Applying the health belief model to understand college students' intention to vaccinate against the seasonal influenza: Opportunities for health promotion

Background: Research suggests that very few college students receive the seasonal flu vaccine; however, few studies have assessed college student attitudes and beliefs toward flu vaccination. Therefore, the goal of this study was to develop a measure based on the health belief model to understand college students’ beliefs about the flu vaccine and identify predictors for intention to vaccinate.

Method: College students from across the U.S. were recruited through MTurk, an online system where surveys can be completed for payment.  Participants completed a survey assessing perceived severity and susceptibility for the flu, perceived barriers and benefits of the flu vaccine, cues to action, and intention. 

Results: Exploratory and confirmatory factor analyses, consistent with classical test theory, supported the new measures with good to excellent reliability (α=0.64–0.92) and adequate fit.  Two subscales were identified for perceived barriers (potential risks and process barriers), cues to action (influential others and popular media), perceived severity (severity of the flu and complications of the flu), and perceived susceptibility (susceptibility to the flu and perceived exposure risk).  The multiple linear regression analysis predicted 60.6% of the variance in intention to vaccinate, F(9, 751)=128.23, p<0.001, R²=0.606.  The three strongest predictors included: cues to action - influential others (t(751)=8.96, p<0.001), severity of the flu (t(751)=8.31, p<0.001) and susceptibility to the flu (t(751)=7.34, p<0.001).

Conclusion: Engaging influential others (doctors, nurses) in providing college students cues to get vaccinated, and increasing knowledge and awareness of perceived severity and susceptibility, should be addressed in an effort to increase vaccination rates on college campuses.