ABSTRACT
China's recent termination of strict COVID-19 control necessitates taking a booster vaccine shot as a precaution against the pandemic as quickly as possible. A large body of research has examined people's attitudes toward and intentions for the booster shot. However, most studies failed to explore how China's sociopolitical context has shaped their attitude regarding the booster jab take-up. The current study utilizes data from a national survey adopting quota sampling to analyze the Chinese public's medical and non-medical considerations to determine their intention for the third dose of the COVID-19 vaccine. The study found that thanks to China's initial successful lockdown policies, personal risk and benefit perceptions did not dominate their views regarding booster vaccination. Instead, respondents' gender, nationalism, endorsement of the zero-COVID policy, self-efficacy regarding vaccination, and perceived infection severity were the major factors underlying their booster shot intention. The situation highlights how the politicized context of China's COVID-19 control has impacted people's plans to practice preventive behaviors. It is necessary to offset the negative consequences. One strategy is to educate the Chinese public with more medically relevant information to help them make rational choices regarding vaccination and other protective measures. On the other hand, such education can utilize this nationalistic mental status to enhance the persuasion effect.
ABSTRACT
Introduction: China's loosening its COVID-19 controls highlighted its insufficiency in vaccination protection. Mandatory vaccination might be necessary if the gap cannot be filled over a short time. However, few studies have explored how Chinese people view the COVID-19 vaccine mandates, let alone placing such views in the country's highly politicized context. Material and methods: The current study utilizes data from a national survey adopting quota sampling to analyze the Chinese public's medical and non-medical considerations when judging compulsory COVID-19 vaccination (n = 1,523). The survey was conducted between 1 and 8 April 2021. All adults aged 18 years and older were eligible to take part. The survey included sociodemographic details, perceived susceptibility to infection, perceived vaccine benefit, attitudes to vaccination policies, nationalism, beliefs in various conspiracy theories and science literacy. Multiple regression analyses were done to examine factors associated with the attitude to COVID-19 vaccine mandates. Results: The study reveals that personal risk and benefit perceptions did not dominate the Chinese public's attitude toward vaccination mandates. Instead, nationalism was relatively strongly associated with their willingness to accept mandatory vaccination. Contrary to studies in the West, various conspiracy beliefs and conspiratorial thinking were robustly related to the support for mandatory vacciniation. Science literacy didn't link to the attitude to vaccination mandates. It only had a weak moderating effect on the influence of conspiratorial thinking on attitudes to the vaccination policies. Conclusions: The results indicated that Chinese people's attitude to the COVID-19 vaccination policy is highly politicized and influenced by conspiracy theories. Given the potentially massive impacts of the COVID-19 infection, we need to educate the Chinese public with more medically valuable and relevant information to help them make sound decisions regarding vaccination. Meanwhile, we can adopt nationalistic tones to improve the persuasion effect, but misinformation during the process must be overcome.
ABSTRACT
BACKGROUND: Since its outbreak in January 2020, COVID-19 has quickly spread worldwide and has become a global pandemic. Social media platforms have been recognized as important tools for health-promoting practices in public health, and the use of social media is widespread among the public. However, little is known about the effects of social media use on health promotion during a pandemic such as COVID-19. OBJECTIVE: In this study, we aimed to explore the predictive role of social media use on public preventive behaviors in China during the COVID-19 pandemic and how disease knowledge and eHealth literacy moderated the relationship between social media use and preventive behaviors. METHODS: A national web-based cross-sectional survey was conducted by a proportionate probability sampling among 802 Chinese internet users ("netizens") in February 2020. Descriptive statistics, Pearson correlations, and hierarchical multiple regressions were employed to examine and explore the relationships among all the variables. RESULTS: Almost half the 802 study participants were male (416, 51.9%), and the average age of the participants was 32.65 years. Most of the 802 participants had high education levels (624, 77.7%), had high income >¥5000 (US $736.29) (525, 65.3%), were married (496, 61.8%), and were in good health (486, 60.6%). The average time of social media use was approximately 2 to 3 hours per day (mean 2.34 hours, SD 1.11), and the most frequently used media types were public social media (mean score 4.49/5, SD 0.78) and aggregated social media (mean score 4.07/5, SD 1.07). Social media use frequency (ß=.20, P<.001) rather than time significantly predicted preventive behaviors for COVID-19. Respondents were also equipped with high levels of disease knowledge (mean score 8.15/10, SD 1.43) and eHealth literacy (mean score 3.79/5, SD 0.59). Disease knowledge (ß=.11, P=.001) and eHealth literacy (ß=.27, P<.001) were also significant predictors of preventive behaviors. Furthermore, eHealth literacy (P=.038) and disease knowledge (P=.03) positively moderated the relationship between social media use frequency and preventive behaviors, while eHealth literacy (ß=.07) affected this relationship positively and disease knowledge (ß=-.07) affected it negatively. Different social media types differed in predicting an individual's preventive behaviors for COVID-19. Aggregated social media (ß=.22, P<.001) was the best predictor, followed by public social media (ß=.14, P<.001) and professional social media (ß=.11, P=.002). However, official social media (ß=.02, P=.597) was an insignificant predictor. CONCLUSIONS: Social media is an effective tool to promote behaviors to prevent COVID-19 among the public. Health literacy is essential for promotion of individual health and influences the extent to which the public engages in preventive behaviors during a pandemic. Our results not only enrich the theoretical paradigm of public health management and health communication but also have practical implications in pandemic control for China and other countries.