Predicting COVID-19 Vaccination Intentions to Inform Evidence-Based Messaging for Building Vaccine Confidence Among Rural Americans.

PURPOSE: Examine possible message topics to promote rural vaccination using psychosocial antecedents of vaccination. DESIGN: Cross-sectional survey administered by Research America, Inc. SETTING: West Virginia (WV). SAMPLE: 756 WV adults via convenience sample (n = 370; ∼2% response rate from online panel of ∼20 000 WV residents), and random digit dial of landlines (n = 174; ∼1% response rate from 18 432 numbers) and cellphones (n = 212; ∼1% response rate from 20 486 numbers). MEASURES: Outcome measures included self-reported vaccination intention and behavior. Predictor measures, rooted in theories of social and behavioral science that have been found to be predictive of vaccination outcomes (i.e., Reasoned Action Approach, Extended Parallel Process Model), included perceived severity and susceptibility, negative affect, instrumental and affective attitudes, social norms, self-efficacy, response efficacy, and perceived control. ANALYSIS: Multivariate linear regression for intention and logistic regression for behavior. RESULTS: Intention was positively predicted by affective attitude, ß = .30, P < .05, instrumental attitude, ß = .19, P < .05, response efficacy, ß = .19, P < .05, negative affect, ß = .16, P < .05, self-efficacy, ß = .13, P < .05, and subjective norm, ß = .13, P < .05, F(10, 267) = 30.12, Adj. R2 = .53. Vaccination status was predicted by instrumental attitude, exp(B) = 2.09, and subjective norm, exp(B) = 2.00, Pseudo R2 = .29, log likelihood = 125.11, χ2(10) = 38.34, P < .05. Promising message targets were instrumental attitude, M = 3.21, SD = 1.46, and subjective norms, M = 3.76, SD = 1.71. CONCLUSION: COVID-19 vaccine confidence messages should address (1) positive feelings and safety perceptions, (2) vaccination's effectiveness in preventing serious COVID-19, and (3) subjective vaccination norms.

Healthcare provider Communication and Data-Informed Message Strategies for Encouraging Older Adults to Stay up to Date on COVID-19 Vaccination.

Older adults are a high in risk of severe COVID-19 disease outcomes and experience "vaccine hesitancy." Guided by health communication models such as the Reasoned Action Approach and the Extended Parallel Process Model, online surveys designed to inform statewide public health communication efforts were administered in West Virginia, a primarily rural and fully Appalachian state, in Winter 2021 (n = 272) and Fall 2022 (n = 248). Adults ages 50+ years (N = 520) reported attitudes, intentions, and behaviors regarding COVID-19 vaccination and their related patient-provider communication. Vaccine usefulness/safety, perceived effectiveness, and subjective norms predicted behavior while perceived severity, efficacy, and usefulness/safety predicted intention to get a booster, specifically the updated Fall 2022 Omicron (bivalent) booster. As patient-provider communication (which a minority reported receiving) was a strong predictor of behavioral outcomes, characteristics of effective healthcare provider communication and considerations for public message construction are discussed.

Quantitatively Identifying Messaging Topics to Encourage West Virginia nurses' COVID-19 Vaccination.

Nurses are particularly influential to others as it relates to COVID-19 vaccination decision-making and are at higher risk of COVID-19 themselves. Yet, nurses' COVID-19 vaccination remains suboptimal. This study combines communication science frameworks with a novel conceptualize of identity-identity fusion-to explore why nurses may not vaccinate and what strategies might encourage them to protect themselves from COVID-19. Practicing nurses recruited from the West Virginia Nurses Association (N = 328) were asked about their nursing identity, COVID-19 threat perceptions, vaccination efficacy perceptions, vaccination social norms, and both vaccination and information seeking plans. Findings show that social norms may have particular influence over nurses' vaccination intentions, though this is unique to nurses who do not view themselves as completely "fused" with the nursing identity. "Fully fused" nurses, on the other hand, may respond well to information conveying their particular risk for COVID-19. Data suggest information on one's self-efficacy or ability to get vaccinated should be avoided, as it might discourage some nurses'vaccination. Findings are discussed in terms of how identity may influence vaccination.