Evidence of Validity and Measurement Invariance by Gender of the Vaccination Attitudes Examination (VAX) Scale in Colombian University Students
Tener una herramienta válida para evaluar las actitudes hacia la vacunación e identificar las preocupaciones que impulsan el rechazo a la vacunación puede facilitar los estudios de población y ayudar a guiar las intervenciones de salud pública. El objetivo de este estudio ha sido adaptar la escala E...
- Autores:
-
Martín Carbonell, Marta de la Caridad
Espejo Tort, Begoña
Fernández Daza, Martha Patricia
Romero, Kelly
Paternina Avilés, Yadid Esther
- Tipo de recurso:
- Article of investigation
- Fecha de publicación:
- 2022
- Institución:
- Universidad Cooperativa de Colombia
- Repositorio:
- Repositorio UCC
- Idioma:
- OAI Identifier:
- oai:repository.ucc.edu.co:20.500.12494/52505
- Palabra clave:
- Vaccine hesitancy
Vaccine refusal
Confirmatory factor analysis
Structural equation modeling
Measurement invariance
Concurrent validity
Psychometric properties
Covid-19
- Rights
- openAccess
- License
- Atribución – No comercial
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dc.title.none.fl_str_mv |
Evidence of Validity and Measurement Invariance by Gender of the Vaccination Attitudes Examination (VAX) Scale in Colombian University Students |
title |
Evidence of Validity and Measurement Invariance by Gender of the Vaccination Attitudes Examination (VAX) Scale in Colombian University Students |
spellingShingle |
Evidence of Validity and Measurement Invariance by Gender of the Vaccination Attitudes Examination (VAX) Scale in Colombian University Students Vaccine hesitancy Vaccine refusal Confirmatory factor analysis Structural equation modeling Measurement invariance Concurrent validity Psychometric properties Covid-19 |
title_short |
Evidence of Validity and Measurement Invariance by Gender of the Vaccination Attitudes Examination (VAX) Scale in Colombian University Students |
title_full |
Evidence of Validity and Measurement Invariance by Gender of the Vaccination Attitudes Examination (VAX) Scale in Colombian University Students |
title_fullStr |
Evidence of Validity and Measurement Invariance by Gender of the Vaccination Attitudes Examination (VAX) Scale in Colombian University Students |
title_full_unstemmed |
Evidence of Validity and Measurement Invariance by Gender of the Vaccination Attitudes Examination (VAX) Scale in Colombian University Students |
title_sort |
Evidence of Validity and Measurement Invariance by Gender of the Vaccination Attitudes Examination (VAX) Scale in Colombian University Students |
dc.creator.fl_str_mv |
Martín Carbonell, Marta de la Caridad Espejo Tort, Begoña Fernández Daza, Martha Patricia Romero, Kelly Paternina Avilés, Yadid Esther |
dc.contributor.author.none.fl_str_mv |
Martín Carbonell, Marta de la Caridad Espejo Tort, Begoña Fernández Daza, Martha Patricia Romero, Kelly Paternina Avilés, Yadid Esther |
dc.subject.other.none.fl_str_mv |
Vaccine hesitancy Vaccine refusal Confirmatory factor analysis Structural equation modeling Measurement invariance Concurrent validity Psychometric properties Covid-19 |
topic |
Vaccine hesitancy Vaccine refusal Confirmatory factor analysis Structural equation modeling Measurement invariance Concurrent validity Psychometric properties Covid-19 |
description |
