How do vaccination intentions change over time? The role of motivational growth.

OBJECTIVE: Across nationwide rollout of COVID-19 vaccination, people in Belgium differed widely in their vaccination intention. In the present study, we examined (a) how people's vaccination intentions changed during the vaccination rollout and (b) whether changes in motivation (i.e., autonomous, controlled, and distrust-based (a)motivation) predicted changes in vaccination intention, thereby taking into account people's vaccination intention at baseline. METHOD: Using 4 subsamples of participants who were vaccinated at different time points (ntotal = 10,799) between December 2020 and June 2021; we used latent change modeling and latent growth curve modeling to examine the associations among initial levels and changes in vaccination motivation and vaccination intention. RESULTS: Across subsamples, changes in vaccination intention were found to be qualified by changes in motivation. An increase in autonomous motivation was related to a positive shift in vaccination intention, while an increase in both controlled motivation and distrust-based amotivation was related to a negative shift in vaccination intention. Moreover, autonomous motivation predicted especially an increase in vaccination intention among those initially low in vaccination intention, whereas an increase in either controlled motivation or distrust-based amotivation especially predicted a decrease in vaccination intention among those initially high in vaccination intention. CONCLUSIONS: Findings suggest that a growing sense of ownership and a reduction in distrust is critical for individuals to develop a stronger intention to get vaccinated, particularly when people had initially low vaccination intentions. We discuss conceptual, methodological, and practical implications. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Who is motivated to accept a booster and annual dose? A dimensional and person-centered approach.

The transmissibility of new COVID-19 variants and decreasing efficacy of vaccines led authorities to recommend a booster and even an annual dose. However, people's willingness to accept new doses varied considerably. Using two independent longitudinal samples of 4596 (Mean age = 53.6) and 514 (Mean age = 55.9) vaccinated participants, we examined how people's (lack of) vaccination motivation for their first dose was associated with their intention to get a booster (Sample 1) and an annual dose (Sample 2) several months later (Aim 1). We also aimed to capture the impact of the motivational heterogeneity on these intentions by capitalizing on participants' different motivational profiles collected at baseline (Aim 2). Across both samples, autonomous motivation, controlled motivation, and distrust-based amotivation were uniquely related to, respectively, higher, lower, and even lower booster and annual dose intentions. Further, a two-step clustering procedure revealed five profiles, with the profiles characterized by higher autonomous motivation (i.e. Good Quality and High Quantity profiles) reporting the highest vaccination intentions and the profile characterized by the highest number of obstacles (i.e. Global Amotivated profile) yielding the lowest vaccination intentions. These results stress the critical need to support citizens' volitional endorsement of vaccination to harvest long-term benefits with respect to COVID-19.

Predicting Compliance with Sanitary Behaviors among Students in Higher Education During the Second COVID-19 Wave: The Role of Health Anxiety and Risk Perception.

To limit the spread of COVID-19, public authorities have recommended sanitary behaviors such as handwashing, mask-wearing, physical distancing, and social distancing. We recruited a large sample of higher education students in Belgium (N = 3201-3441) to investigate the role of sociodemographic variables, mental health, previous COVID-19 infections, academic involvement, and risk perception on adherence to these sanitary behaviors. This cross-sectional study took place during the second COVID-19 wave in Belgium, between February and March 2021. Analyses showed that living alone, being female, later in the academic curriculum, having higher general and health anxiety, higher academic involvement, and higher risk perception were positively associated with adherence to the four aforementioned sanitary behaviors. Conversely, previous infection with COVID-19 and having been quarantined were negative predictors. Our results show a set of predictors highly similar for the four sanitary behaviors. We discuss potential initiatives to increase adherence to sanitary behaviors in this group of highly educated youngsters.

The Role of Communication Style and External Motivators in Predicting Vaccination Experiences and Intentions: An Experimental Vignette Study.

This vignette-based study examined in a sample of unvaccinated Belgian citizens (N = 1918; Mage = 45.99) how health care workers could foster reflection about and intentions to get vaccinated against COVID-19 by experimentally varying their communication style (i.e., autonomy-supportive vs. controlling) and the reference to external motivators (i.e., use of a monetary voucher or corona pass vs. the lack thereof). Each participant was randomly assigned to one of six conditions and rated a vignette in terms of anticipated autonomy satisfaction, perceived effectiveness, reflection, and vaccination intention. An autonomy-supportive, relative to a controlling, communication style predicted greater autonomy need satisfaction, which in turn related positively to perceived effectiveness, reflection, and vaccination intention. External motivators failed to generate positive effects compared to the control condition. The findings highlight the critical role of autonomy support in promoting a self-endorsed decision to get vaccinated.

