ABSTRACT
BackgroundOne of the newly faced challenges during the COVID-19 is vaccine hesitancy (VH). The validated 5C scale, that assesses five psychological antecedents of vaccination, could be effective in exploring COVID-19 VH. This study aimed to determine a statistically valid cutoff points for the 5C sub-scales among the Arab population. MethodsA cross-sectional study was conducted among 446 subjects from three Arab countries (Egypt, United Arab Emirates UAE, and Jordan). Information regarding sociodemographics, clinical history, COVID-19 infection and vaccination history, and 5C scale were collected online. The 5C scores were analyzed to define the cutoff points using the receiver operating characteristic curve (ROC) and to verify the capability of the questionnaire to differentiate whether responders are hesitant or non-hesitant to accept vaccination. ROC curve analysis was conducted setting for previous vaccine administration as a response, with the predictors being the main five domains of the 5C questionnaire. The mean score of each sub-scale was compared with COVID-19 vaccine intake ResultsThe mean age of the studied population was 37{+/-}11, 42.9% were males, 44.8% from Egypt, 21.1% from Jordan, and 33.6% from UAE. Statistically significant differences between vaccinated and unvaccinated participants, respectively, weredetetd in the median score of confidence [6.0(1.3) versus 4.7(2.0)], complacency [(2.7(2.0) versus 3.0(2.0), constraints [1.7(1.7) versus 3.7(2.3)], and collective responsibility [6.7(1.7) versus 5.7(1.7)]. The area under the curve of the five scales was 0.72, 0.60, 0.76, 0.66, 0.66 for confidence, complacency, constraints, calculation, and collective responsibility at cutoff values of 5.7, 4.7, 6.0, 6.3, and 6.2, respectively. Conclusionthe Arabic validated version of the 5C scale has a good discriminatory power to predict COVID-19 vaccines antecedent.
ABSTRACT
BackgroundIn the Arab countries, there has not been yet a specific validated questionnaire that can assess the psychological antecedents of COVID-19 vaccine among the general population. This study, therefore, aimed to translate, culturally adapt, and validate the 5C scale into the Arabic language. MethodsThe 5C scale was translated into Arabic by two independent bilingual co-authors, and then subsequently translated back into English. After reconciling translation disparities, the final Arabic questionnaire was disseminated into four randomly selected Arabic countries (Egypt, Libya, United Arab Emirates (UAE), and Saudi Arabia). Data from 350 Arabic speaking adults (aged [≥]18 years) were included in the final analysis. Convergent, discriminant, exploratory and confirmatory factor analyses were carried out. Internal consistency was assessed by Cronbach alpha. ResultsAge of participants ranged between 18 to 73 years; 57.14% were females, 37.43% from Egypt, 36.86%, from UAE, and 30% were healthcare workers. The 5 sub-scales of the questionnaire met the criterion of internal consistency (Cronbach alpha [≥]0.7). Convergent validity was identified by the significant inter-item and item-total correlation (P<0.001). Discriminant validity was reported as inter-factor correlation matrix (<0.7). Exploratory factor analysis indicated that the 15 items of the questionnaire could be summarized into five factors. Confirmatory factor analysis confirmed that the hypothesized five-factor model of the 15-item questionnaire was satisfied with adequate psychometric properties and fit with observed data (RMSEA=0.060,GFI=0.924, CFI=0.957, TLI=0.937, SRMR=0.076 & NFI=906). Conclusionthe Arabic version of the 5C scale is a valid and reliable tool to assess the psychological antecedents of COVID-19 vaccine among Arab population.
