Using the Theory of Planned Behavior to determine COVID-19 vaccination intentions and behavior among international and domestic college students in the United States

PLoS One. 2024 Feb 2;19(2):e0293130. doi: 10.1371/journal.pone.0293130. eCollection 2024.

Abstract

Vaccination is the most effective strategy for preventing infectious diseases such as COVID-19. College students are important targets for COVID-19 vaccines given this population's lower intentions to be vaccinated; however, limited research has focused on international college students' vaccination status. This study explored how psychosocial factors from the Theory of Planned Behavior (TPB; attitudes, perceived behavioral control, subjective norms, and behavioral intentions) related to students' receipt of the full course of COVID-19 vaccines and their plans to receive a booster. Students were recruited via Amazon mTurk and the Office of the Registrar at a U.S. state university. We used binary logistic regression to examine associations between students' psychosocial factors and full COVID-19 vaccination status. Hierarchical multiple regression was employed to evaluate relationships between these factors and students' intentions to receive a booster. The majority of students in our sample (81% of international students and 55% of domestic students) received the complete vaccination series. Attitudes were significantly associated with all students' full vaccination status, while perceived behavioral control was significantly associated with domestic students' status. Students' intentions to receive COVID-19 vaccines were significantly correlated with their intentions to receive a booster, with international students scoring higher on booster intentions. Among the combined college student population, attitudes, intentions to receive COVID-19 vaccines, and subjective norms were significantly related to students' intentions to receive a booster. Findings support the TPB's potential utility in evidence-based interventions to enhance college students' COVID-19 vaccination rates. Implications for stakeholders and future research directions are discussed.

MeSH terms

  • COVID-19 Vaccines*
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Intention
  • Students / psychology
  • Surveys and Questionnaires
  • Theory of Planned Behavior
  • United States
  • Vaccination / psychology

Substances

  • COVID-19 Vaccines

Grants and funding

The authors would like to thank the Sherwood foundation (RN031103—LIUSF) who provided research funding to help us focus on the vaccination status among international and domestic students in the United States. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.