Tener una herramienta válida para evaluar las actitudes hacia la vacunación e identificar las preocupaciones que impulsan el rechazo a la vacunación puede facilitar los estudios de población y ayudar a guiar las intervenciones de salud pública. El objetivo de este estudio ha sido adaptar la escala Examen de Actitudes hacia la Vacunación (VAX) en universitarios colombianos y estudiar sus propiedades psicométricas en una muestra no probabilística de 1074 universitarios colombianos. Métodos: Se utilizó un análisis factorial confirmatorio para estudiar la estructura factorial. Se probó un modelo de ecuaciones estructurales para estudiar la validez concurrente y comprobar si los factores predecían haber recibido la vacuna contra el coronavirus. También se estudió la invariancia de la medición basada en el género para el mejor modelo. Resultados: Los resultados apoyan la estructura de cuatro factores relacionados. El índice de confiabilidad compuesto fue bueno para todos los factores, pero la varianza promedio extraída no fue tan buena para el segundo factor. Hubo una fuerte invariancia de medición por género, y dos factores son buenos predictores de estar vacunado o no. Conclusiones: El VAX ha mostrado validez de constructo y concurrente y es una herramienta confiable para evaluar las actitudes hacia las vacunas en estudiantes universitarios en Colombia. Puede ayudar a orientar la implementación de acciones para el Plan Nacional de Vacunación y las políticas institucionales. |
publishDate |
2022 |
dc.date.issued.none.fl_str_mv |
2022-08-10 |
dc.date.accessioned.none.fl_str_mv |
2023-08-22T14:17:13Z |
dc.date.available.none.fl_str_mv |
2023-08-22T14:17:13Z |
dc.type.none.fl_str_mv |
Artículos Científicos |
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info:eu-repo/semantics/publishedVersion |
dc.type.coar.none.fl_str_mv |
http://purl.org/coar/resource_type/c_2df8fbb1 |
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http://purl.org/coar/version/c_970fb48d4fbd8a85 |
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dc.identifier.issn.none.fl_str_mv |
20770383 |
dc.identifier.uri.none.fl_str_mv |
https://doi.org/10.3390/jcm11164682 https://hdl.handle.net/20.500.12494/52505 |
dc.identifier.bibliographicCitation.none.fl_str_mv |
Espejo, B.; Martín-Carbonell, M.; Romero-Acosta, K.C.; Fernández-Daza, M.; Paternina, Y. Evidence of Validity and Measurement Invariance by Gender of the Vaccination Attitudes Examination (VAX) Scale in Colombian University Students. J. Clin. Med. 2022, 11, 4682. https://doi.org/10.3390/jcm11164682 |
identifier_str_mv |
20770383 Espejo, B.; Martín-Carbonell, M.; Romero-Acosta, K.C.; Fernández-Daza, M.; Paternina, Y. Evidence of Validity and Measurement Invariance by Gender of the Vaccination Attitudes Examination (VAX) Scale in Colombian University Students. J. Clin. Med. 2022, 11, 4682. https://doi.org/10.3390/jcm11164682 |
url |
https://doi.org/10.3390/jcm11164682 https://hdl.handle.net/20.500.12494/52505 |
dc.relation.isversionof.none.fl_str_mv |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9409776/pdf/jcm-11-04682.pdf |
dc.relation.ispartofjournal.none.fl_str_mv |
J. Clin. Med. |
dc.relation.references.none.fl_str_mv |
Guedes G.R., Coutinho R.Z., Marteleto L., Pereira W.H.S., Duarte D. Why social perception matters during disease outbreaks: Looking at how individuals understand the zika virus by self-reported history of infection. Cad. Saude Publica. 2018;34:9–10. doi: 10.1590/0102-311x00139718. - DOI - PubMed WHO Europe . Vaccination and Trust. World Health Organization; Copenhaguen, Denmark: 2017. Al-Amer R., Maneze D., Everett B., Montayre J., Villarosa A.R., Dwekat E., Salamonson Y. COVID-19 vaccination intention in the first year of the pandemic: A systematic review. J. Clin. Nurs. 2022;31:62–86. doi: 10.1111/jocn.15951. - DOI - PMC - PubMed Küçükali H., Ataç Ö., Palteki A.S., Tokaç A.Z., Hayran O. Vaccine Hesitancy and Anti-Vaccination Attitudes during the Start of COVID-19 Vaccination Program: A Content Analysis on Twitter Data. Vaccines. 