Understanding COVID-19 vaccination disparity among Black adults in North America: A two-study motivational approach

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-10-02 DOI:10.1016/j.vaccine.2025.127803

Xiaoyan Fang , Anne C. Holding , Élodie C. Audet , Helen Thai , Richard Koestner

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引用次数: 0

Abstract

Previous research has revealed lower vaccination rates among Black communities relative to other racial-ethnic communities in North America. However, there remains a gap in understanding the motivational barriers contributing to these persistent disparities. Grounded in Self-Determination Theory, the current research aimed to examine the effects of different motivations for vaccine acceptance across population groups (autonomous, controlled, and amotivation). The current investigation involved two survey studies conducted in the United States and Canada during the second year of the COVID-19 pandemic. Study 1 was cross-sectional and included 623 Americans (60.4 % female). Study 2 was a prospective longitudinal study of 413 Canadians (54 % female; M_age = 47.6, SD = 17.9). In both studies, Black adults reported significantly lower levels of vaccination (M_Black = 1.15 vs. M_Non-Black = 1.48 in Study 1; M_Black = 2.25 vs. M_Non-Black = 2.63 in Study 2), lower autonomous motivation, and higher distrust-based amotivation compared to individuals from other population groups. In the cross-sectional study, autonomous motivation (β = 0.45, p < .001) was positively associated with vaccine uptake while distrust-based amotivation (β = −0.23, p < .001) was negatively associated with vaccine uptake. In the longitudinal study, distrust-based amotivation (β = −0.11, p < .01) was associated with vaccination uptake for all groups, while lower autonomous motivation (b = 0.17, p < .01) and higher controlled motivation (b = −0.14, p < .05) were associated with lower vaccine uptake among Black individuals. These findings suggest that while addressing distrust-based amotivation at the institutional and systemic level to promote utilization of vaccination services is essential across all population groups, tailored public health interventions and policies that foster a sense of autonomy over one's healthcare decisions may play a particularly significant role for Black adults in supporting vaccine acceptance and uptake.

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了解北美黑人成人COVID-19疫苗接种差异：一项两项研究的动机方法

先前的研究表明，与北美其他种族社区相比，黑人社区的疫苗接种率较低。然而，在理解导致这些持续差异的动机障碍方面仍然存在差距。在自我决定理论的基础上，目前的研究旨在检查不同动机对不同人群（自主、受控和动机）接受疫苗的影响。目前的调查涉及2019冠状病毒病大流行第二年在美国和加拿大进行的两项调查研究。研究1是横断面的，包括623名美国人（60.4%为女性）。研究2是一项对413名加拿大人进行的前瞻性纵向研究（54%为女性，Mage = 47.6, SD = 17.9）。在这两项研究中，与其他人群相比，黑人成年人的疫苗接种水平明显较低（研究1中MBlack = 1.15 vs. MNon-Black = 1.48；研究2中MBlack = 2.25 vs. MNon-Black = 2.63），自主动机较低，基于不信任的动机较高。在横断面研究中，自主动机（β = 0.45, p < .001）与疫苗摄取呈正相关，而基于不信任的动机（β = - 0.23, p < .001）与疫苗摄取负相关。在纵向研究中，基于不信任的动机（β = - 0.11, p < 0.01）与所有组的疫苗接种率相关，而较低的自主动机（b = 0.17, p < 0.01）和较高的控制动机（b = - 0.14, p < 0.05）与黑人个体的疫苗接种率较低相关。这些发现表明，虽然在机构和系统层面解决基于不信任的动机以促进疫苗接种服务的利用对所有人群都至关重要，但量身定制的公共卫生干预措施和政策可以促进个人医疗保健决策的自主意识，这可能对黑人成年人在支持疫苗接受和吸收方面发挥特别重要的作用。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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