A cross-national and longitudinal analysis of handwashing and its predictors during the COVID-19 pandemic in France and Belgium.

BACKGROUND: Using a longitudinal design, we investigate how the adherence to handwashing and its underlying socio-psychological predictors evolved over time during the COVID-19 pandemic and under distinct circumstances (e.g. when the crisis was more acute or chronic). METHOD: We collected data (N = 753) in Belgium and France at the onset of the COVID-19 pandemic when the crisis was at its peak (April 2020), and almost a year later (February 2021), when the outbreak was more manageable. RESULTS: Regression models suggest that the compliance with handwashing and its pattern of underlying predictors remained remarkably stable over time despite the variations in contextual factors such as the severity of the health crisis and the stringency of health measures. As such, the findings also highlight the robustness of the models that predict it, namely the Theory of Planned Behavior. The intentions to perform the behavior, the perceived control over it, and being part of the (para)medical field were among the strongest predictors. CONCLUSIONS: In practice, the stability of the underlying factors suggests a set of action levers that can be used in communication campaigns aimed at fostering its adherence throughout the pandemic.

Personal and contextual determinants of COVID-19 vaccination intention: a vignette study.

BACKGROUND: This vignette study explores which factors contribute to higher COVID-19 vaccination intentions. METHODS: Between the 4th-11 January 2021, we recruited 15,901 Belgian citizens (Mage = 50.11 years, range 18-100) through convenience sampling to participate in a vignette study. In each vignette, we manipulated contextual determinants consisting of different factors. Each participant rated six vignettes in terms of the outcomes 'vaccination intention' and 'recommendation to others.' Finally, we explored the benefits of tailored communication by examining whether these ratings depended upon citizens' initial motives for vaccination. RESULTS: Participants are most likely to accept a vaccine when they expect no or only small side effects, when the vaccine offers a 95% protection, and when people can no longer infect others (p < 0.001). The possibility to receive the vaccine at home or at the GP's office, highlighting that most citizens are willing to get vaccinated, and emphasizing the protective benefits for others yielded additional positive effects (p < 0.001). Results showed that tailored communication has a small but significant effect, especially for individuals high on distrust-based amotivation (p < 0.01). CONCLUSION: In addition to vaccine characteristics, there is room for policymakers to respond to those determinants that fall under their control and can thus be highlighted within communication campaigns.

The relation between conspiracism, government trust, and COVID-19 vaccination intentions: The key role of motivation.

RATIONALE: Vaccination willingness is a critical step in the effort to reach herd immunity and control the COVID-19 pandemic. Nevertheless, many people remain reluctant to be vaccinated. OBJECTIVE: Integrating the literature on Self-Determination Theory, trust in authorities, and conspiracy theories, this research examines (a) the direct and indirect effect of government trust and conspiracism via underlying forms of motivations for (not) getting vaccinated against COVID-19 and (b) whether these associations differ across the two largely politically independent Belgian linguistic groups. METHODS: Using Structural Equation Modeling, we tested our models in two independent samples, in February 2021 (T1) and April 2021 (T2) (Total N = 8264). RESULTS: At T1 and T2, Government trust and conspiracism both predict COVID-19 vaccination intention, respectively positively and negatively. These relations are fully mediated by motivational factors, with identified motivations having a larger positive contribution. Looking at linguistic context, differences emerge at T2, with French-speaking Belgians showing lower levels of government trust and higher levels of conspiracism than Dutch speakers. CONCLUSIONS: Results highlight the importance of integrating distal (trust in government, conspiracism) and proximal (motivational) variables to understand vaccination intentions.

Predicting health behaviors across Belgium and France during the first wave of COVID-19 pandemic.

The objective of the current research was to investigate how a series of psychological factors may underlie two COVID-19 health behaviors, and how a contextual factor (country of residence) could shape their influence. Cross-sectional results from the first pandemic wave (NBelgium = 4878, NFrance = 1071) showed that handwashing and social contacts limitation are predicted by a unique set of psychological variables that holds across Belgium and France, despite their distinct lockdown-policies strictness. In practice, policy-makers could leverage on these unique predictors and fine-tune their strategies accordingly to promote adherence to each measure while generalizing it across similar nations.

Predicting vaccine uptake during COVID-19 crisis: A motivational approach.