2022;10:161. doi: 10.3390/vaccines10020161. - DOI - PMC - PubMed Martin L.R., Petrie K.J. Understanding the Dimensions of Anti-Vaccination Attitudes: The Vaccination Attitudes Examination (VAX) Scale. Ann. Behav. Med. 2017;51:652–660. doi: 10.1007/s12160-017-9888-y. - DOI - PubMed Böhm R., Betsch C. Prosocial vaccination. Curr. Opin. Psychol. 2022;43:307–311. doi: 10.1016/j.copsyc.2021.08.010. - DOI - PubMed Li H., Cao Y. Your pain, my gain: The relationship between self-report and behavioral measures of everyday sadism and COVID-19 vaccination intention. Curr. Psychol. 2022 doi: 10.1007/s12144-022-02791-y. - DOI - PMC - PubMed Enea V., Eisenbeck N., Carreno D.F., Douglas K.M., Sutton R.M., Agostini M., Bélanger J.J., Gützkow B., Kreienkamp J., Abakoumkin G., et al. Intentions to be Vaccinated Against COVID-19: The Role of Prosociality and Conspiracy Beliefs across 20 Countries. Health Commun. 2022 doi: 10.1080/10410236.2021.2018179. - DOI - PubMed Hornsey M.J., Harris E.A., Fielding K.S. The psychological roots of anti-vaccination attitudes: A 24-nation investigation. Heal. Psychol. 2018;37:307–315. doi: 10.1037/hea0000586. - DOI - PubMed Ruiz-Rodríguez M., Vera-Cala L.M., López-Barbosa N. Seguro de salud y cobertura de vacunación en población infantil con y sin experiencia de desplazamiento forzado en Colombia [Health insurance for infants and infant vaccination related to forced-displacement in Colombia] Rev. Salud Publica. 2008;10:49–61. doi: 10.1590/S0124-00642008000100005. - DOI - PubMed Rodríguez-Orejuela A., Montes-Mora C.L., Osorio-Andrade C.F. Sentimientos hacia la vacunación contra la COVID-19: Panorama colombiano en Twitter. Palabra Clave. 2022;25:e2514. doi: 10.5294/pacla.2022.25.1.4. - DOI Alvis-Guzmán N., Alvis-Zakzuk J., Paz-Wilches J., Fernandez-Mercado J.C., de la Hoz-Restrepo F. Disposición a recibir la vacuna contra COVID-19 en población de 80 y más años en Colombia 2021 [Willingness to receive the COVID-19 vaccine in the population aged 80 years and older in Colombia 2021] Vacunas. 2021;22:138–149. doi: 10.1016/J.VACUNE.2021.10.008. - DOI - PMC - PubMed Campo-Arias A., Caamano-Rocha L.E., Pedrozo-Pupo J.C. Spanish Version of the Attitude Towards COVID-19 Vaccines Scale: Reliability and Validity Assessment. medRxiv. 2021 doi: 10.1891/JNM-2021-0044. - DOI - PubMed Rodríguez M. Magnitud y causas de oportunidades perdidas en vacunación en población menor de dos años en América. CES Med. 2001;1:71–80. Simas C., Munoz N., Arregoces L., Larson H.J. HPV vaccine confidence and cases of mass psychogenic illness following immunization in Carmen de Bolivar, Colombia. Hum. Vaccines Immunother. 2019;15:163–166. doi: 10.1080/21645515.2018.1511667. - DOI - PMC - PubMed Castro C. What happened in Colombia with the HPV Vaccination program- A story of light and shadows... Happiness and Tears. Cancer Ther. Oncol. Int. J. 2018;9:9–10. doi: 10.19080/CTOIJ.2018.09.555757. - DOI Yaqub O., Castle-Clarke S., Sevdalis N., Chataway J. Attitudes to vaccination: A critical review. Soc. Sci. Med. 2014;112:1–11. doi: 10.1016/j.socscimed.2014.04.018. - DOI - PubMed Hickler B., Guirguis S., Obregon R. Vaccine Special Issue on Vaccine Hesitancy (Editorial) Vaccine. 2015;33:4155–4156. doi: 10.1016/j.vaccine.2015.04.034. - DOI - PubMed Larson H.J., Jarrett C., Eckersberger E., Smith D.M.D., Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007–2012. Vaccine. 