Family health and willingness to Receive Self-paid vaccines: the role of Self-efficacy and health literacy.

High level of willingness to receive self-paid vaccines is a prerequisite for the behavior of receiving self-paid vaccines. This study aimed to explore how family health can increase the willingness to receive self-paid vaccines among Chinese adults through the mediating role of self-efficacy and health literacy. Obtained from Psychology and Behavior Investigation of Chinese Residents (PBICR) 2021, the research data involved 9966 adults. Linear regression analysis and the PROCESS macro were used for examining the chain mediating effect of self-efficacy and health literacy on the associations of family health with the willingness to receive self-paid vaccines. The results showed that only 56.72% participants belonging to high willingness to receive self-paid vaccines. After controlling the potential confounding factors, family health had a significant positive effect on people's willingness to receive self-paid vaccines (β = 0.182, p < 0.001). Self-efficacy and health literacy played independent and chain mediating roles in the process (indirect effect = 0.261, effect weight = 34.85%). The independent mediating effect of self-efficacy was 0.093 with a weight of 12.42%, the independent mediating effect of health literacy was 0.079 with a weight of 10.55%, and the effect of the chain mediation of them was 0.089 with a weight of 11.88%. The findings indicate that improving family health can increase the level of self-efficacy and health literacy, which can promote willingness to receive self-paid vaccines for people. That provides an invaluable reference for the design of health education and vaccine promotion program.