The present research examined which motivational factors contribute to individuals' intention to take a vaccine that protects against SARS-CoV-2-virus and their self-reported vaccine uptake several months later. The role of different types of motivation was investigated (i.e., autonomous and controlled regulation) as well as vaccine distrust and effort to obtain a vaccine. Across two large-scale cross-sectional (N = 8887) and longitudinal (N = 6996) studies and controlling for various covariates, autonomous motivation and distrust-based amotivation contributed positively and negatively, respectively, to a) concurrent vaccination intentions, b) self-reported vaccination and c) subsequent subscription to a waitlist to obtain a vaccine. Participants' infection-related risk perception predicted more positive vaccination outcomes through fostering greater autonomous motivation for vaccination and lower distrust, whereas pandemic-related health concerns failed to yield such adaptive effects. The results emphasize the importance of fostering autonomous motivation for vaccination and handling distrust.

The Theory of Planned Behavior during the COVID-19 pandemic: A comparison of health behaviors between Belgian and French residents.

The COVID-19 pandemic presents a global crisis and authorities have encouraged the population to promote preventive health behaviors to slow the spread of the virus. While the literature on psychological factors influencing health behaviors during the COVID-19 is flourishing, there is a lack of cross-national research focusing on multiple health behaviors. The present study overcomes this limitation and affords a validation of the Theory of Planned Behavior (TPB) as a conceptual framework for explaining the adoption of handwashing and limitation of social contacts, two health behaviors that highly differ in their nature. Specifically, we compare TPB model on these two protective behaviors among people living in Belgium (N = 3744) and France (N = 1060) during the COVID-19 sanitary crisis. Data were collected from March 18 until April 19, 2020, which corresponds to the spring lockdown and the first peak of the pandemic in these countries. Results indicated that more positive attitudes, greater social norms, increased perceived control and higher intentions were related to higher adherence to handwashing and limitation of social contacts, for both Belgian and French residents. Ultimately, we argued that the TPB model tends to manifest similarly across countries in explaining health behaviors, when comparing handwashing and limitation of social contacts among individuals living in different national contexts.

Sociodemographic, Cognitive, and Emotional Determinants of Two Health Behaviors during SARS-CoV-2 Outbreak: An Online Study among French-Speaking Belgian Responders during the Spring Lockdown.

To contain the SARS-CoV-2 infection rate, health authorities have encouraged the population to enhance protective behaviors such as physical distancing and handwashing. Behavioral sciences emphasize the role of sociocognitive determinants to explain health behaviors, while largely ignoring emotional factors. In a large online study (N > 4000), we investigated the role of sociodemographic, cognitive, emotional, and social factors that can facilitate or hinder handwashing and limitation of social contacts. Data were collected from March 18 until April 19, 2020, which corresponds to the spring lockdown and the first peak of the pandemic in Belgium. Logistic regressions showed that sociodemographic factors (gender, age, level of education) and the dimensions of the Theory of Planned Behavior (intentions, attitudes, perceived behavioral control and subjective norms) had a strong impact on health behaviors, but that emotional factors explained an additional part of the variance. Being more attentive/determined and frightened/anxious, along with scoring higher on health anxiety were related to a higher frequency of handwashing. In contrast, being enthusiastic/happy was related to lower adherence to limiting social contacts. Our results suggest that the type of predictors and the direction of associations depend on the type of health behavior considered. The role of specific emotional factors in addition to more classical predictors is discussed. The study offers new perspectives regarding the factors that are associated with the adherence to behaviors recommended to adopt when faced with a pandemic.

Psychological Distress among Students in Higher Education: One Year after the Beginning of the COVID-19 Pandemic.

The COVID-19 pandemic has affected the psychological well-being of students. Several stressors (such as socioeconomic and education-related contexts) could influence mental health, as well as individual and relational dimensions. This study proposes to evaluate the predictive effect of these factors on anxiety and depressive symptoms among students in higher education one year after the beginning of the pandemic. A sample of 23,307 students (Mage = 20.89; SD = 1.96; 69.08% of women) was assessed through an online self-report questionnaire including adapted and validated measures. The main rates were as follows: 50.6% of students presented anxiety symptoms; 55.1% reported depressive symptoms; 20.8% manifested suicidal ideations; 42.4% saw their financial situation deteriorate; 39.1% felt they were dropping out of school. One year after the beginning of the pandemic, students in higher education are anxious and depressed, especially those who identify as women (for both anxiety and depression) and as a non-binary gender (only for anxiety), experience a deterioration in their financial situation, are dropping out of school, or manifest hostility (for both anxiety and depression). The degree of study affects the symptoms' severity (Bachelor 2 and 3 for anxiety and Master for depression). Contact with family and friends (for both anxiety and depression) as well as regular physical activity (only for depression) should provide some protection against psychological distress. Policy-makers must make a long-term investment in the well-being and positive mental health of the student community.