To identify the driving and inhibiting factors and to find a prototype of community involvement in the COVID-19 vaccine.
MethodData sources from PubMed database, Google Scholar, Web of Science, and ProQuest. The data were obtained based on searches using the keyword COVID-19 (n=11,.599), focusing on community acceptance (n=813), community involvement (n=86), and types of articles (n=46). Articles that meet the inclusion criteria are seven, and the data were analyzed with ATLAS Ti.9 software.
ResultsEngagement and driving factors have the highest correlation (0.38). The drivers, perceptions of vulnerability, and inhibiting factors determine community involvement. The perception of exposure can be a supporting or inhibiting factor influenced by information reinforcement.
ConclusionsStrengthening positive information can alter the sense of community vulnerability, making it a driving force for participation in the COVID-19 vaccine campaign. This finding is an appropriate strategy to expand the reach and resolve public doubts about accepting the vaccine.
Identificar los factores impulsores e inhibidores y encontrar un prototipo de participación comunitaria en la vacuna contra la COVID-19.
MétodoFuentes de datos de las bases de datos PubMed, Google Scholar, Web of Science y ProQuest. Los datos totales se basan en búsquedas con la palabra clave COVID-19 (n=11.599), centrándose en la aceptación de la comunidad (n=813), la participación de la comunidad (n=86) y los tipos de artículos de investigación (n=46). Los artículos que cumplieron con los criterios de inclusión fueron siete. Los datos se analizaron con el software ATLAS Ti.9.
ResultadosEl compromiso y los factores impulsores tienen la correlación más alta (0,38). La participación de la comunidad está determinada por tres factores: impulsores, percepciones de vulnerabilidad e inhibidores. La percepción de vulnerabilidad puede ser un factor de apoyo o de inhibición que se ve influido por el refuerzo de la información.
ConclusionesFortalecer la información positiva puede cambiar la percepción de vulnerabilidad de la comunidad para que se convierta en un factor motivador para que esta se involucre en la vacuna contra la COVID-19. Este hallazgo es una estrategia adecuada para ampliar el alcance y resolver las dudas del público sobre la aceptación de la vacuna contra la COVID-19.
The COVID-19 pandemic has changed all aspects of human life. Every nation attempts to prevent the spread by boosting widespread immunity through vaccination programs. The target population for the distribution of vaccines in Indonesia is 208,266,720 individuals. Dose 1 and 2 that has been administered to 124,156,167 (19.61%) and 78,114,072 (37.51%) recipients on November 6, 2021 did not meet this target.1,2 Meanwhile, vaccine acceptance rates in several countries were recorded, and China was the highest recipient country at 91.3%, followed by European countries and the United States at 74% and 67%.3 Distrust and doubt in the government are the main obstacles to the failure of the vaccine.4 This literature study has a distinct benefit over prior studies, specifically the development of grounded theory through qualitative analysis with ATLAS.ti9.
The reason for the reluctance to get involved in the vaccine is the concern about the effect5 due to a history of past diseases such as heart and respiratory6 and the reluctance to receive vaccines. People who lack adequate documentation fear being humiliated, rejected, and made a burden on the state if they visit vaccination centers.7 The same opinion was conveyed by previous research on reluctance due to doubts and inequality of vaccines. Furthermore, political and religious conspiracy theories discourage Pakistanis from receiving vaccines.8
Based on this data, the formulation of the problem in writing a literature review is: what are the driving and inhibiting factors for community involvement in the COVID-19 vaccine? How is the community involved in the vaccine? Therefore, this literature review is useful as a strategy to succeed and support the implementation of the vaccine program.
Carson et al., 7 described community involvement in the COVID-19 vaccine as determined by trust in medical personnel, perception of infection, and safety. Sethi et al.9 explored the driving and inhibiting factors for the absorption and conducted a quantitative analysis. The main obstacle to the vaccine's success was dispelling public doubts about the side effect.9 This literature review has an advantage that previous research has not conducted, namely developing grounded theory through qualitative analysis using ATLAS.Ti9 software after analyzing several selected articles. Therefore, this literature review is a development of previous theoretical concepts that are systematic and can be accounted for their objectivity and validity.
The theoretical basis for building this prototype uses the Health Belief Model theory, adding to the perception of vulnerability. A person will take action to prevent disease and be willing to be vaccinated when they have low confidence and are susceptible to disease. Vaccines are believed to reduce their susceptibility to COVID-19 and encourage them to take positive action.10
This literature review aims to identify the factors that encourage and discourage community participation in the vaccine program. Therefore, this literature review found the right strategy to expand the reach and resolve public doubts on receiving the vaccine.
MethodThe literature review uses secondary data from previous studies, and data collection was carried out for 1 week. The data search was conducted through the PubMed database, Google Scholar, Scopus, Web of Science, and Proquest. The search used the “boolean searching” method using the keywords “community engagement” AND “COVID-19 vaccine” AND “vaccine program” AND “vaccine acceptance” AND “community participation”. The tracing steps for determining samples using PRISMA developed by Page et al.11 are described in Figure 1.