2014;32:2150–2159. doi: 10.1016/j.vaccine.2014.01.081. - DOI - PubMed MacDonald N.E., Eskola J., Liang X., Chaudhuri M., Dube E., Gellin B., Goldstein S., Larson H., Manzo M.L., Reingold A., et al. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015;33:4161–4164. doi: 10.1016/j.vaccine.2015.04.036. - DOI - PubMed Allen J.D., Coronado G.D., Williams R.S., Glenn B., Escoffery C., Fernandez M., Tuff R.A., Wilson K.M., Mullen P.D. A systematic review of measures used in studies of human papillomavirus (HPV) vaccine acceptability. Vaccine. 2010;28:4027–4037. doi: 10.1016/j.vaccine.2010.03.063. - DOI - PMC - PubMed Shapiro G.K., Kaufman J., Brewer N.T., Wiley K., Menning L., Leask J., Abad N., Betsch C., Bura V., Correa G., et al. A critical review of measures of childhood vaccine confidence. Curr. Opin. Immunol. 2021;71:34–45. doi: 10.1016/j.coi.2021.04.002. - DOI - PubMed Marbán-Castro E., Villén-Gonzalvo A., Enguita-Fernàndez C., Romero-Acosta K.C., Marín-Cos A., Arrieta G.J., Mattar S., Menéndez C., Maixenchs M., Bardají A. Acceptability of a hypothetical zika vaccine among women from Colombia and Spain exposed to zikv: A qualitative study. Vaccines. 2020;8:580. doi: 10.3390/vaccines8040580. - DOI - PMC - PubMed Wood L., Smith M., Miller C.B., O’Carroll R.E. The Internal Consistency and Validity of the Vaccination Attitudes Examination Scale: A Replication Study. Ann. Behav. Med. 2019;53:109–114. doi: 10.1093/abm/kay043. - DOI - PubMed Huza G. The Psychometric Properties of a Romanian Version of the Vaccination Attitudes Examination (VAX) Scale. Int. J. HIV/AIDS Prev. Educ. Behav. Sci. 2020;6:25–31. doi: 10.11648/j.ijhpebs.20200601.14. - DOI Yildiz E., Gungormus Z., Dayapoglu N. Assessment of Validity and Reliability of the Turkish Version of the Vaccination Attitudes Examination (VAX) Scale. Int. J. Caring Sci. 2021;14:261–268. Paredes B., Cárdaba M.Á., Cuesta U., Martinez L. Validity of the spanish version of the vaccination attitudes examination scale. Vaccines. 2021;9:1237. doi: 10.3390/vaccines9111237. - DOI - PMC - PubMed López-Gómez M., Cáceres M.P., Montoro M.A. Estudio sobre Liderazgo Estudiantil desde un Enfoque Socio-político en la Universidad Santo Tomás de Bucaramanga (Colombia) [Study on Leadership Student at the University of Santo Tomas Bucaramanga (Colombia)] Int. J. Educ. Leadersh. Manag. 2017;5:178–197. doi: 10.17583/ijelm.2017.2514. - DOI Winter K., Pummerer L., Hornsey M.J., Sassenberg K. Pro-vaccination subjective norms moderate the relationship between conspiracy mentality and vaccination intentions. Br. J. Health Psychol. 2022;27:390–405. doi: 10.1111/bjhp.12550. - DOI - PMC - PubMed Graupensperger S., Abdallah D.A., Lee C.M. Social norms and vaccine uptake: College students’ COVID vaccination intentions, attitudes, and estimated peer norms and comparisons with influenza vaccine. Vaccine. 2021;39:2060–2067. doi: 10.1016/j.vaccine.2021.03.018. - DOI - PMC - PubMed Barello S., Nania T., Dellafiore F., Graffigna G., Caruso R. ‘Vaccine hesitancy’ among university students in Italy during the COVID-19 pandemic. Eur. J. Epidemiol. 2020;35:781–783. doi: 10.1007/s10654-020-00670-z. - DOI - PMC - PubMed LaCour M., Davis T. Vaccine skepticism reflects basic cognitive differences in mortality-related event frequency estimation. Vaccine. 