背景:COVID-19大流行促使美国卫生与人类服务部发起了“COVID-19公众教育运动”,以提高成年人对疫苗的信心和吸收,因为疫苗是预防严重疾病和死亡的关键。
目的:过去与COVID-19行为相关的细分研究发现了态度上的重要差异,社会人口统计学,以及随后在不同人群中的COVID-19预防行为。这项研究通过纳入更全面的态度来扩展先前的工作,行为,和社会人口统计学变量,通过不同水平的COVID-19疫苗信心来识别人群,并评估他们随后吸收COVID-19预防行为的差异。
方法:数据来自基于网络的纵向的5波(2021年1月至2022年6月),以英语和西班牙语进行的基于概率的美国成年人小组调查(N=4398)。参与者是从芝加哥大学国家AmeriSpeak小组的NORC招募的,并被邀请参加多次浪潮。潜在类别聚类分析基于40多种COVID-19态度估计的受访者细分,信仰,行为,和第1波中报道的社会人口统计学。调查加权交叉表格和双变量回归分析评估了COVID-19疫苗摄取的差异,助推器摄取,面罩使用,以及所有5次调查浪潮中所有细分领域的社交距离。
结果:总共6个部分(强硬派非有意者,符合预防规定的非故意者,被烧死的服务员,焦虑的服务员,持怀疑态度的密友,和准备好的密友)被确认,这与他们对COVID-19疫苗的信心不同,与预防相关的态度和行为,和社会人口统计学。交叉表格和回归结果表明,COVID-19疫苗和加强时机存在显著的部门成员差异,面罩使用,和社交距离。调查加权交叉表比较了各段COVID-19疫苗和加强剂摄取的结果表明,这些结果在6个段之间存在统计学上的显著差异(P<.001)。每个部分的结果均具有统计学意义(精疲力尽的服务员中的助推器摄取P<0.01;所有其他系数P<0.001),表明,平均而言,疫苗接种意愿较低的细分市场的受访者报告说,与已准备好的密友接种疫苗和加强剂的时间相比,COVID-19疫苗和加强剂的接收时间较晚。
结论:结果通过显示与COVID-19疫苗接种相关的初始信念和行为,扩展了以前的研究,面罩使用,和社会距离对于理解随后对推荐的COVID-19预防措施的依从性差异很重要。具体来说,我们发现,在受访者群体中,接种疫苗和加强疫苗的概率与COVID-19疫苗信心和面罩使用以及社交距离依从性相对应;在疫苗信心水平相似的情况下,更合规的部分比不合规的部分更有可能接种疫苗或加强疫苗接种.这些发现有助于确定活动的适当受众。结果突出了使用全面的态度清单,行为,以及其他个体水平的特征,这些特征可以作为未来与COVID-19和其他传染病相关的细分工作的基础。
BACKGROUND: The COVID-19 pandemic prompted the launch of the US Department of Health and Human Services\' COVID-19 Public Education Campaign to boost vaccine confidence and uptake among adults, as vaccines are key to preventing severe illness and death.
OBJECTIVE: Past segmentation research relevant to COVID-19 behavior has found important differences in attitudes, sociodemographics, and subsequent COVID-19 prevention behaviors across population segments. This study extends prior work by incorporating a more comprehensive set of attitudes, behaviors, and
sociodemographic variables to identify population segments by differing levels of COVID-19 vaccine confidence and evaluate differences in their subsequent uptake of COVID-19 prevention behaviors.
METHODS: Data were obtained from 5 waves (January 2021 to June 2022) of a web-based longitudinal, probability-based panel survey of US adults (N=4398) administered in English and in Spanish. Participants were recruited from NORC at the University of Chicago\'s national AmeriSpeak panel and were invited to participate across multiple waves. Latent class cluster analysis estimated segments of respondents based on over 40 COVID-19 attitudes, beliefs, behaviors, and sociodemographics as reported in wave 1. Survey-weighted cross-tabulations and bivariate regression analyses assessed differences in COVID-19 vaccine uptake, booster uptake, mask use, and social distancing in all segments across all 5 survey waves.
RESULTS: A total of 6 segments (hardline nonintenders, prevention-compliant nonintenders, burned-out waiters, anxious waiters, skeptical confidents, and ready confidents) were identified, which differed by their COVID-19 vaccine confidence, prevention-related attitudes and behaviors, and sociodemographics. Cross-tabulations and regression results indicated significant segment membership differences in COVID-19 vaccine and booster timing, mask use, and social distancing. Results from survey-weighted cross-tabulations comparing COVID-19 vaccine and booster uptake across segments indicate statistically significant differences in these outcomes across the 6 segments (P<.001). Results were statistically significant for each segment (P<.01 for booster uptake among burned-out waiters; P<.001 for all other coefficients), indicating that, on average, respondents in segments with lower intentions to vaccinate reported later receipt of COVID-19 vaccines and boosters relative to the timing of vaccine and booster uptake among ready confidents.
CONCLUSIONS: Results extend previous research by showing that initial beliefs and behaviors relevant to COVID-19 vaccination, mask use, and social distancing are important for understanding differences in subsequent compliance with recommended COVID-19 prevention measures. Specifically, we found that across respondent segments, the probability of vaccine and booster uptake corresponded with both COVID-19 vaccine confidence and mask use and social distancing compliance; more compliant segments were more likely to get vaccinated or boosted than less compliant segments given similar levels of vaccine confidence. These findings help identify appropriate audiences for campaigns. Results highlight the use of a comprehensive list of attitudes, behaviors, and other individual-level characteristics that can serve as a basis for future segmentation efforts relevant to COVID-19 and other infectious diseases.