The total search for data based on the COVID-19 vaccine (n=11,599) focused on public acceptance (n=813) and community involvement (n=86), then searched by type of article (n=46). Furthermore, from 46 types, the selected articles were analyzed based on the PICOS inclusion criteria: 1) community population; 2) without intervention; 3) without comparison; 4) outcome: factors supporting, inhibiting, and accepting the vaccine; 5) research articles; 6) articles published in 2021; and 7) English.
Each article was studied and analyzed according to the inclusion criteria. Many articles were eliminated because they did not meet the criteria, including an intervention. The results section did not describe the specified variables, and the research year was not 2021. The articles were analyzed using the qualitative software ATLAS.Ti9 after carrying out the identification, screening, and criteria determination stages. Articles that meet the criteria are stored in one folder and inputted into the ATLAS.Ti9 software for further data analysis.
A total of seven international articles met the criteria and were sampled for synthesis and analysis. The inclusion criteria “outcome” was determined according to the purpose of writing a literature review. Variables were included in the PICOS method to reveal the factors that supported the community being involved and the vaccine. The issues that prevented the population from receiving immunizations were also identified, and the rationale for receiving the vaccine was examined in depth.
The seven articles that fit the criteria were examined, synthesized, and displayed in Table 1.
Synthesis of previous research.
Author, year | Title | Aim | Design, samples and measurements | Technical analysis | Results |
---|---|---|---|---|---|
Carson et al.7, 2021 | COVID-19_vaccine_decision-making_factors_in_racial_and_ethnic_minority_Communities_in_Los_ Angeles_California | Finding factors that influence the decision-making process in receiving the COVID-19 vaccineFinding public trust and acceptance of the COVID-19 vaccine | Kualitatif desain deskriptifJumlah informan 70 orang.Data dikumpulkan dengan Focus group discussionQualitative descriptive designThe number of informants is 70 peopleData collected by Focus group discussion | Data obtained from interviewsData analysis was compiled in the transcript of the interview resultsATLAS.Ti9 Analysis | There are 37 informants received vaccines if availablePeople need correct information and reliable sources, direct information from health workers provides peace of mindFear of black people being treated differently from whites, fear of being the subject of experimentation and ill-treatmentBarriers to access, it takes one day off work if they are willing to be vaccinated |
Sethi et al.9, 2021 | The_UPTAKE_study:_a_cross-sectional_survey_examining_the_insights_and_beliefs_of_the_UK_population_on_COVID-19_vaccine_uptake_and_hesitancy | Discover the challenges of successful implementation of the COVID-19 vaccine, examine the drivers and barriers to acceptance of the Covid-19 vaccine | Cross sectional design, carried out with an online survey via Facebook, Twitter, LinkedIn and Instagram | The analysis was performed using a nultinominal logistic regression test | Respondents who are interested and agree to receive the vaccine (79.3%)Educated respondents agree with vaccines compared to uneducatedThere are reasons respondents did not receive the vaccine including; disinterested, unsure, distrustful, vaccine safety, as a trial, and fearThe reason for increasing vaccine acceptance is due to the imbalance in the number of deaths and patients being treated |
Green et al.13, 2021 | A_study_of_ethnic_gender_and_educational_differences_in_attitudes_toward_COVID-19_vaccines_in_Israel_implications_for_vaccination_implementation_policies | Assessing ethnicity and sociodemographic factors of attitudes towards the COVID-19 vaccine | Cross sectional survey research designData was collected using an online questionnaire in October 2020The sample was 957 adults over the age of 30, consisting of 606 Jews and 351 Arabs | Descriptive analysis measures the percentage, the comparison of prevalence between groups using the chi-square test Multiple logistic regression test examines the relationship between variables | There are 23.1% Arab respondents and want to get vaccinated immediately compared to 13.6% JewsHigher education has few doubts about vaccinesConfidence in vaccines is driven by government policies in imposing less stringent restrictions |
Abdelhafiz et al.18, 2021 | Factors_Influencing_Participation_in_COVID-19_Clinical_Trials_A_Multi-National_Study | Analyzing public perceptions and attitudes towards the COVID-19 vaccine clinical trial | The study used a cross sectional design, data was collected using Google forms via social media Facebook, WhatsApp, LinkedIn and distributed to Egypt, and Jordan | The psychometric questionnaire was analyzed by assessing the intra-class correlation coefficient Cronbach alpha assessed the consistency of the questionnairePearson correlation analysis calculates the total correlation | The majority of respondents’ attitudes towards vaccine trials stated their willingness to participate (57.6%)Female respondents have a negative attitude compared to males in receiving vaccine trials living in urban areasAttitude in receiving the COVID-19 vaccine is positively correlated with the country of residence |