2020;38:3790–3799. doi: 10.1016/j.vaccine.2020.02.052. - DOI - PubMed de Angelis T. How APA Is Helping COVID’s Overlooked Populations. Consider Joining One of the 10 Working Groups Tasked with Culling Resources to Aid Clinicians in Working with Underserved Groups during the Pandemic 2020. [(accessed on 5 May 2022)]. Available online: https://www.apaservices.org/practice/news/covid-19-overlooked-populations. Rivera R. The Research Initiatives Working Group at the APA Interdivisional Task Force on the Pandemic. How to Advance Multidimensional COVID-19 Scholarship from a Global International Perspective. [(accessed on 5 May 2022)];Int. Psychol. Bull. 2021 25 Available online: https://div52.net/ipb-2021-25-3/#collaborations. Gallant A.J., Brown Nicholls L.A., Rasmussen S., Cogan N., Young D., Williams L. Changes in attitudes to vaccination as a result of the COVID-19 pandemic: A longitudinal study of older adults in the UK. PLoS ONE. 2021;16:e0261844. doi: 10.1371/journal.pone.0261844. - DOI - PMC - PubMed Muñiz J., Elosúa P., Padilla J.L., Hambleton R.K. Test adaptation standards for cross-lingual assessment. In: Wells C.S., Faulkner-Bond M., editors. Educational Measurement. From Foundations to Future. Guilford Press; New York, NY, USA: 2016. pp. 291–304. Raykov T. Scale construction and development using structural equation modeling. In: Hoyle R.H., editor. Handbook of Structural Equation Modeling. The Guilford Press; New York, NY, USA: 2012. pp. 472–492. Rigdon E.E., Schumacker R.E., Wothke W. A comparative review of interaction and nonlinear modeling. In: Schumacker R.E., Marcoulides G.A., editors. Interaction and Nonlinear Effects in Structural Equation Modeling. Lawrence Erlbaum; Mahwah, NJ, USA: 2017. pp. 251–294. Modern Methods for Business Research. Raykov T. Scale validity evaluation with congeneric measures in hierarchical designs. Br. J. Math. Stat. Psychol. 2011;64:427–438. doi: 10.1348/000711009X484286. - DOI - PubMed Kline R.B. Principles and Practice of Structural Equation Modeling. 4th ed. Guilford Press; New York, NY, USA: 2016. Raykov T., Marcoulides G.A. Introduction to Psychometric Theory. Routledge Ltd.; New York, NY, USA: 2011. Jöreskog K.G. On the estimation of polychoric correlations and their asymptotic covariance matrix. Psychometrika. 1994;59:381–389. doi: 10.1007/BF02296131. - DOI Cheung G.W., Rensvold R.B. Evaluating goodness-of-fit indexes for testing measurement invariance. Struct. Equ. Model. 2002;9:233–255. doi: 10.1207/S15328007SEM0902_5. - DOI Muthén L.K., Muthén B. Mplus User’s Guide. 8th ed. Muthén & Muthén; Los Angeles, CA, USA: 2017 Bedford H., Attwell K., Danchin M., Marshall H., Corben P., Leask J. Vaccine hesitancy, refusal and access barriers: The need for clarity in terminology. Vaccine. 2018;36:6556–6558. doi: 10.1016/j.vaccine.2017.08.004. - DOI - PubMed Valentini F., Damásio B.F. Average Variance Extracted and Composite Reliability: Reliability Coefficients. Psicol. Teor. E Pesqui. 2016;32:1–7. doi: 10.1590/0102-3772e322225. - DOI Yeh Y.C., Chen I.H., Ahorsu D.K., Ko N.Y., Chen K.L., Li P.C., Yen C.F., Lin C.Y., Griffiths M.D., Pakpour A.H. Measurement invariance of the drivers of COVID-19 vaccination acceptance scale: Comparison between taiwanese and mainland chinese-speaking populations. Vaccines. 2021;9:297. doi: 10.3390/vaccines9030297. - DOI - PMC - PubMed Fischer R., Karl J.A. Predicting Behavioral Intentions to Prevent or Mitigate COVID-19: A Cross-Cultural Meta-Analysis of Attitudes, Norms, and Perceived Behavioral Control Effects. Soc. Psychol. Personal. Sci. 2022;13:264–276. doi: 10.1177/19485506211019844. - DOI |
