The relationship between perceptions and self-paid hepatitis B vaccination: A structural equation modeling approach

a:8:{i:0;s:10:"Background";i:1;s:526:"Malaysia has a comprehensive, publicly-funded immunization program for hepatitis B (HepB) among infants, but adults must pay for the vaccine. The number of HepB carriers among adults is expected to increase in the future; therefore, we examined the impact of five constructs (cues to action, perceived barriers, perceived benefit, perceived severity, and perceived susceptibility) on adults' willingness to pay (WTP) for HepB vaccine; secondarily, we examined the association between perceived barriers and perceived benefits.";i:2;s:7:"Methods";i:3;s:337:"Adults were selected through a stratified, two-stage cluster community sample in Selangor, Malaysia. The reliability, convergent validity, and discriminant validity of the measurement model were assessed before implementing a partial least squares structural equation model (PLS-SEM) to evaluate the significance of the structural paths.";i:4;s:7:"Results";i:5;s:635:"A total of 728 participants were enrolled. The five constructs all showed adequate internal reliability, convergent validity, and discriminant validity. There was a significant, positive relationship to WTP from constructs (perceived barriers [Path coefficient (beta) = 0.082, P= 0.036], perceived susceptibility [beta = 0.214, P<0.001], and cues to action [beta = 0.166, P<0.001]), and the model all together accounted for 8.8% of the variation in WTP. There was a significant, negative relationship between perceived barriers and perceived benefit [beta = -0.261, P<0.001], which accounted for 6.8% of variation in perceived benefit.";i:6;s:11:"Conclusions";i:7;s:316:"Policy and programs should be targeted that can modify individuals' thoughts about disease risk, their obstacles in obtaining the preventive action, and their readiness to obtain a vaccine. Such programs include educational materials about disease risk and clinic visits that can pair HepB screening and vaccination.";}