Thompson et al.17, 2021 | Factors_Associated_With_Racial/Ethnic_Group–Based_Medical_Mistrust_and_Perspectives_on_COVID-19_Vaccine_Trial_Participation_and_Vaccine_Uptake_in_the_US | Testing the acceptability of the COVID-19 vaccine trial | The study was conducted by means of a survey of 1835 people in Michigan. The sample selection using purposive sampling technique was distributed to nine community organizations | Socio-demographic data is calculated in percentage, continuous data based on mean and standard deviationRelationships were analyzed by path analysis | There is a relationship between medical distrust based on the race of certain groupsBlacks are more likely to refuse vaccines than whitesA total of 45% of black respondents reported negative experiences from medical personnel |
Seale et al.14, 2021 | Examining_Australian_public_perceptions_and_behaviors_towards_a_future_COVID-19_vaccine | Ensuring community readiness to administer the COVID-19 vaccineUnderstand the Australian public's perception of the COVID-19 vaccine | A cross sectional survey was conducted on 1420 samples of Australian adults aged 18 years and over | Data analysis using logistic model regression | The majority of respondents (80%) have a positive view of the COVID-19 vaccineWomen are more likely to agree than menRespondents with chronic disease 1.4 times agreed to receive the vaccine. The decision to receive the vaccine is supported by family and friends |
Adebisi et al.12, 2021 | When_it_is_available_will_we_take_it? Social_media_users’_perception_of_hypothetical_COVID-19_vaccine_in_Nigeria | Understanding the perception of social media users regarding the COVID-19 vaccine in Negeria | A cross sectional survey, using an online questionnaire, including demographic characteristics and perceptions of vaccines. The sample is 517 respondents | Data analysis using STATA 14 | The majority of respondents were male (56.9%) and a number (74.5%) intended to receive the vaccine, the remaining 25.5% had received the vaccineThe reason for refusal was because clinical trials were not valid, they had the perception that they would not contract COVID-19 because they believed their immune system was goodBased on the results of the mapping analysis (STATA) it was obtained that geographic location was related to acceptance of the COVID-19 vaccine |
Source: primary data (2021).
The literature review results were obtained after carrying out the stages of identification, screening, and determining criteria until seven articles were analyzed. The articles were analyzed using the qualitative software ATLAS.Ti9. A literature review showed encouraging, inhibiting, and community involvement in the COVID-19 vaccine.
In accordance with writing to show community involvement, a variable construct was built based on the Health Belief Model theory, supported by Adebisi et al.12 and Jones et al.10, which describes that messages or information can optimally achieve behavior change when they target obstacles. Therefore, factors that hinder the administration of the COVID-19 vaccination should be investigated in depth based on several prior research. According to Jones et al.10, self-efficacy can affect barriers, while self-confidence plays an important role in acting. This was described in the campaign (self-efficacy (perceived inhibition) scheme.
The three themes that became the purpose of writing a literature review were driving factors, inhibiting factors, and perceptions of vulnerability12. As illustrated in Figure 2, seven themes or constructs were obtained.
The results of data analysis showed that seven themes are related to driving factors, inhibiting factors, and perceptions of community vulnerability. Previous studies analyzed seven articles with similarities and differences. In several countries such as America, Carson's research7 found that people's reluctance to participate in vaccination programs results from one day of lost productivity. Green et al.13 states that the inhibiting factor for people to receive the vaccine is their beliefs and doubt. Seale et al.14 explained that Australians are involved in the vaccine because they are susceptible to the disease. Therefore, people with chronic diseases are 1.4 times more likely to strongly agree to be vaccinated, in addition to family support. The results are the basis for the perception of vulnerability which is a variable between the driving and inhibiting factors. Based on research by Jones et al.10, Green et al.13 and Seale et al.14, it is important to add the perception of vulnerability as a constructed variable in the prototype.
Some of the themes were found using the ATLAS.Ti9 software is the basis for developing the theory. The next phase in producing this theory is to examine the tight relationship between the literature study's themes and create a prototype model based on grounded theory. Meanwhile, the co-occurrence values are shown in Table 2.
Co-occurrence value of research themes.
Conflicting information(5) | Encourage (14) | Family support (2) | Information reinforcement (8) | Involvement (15) | Medical mistrust (5) | Obstacles (15) | Perception of vulnerability (9) | Rejected (10) | Uncertainly (2) | |
---|---|---|---|---|---|---|---|---|---|---|
Conflicting information (5) | 2 (0.18) | 4 (01.25) | (0.08) | 1 (0.07) | 1 (0.07) | |||||
Encourage (14) | 2 (0.14) | 8 (0.38) | 1 (0.04) | 2 (0.10) | ||||||
Family support (2) | 2 (0.14) | 2 (0.13) | ||||||||
Information reinforcement (8) | 2 (0.18) | 2 (0.10) | 2 (0.10) | 2 (0.13) | 1 (0.11) | |||||
Involvement (15) | 8 (0.38) | 2 (0.13) | 2 (0.10) | 1 (0.03) | 1 (0.04) | |||||