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Martín Carbonell, Marta de la CaridadEspejo Tort, BegoñaFernández Daza, Martha PatriciaRomero, KellyPaternina Avilés, Yadid Esther 11(16)2023-08-22T14:17:13Z2023-08-22T14:17:13Z2022-08-1020770383https://doi.org/10.3390/jcm11164682https://hdl.handle.net/20.500.12494/52505Espejo, B.; Martín-Carbonell, M.; Romero-Acosta, K.C.; Fernández-Daza, M.; Paternina, Y. Evidence of Validity and Measurement Invariance by Gender of the Vaccination Attitudes Examination (VAX) Scale in Colombian University Students. J. Clin. Med. 2022, 11, 4682. https://doi.org/10.3390/jcm11164682Tener una herramienta válida para evaluar las actitudes hacia la vacunación e identificar las preocupaciones que impulsan el rechazo a la vacunación puede facilitar los estudios de población y ayudar a guiar las intervenciones de salud pública. El objetivo de este estudio ha sido adaptar la escala Examen de Actitudes hacia la Vacunación (VAX) en universitarios colombianos y estudiar sus propiedades psicométricas en una muestra no probabilística de 1074 universitarios colombianos. Métodos: Se utilizó un análisis factorial confirmatorio para estudiar la estructura factorial. Se probó un modelo de ecuaciones estructurales para estudiar la validez concurrente y comprobar si los factores predecían haber recibido la vacuna contra el coronavirus. También se estudió la invariancia de la medición basada en el género para el mejor modelo. Resultados: Los resultados apoyan la estructura de cuatro factores relacionados. El índice de confiabilidad compuesto fue bueno para todos los factores, pero la varianza promedio extraída no fue tan buena para el segundo factor. Hubo una fuerte invariancia de medición por género, y dos factores son buenos predictores de estar vacunado o no. Conclusiones: El VAX ha mostrado validez de constructo y concurrente y es una herramienta confiable para evaluar las actitudes hacia las vacunas en estudiantes universitarios en Colombia. Puede ayudar a orientar la implementación de acciones para el Plan Nacional de Vacunación y las políticas institucionales.Having a valid tool to assess attitudes toward vaccination and identify the concerns that drive vaccine refusal can facilitate population studies and help guide public health interventions. The objective of this study has been to adapt the Vaccination Attitudes Examination (VAX) scale in Colombian university students and to study its psychometric properties in a non-probabilistic sample of 1074 Colombian university students. Methods: A confirmatory factor analysis was used to study the factorial structure. A structural equation model was tested to study concurrent validity and to check whether the factors predicted having received the coronavirus vaccine. Gender-based measurement invariance was also studied for the best model. Results: The results support the structure of four related factors. The composite reliability index was good for all the factors, but the average variance extracted was not as good for the second factor. There was strong measurement invariance by gender, and two factors are good predictors of being vaccinated or not. Conclusions: The VAX has shown construct and concurrent validity and is a reliable tool for evaluating attitudes towards vaccines in university students in Colombia. It may help guide the implementation of actions for the National Vaccination Plan and institutional policies.https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001561776https://orcid.org/0000-0002-6337-577Xmartha.martinc@campusucc.edu.co13Universidad Cooperativa de Colombia, Facultad de Ciencias Sociales, Psicología, Santa MartaPsicologíaSanta Martahttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9409776/pdf/jcm-11-04682.pdfJ. Clin. Med.Guedes G.R., Coutinho R.Z., Marteleto L., Pereira W.H.S., Duarte D. Why social perception matters during disease outbreaks: Looking at how individuals understand the zika virus by self-reported history of infection. Cad. Saude Publica. 