interval 3.38–6.00, P< 0.0005) and the perceived benefit scale (OR= 1.19, 95% Confidence Interval 1.11–1.28, P< 0.0005) were the only significant predictors of intentions to vaccinate against influenza in the next season.

Conclusion

Taking into consideration the altruistic beliefs of HCWs and their explicit past vaccination history augments the utility of the original HBM tool in predicting HCWs’ intentions to vaccinate against influenza in a way that is consistent with the predictive ability of the Theory of Planned Behavior.

中文翻译：

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预测约旦医护人员对流感疫苗摄取意愿的健康信念模型。

背景

没有充分采用健康行为改变的理论来了解医护人员（HCW）接种流感疫苗的比率低的原因。计划行为理论（TPB）用于预测意向-行为关系，而健康信念模型（HBM）用于预测实际行为。这项研究的目的是测试基于HBM结构的概念模型，以预测约旦HCW替代TPB的流感疫苗摄取意向。

方法

2016年，在安曼-约旦的一家三级教学医院进行了基于问卷调查的横断面研究，其中包括与患者直接接触的477名HCW的便利样本。测试了研究仪器的有效性和可靠性。提出了一种概念回归模型，该模型将主要HBM的构建体与威胁构建体进行了一些修改，并包含了有关明确的过去疫苗接种行为（过去一年和/或以前任何流感疫苗吸收史）的附加变量。

结果

几乎所有的HBM构造都表明，有意参加者和无意接种流感疫苗的参与者之间存在显着差异。在最终概念回归模型中对混杂变量进行调整之后，过去的疫苗接种行为（OR = 4.50，95％置信区间3.38–6.00，P <0.0005）和感知的受益规模（OR = 1.19，95 ％置信区间1.11–1.28 ，P <0.0005）是下一季接种流感疫苗的唯一重要预测指标。

结论

考虑到HCW的利他主义信念及其明确的过去疫苗接种历史，可以增强原始HBM工具在预测HCW预防流感疫苗意图方面的效用，其方式与计划行为理论的预测能力相一致。