The Motors of COVID-19 Vaccination Acceptance Scale (MoVac-COVID19S): Measurement Invariant Evidence for Its Nine-Item Version in Taiwan, Indonesia, and Malaysia

Abstract

Iqbal Pramukti,1,* Carol Strong,2 I-Hua Chen,3 Cheng-Fang Yen,4– 6 Ahmad Rifai,7 Kusman Ibrahim,8 Moses Glorino Rumambo Pandin,9 Hema Subramaniam,10 Mark D Griffiths,11 Chung-Ying Lin,2,12– 14,* Nai-Ying Ko7,* 1Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, Indonesia; 2Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 3Chinese Academy of Education Big Data, Qufu Normal University, Qufu City, Shandong, People’s Republic of China; 4Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung, 802, Taiwan; 5Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, 802, Taiwan; 6College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, 91201, Taiwan; 7Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 8Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, Indonesia; 9Faculty of Humanities, Universitas Airlangga, Gubeng, East Java, Indonesia; 10Department of Software Engineering, Faculty of Computer Science and Information Technology, Universiti Malaya, Kuala Lumpur, Malaysia; 11International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK; 12Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 13Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan; 14Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan*These authors contributed equally to this workCorrespondence: Iqbal Pramukti, Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang Km.21, Jatinangor, Sumedang, West Java, Indonesia, Tel [phone], Fax [phone], Email [email protected] Chung-Ying Lin, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Tel [phone], Fax [phone], Email [email protected]: As the number of COVID-19 cases grows worldwide, one solution to the global pandemic is vaccination. Unfortunately, the hesitancy of receiving vaccines is still high, particularly among younger age groups (eg, students). Because the hesitancy of receiving vaccines is an important issue, instruments have been developed to assess vaccine hesitancy. Moreover, the use of these instruments among specific groups such as students is of critical importance.Aim: The present study examined the psychometric properties of the nine-item MoVac-COVID19S (also known as the DrVac-COVID19S) including its measurement invariance among university students in three different countries (ie, Taiwan, Indonesia, and Malaysia).Methods: A multi-country, web-based cross-sectional survey study was conducted among 1809 university students, recruited from the three countries from May to September 2021. The nine-item scale was translated into Traditional Chinese, Bahasa Indonesian, and Malay.Results: The results of the confirmatory factor analysis indicated that the one-factor structure of the MoVac-COVID19S was fully supported among Indonesian and Malay participants (comparative fit index [CFI] = 0.991 and 0.998; Tucker-Lewis index [TLI] = 0.997 and 0.987; root mean sqaure error of approximation [RMSEA] = 0.040 and 0.071; and standardized root mean square residual [SRMR] = 0.014 and 0.039). Moreover, the four-factor structure was supported among Indonesian, Malay, and Taiwanese participants (CFI = 0.998, 0.998, and 0.985; TLI = 0.997, 0.996, and 0.973; RMSEA = 0.044, 0.038, and 0.091; and SRMR = 0.013, 0.018, and 0.049).Conclusion: The MoVac-COVID19S has good construct validity among university students from three different countries (ie, Taiwan, Indonesia, and Malaysia). The four-factor structure of the MoVac-COVID19S was supported. Therefore, health-care providers may want to assess the four underlying constructs to better understand why a university student accepts or declines COVID-19 vaccine uptake in the three countries. Using the findings, government policymakers and health-care authorities can design appropriate programs to help decrease vaccine hesitancy.Keywords: construct validity, COVID-19, factor analysis, measurement invariance, vaccine acceptance

Keywords

• construct validity
• covid-19
• factor analysis
• measurement invariance
• vaccine acceptance