2018;34:9–10. doi: 10.1590/0102-311x00139718. - DOI - PubMedWHO Europe . Vaccination and Trust. World Health Organization; Copenhaguen, Denmark: 2017.Al-Amer R., Maneze D., Everett B., Montayre J., Villarosa A.R., Dwekat E., Salamonson Y. COVID-19 vaccination intention in the first year of the pandemic: A systematic review. J. Clin. Nurs. 2022;31:62–86. doi: 10.1111/jocn.15951. - DOI - PMC - PubMedKüçükali H., Ataç Ö., Palteki A.S., Tokaç A.Z., Hayran O. Vaccine Hesitancy and Anti-Vaccination Attitudes during the Start of COVID-19 Vaccination Program: A Content Analysis on Twitter Data. Vaccines. 2022;10:161. doi: 10.3390/vaccines10020161. - DOI - PMC - PubMedMartin L.R., Petrie K.J. Understanding the Dimensions of Anti-Vaccination Attitudes: The Vaccination Attitudes Examination (VAX) Scale. Ann. Behav. Med. 2017;51:652–660. doi: 10.1007/s12160-017-9888-y. - DOI - PubMedBöhm R., Betsch C. Prosocial vaccination. Curr. Opin. Psychol. 2022;43:307–311. doi: 10.1016/j.copsyc.2021.08.010. - DOI - PubMedLi H., Cao Y. Your pain, my gain: The relationship between self-report and behavioral measures of everyday sadism and COVID-19 vaccination intention. Curr. Psychol. 2022 doi: 10.1007/s12144-022-02791-y. - DOI - PMC - PubMedEnea V., Eisenbeck N., Carreno D.F., Douglas K.M., Sutton R.M., Agostini M., Bélanger J.J., Gützkow B., Kreienkamp J., Abakoumkin G., et al. Intentions to be Vaccinated Against COVID-19: The Role of Prosociality and Conspiracy Beliefs across 20 Countries. Health Commun. 2022 doi: 10.1080/10410236.2021.2018179. - DOI - PubMedHornsey M.J., Harris E.A., Fielding K.S. The psychological roots of anti-vaccination attitudes: A 24-nation investigation. Heal. Psychol. 2018;37:307–315. doi: 10.1037/hea0000586. - DOI - PubMedRuiz-Rodríguez M., Vera-Cala L.M., López-Barbosa N. Seguro de salud y cobertura de vacunación en población infantil con y sin experiencia de desplazamiento forzado en Colombia [Health insurance for infants and infant vaccination related to forced-displacement in Colombia] Rev. Salud Publica. 2008;10:49–61. doi: 10.1590/S0124-00642008000100005. - DOI - PubMedRodríguez-Orejuela A., Montes-Mora C.L., Osorio-Andrade C.F. Sentimientos hacia la vacunación contra la COVID-19: Panorama colombiano en Twitter. Palabra Clave. 2022;25:e2514. doi: 10.5294/pacla.2022.25.1.4. - DOIAlvis-Guzmán N., Alvis-Zakzuk J., Paz-Wilches J., Fernandez-Mercado J.C., de la Hoz-Restrepo F. Disposición a recibir la vacuna contra COVID-19 en población de 80 y más años en Colombia 2021 [Willingness to receive the COVID-19 vaccine in the population aged 80 years and older in Colombia 2021] Vacunas. 2021;22:138–149. doi: 10.1016/J.VACUNE.2021.10.008. - DOI - PMC - PubMedCampo-Arias A., Caamano-Rocha L.E., Pedrozo-Pupo J.C. Spanish Version of the Attitude Towards COVID-19 Vaccines Scale: Reliability and Validity Assessment. medRxiv. 2021 doi: 10.1891/JNM-2021-0044. - DOI - PubMedRodríguez M. Magnitud y causas de oportunidades perdidas en vacunación en población menor de dos años en América. CES Med. 2001;1:71–80.Simas C., Munoz N., Arregoces L., Larson H.J. HPV vaccine confidence and cases of mass psychogenic illness following immunization in Carmen de Bolivar, Colombia. Hum. Vaccines Immunother. 2019;15:163–166. doi: 10.1080/21645515.2018.1511667. - DOI - PMC - PubMedCastro C. What happened in Colombia with the HPV Vaccination program- A story of light and shadows... Happiness and Tears. Cancer Ther. Oncol. Int. J. 2018;9:9–10. doi: 10.19080/CTOIJ.2018.09.555757. - DOIYaqub O., Castle-Clarke S., Sevdalis N., Chataway J. Attitudes to vaccination: A critical review. Soc. Sci. Med. 2014;112:1–11. doi: 10.1016/j.socscimed.2014.04.018. - DOI - PubMedHickler B., Guirguis S., Obregon R. Vaccine Special Issue on Vaccine Hesitancy (Editorial) Vaccine. 2015;33:4155–4156. doi: 10.1016/j.vaccine.2015.04.034. - DOI - PubMedLarson H.J., Jarrett C., Eckersberger E., Smith D.M.D., Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007–2012. Vaccine. 2014;32:2150–2159. doi: 10.1016/j.vaccine.2014.01.081. - DOI - PubMedMacDonald N.E., Eskola J., Liang X., Chaudhuri M., Dube E., Gellin B., Goldstein S., Larson H., Manzo M.L., Reingold A., et al. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015;33:4161–4164. doi: 10.1016/j.vaccine.2015.04.036. - DOI - PubMedAllen J.D., Coronado G.D., Williams R.S., Glenn B., Escoffery C., Fernandez M., Tuff R.A., Wilson K.M., Mullen P.D. A systematic review of measures used in studies of human papillomavirus (HPV) vaccine acceptability. Vaccine. 2010;28:4027–4037. doi: 10.1016/j.vaccine.2010.03.063. - DOI - PMC - PubMedShapiro G.K., Kaufman J., Brewer N.T., Wiley K., Menning L., Leask J., Abad N., Betsch C., Bura V., Correa G., et al. A critical review of measures of childhood vaccine confidence. Curr. Opin. Immunol. 2021;71:34–45. doi: 10.1016/j.coi.2021.04.002. - DOI - PubMedMarbán-Castro E., Villén-Gonzalvo A., Enguita-Fernàndez C., Romero-Acosta K.C., Marín-Cos A., Arrieta G.J., Mattar S., Menéndez C., Maixenchs M., Bardají A. Acceptability of a hypothetical zika vaccine among women from Colombia and Spain exposed to zikv: A qualitative study. Vaccines. 2020;8:580. doi: 10.3390/vaccines8040580. - DOI - PMC - PubMedWood L., Smith M., Miller C.B., O’Carroll R.E. The Internal Consistency and Validity of the Vaccination Attitudes Examination Scale: A Replication Study. Ann. Behav. Med. 2019;53:109–114. doi: 10.1093/abm/kay043. - DOI - PubMedHuza G. The Psychometric Properties of a Romanian Version of the Vaccination Attitudes Examination (VAX) Scale. Int. J. HIV/AIDS Prev. Educ. Behav. Sci. 2020;6:25–31. doi: 10.11648/j.ijhpebs.20200601.14. - DOIYildiz E., Gungormus Z., Dayapoglu N. Assessment of Validity and Reliability of the Turkish Version of the Vaccination Attitudes Examination (VAX) Scale. Int. J. Caring Sci. 2021;14:261–268.Paredes B., Cárdaba M.Á., Cuesta U., Martinez L. Validity of the spanish version of the vaccination attitudes examination scale. Vaccines. 2021;9:1237. doi: 10.3390/vaccines9111237. - DOI - PMC - PubMedLópez-Gómez M., Cáceres M.P., Montoro M.A. Estudio sobre Liderazgo Estudiantil desde un Enfoque Socio-político en la Universidad Santo Tomás de Bucaramanga (Colombia) [Study on Leadership Student at the University of Santo Tomas Bucaramanga (Colombia)] Int. J. Educ. Leadersh. Manag. 2017;5:178–197. doi: 10.17583/ijelm.2017.2514. - DOIWinter K., Pummerer L., Hornsey M.J., Sassenberg K. Pro-vaccination subjective norms moderate the relationship between conspiracy mentality and vaccination intentions. Br. J. Health Psychol. 2022;27:390–405. doi: 10.1111/bjhp.12550. - DOI - PMC - PubMedGraupensperger S., Abdallah D.A., Lee C.M. Social norms and vaccine uptake: College students’ COVID vaccination intentions, attitudes, and estimated peer norms and comparisons with influenza vaccine. Vaccine. 2021;39:2060–2067. doi: 10.1016/j.vaccine.2021.03.018. - DOI - PMC - PubMedBarello S., Nania T., Dellafiore F., Graffigna G., Caruso R. ‘Vaccine hesitancy’ among university students in Italy during the COVID-19 pandemic. Eur. J. Epidemiol. 2020;35:781–783. doi: 10.1007/s10654-020-00670-z. - DOI - PMC - PubMedLaCour M., Davis T. Vaccine skepticism reflects basic cognitive differences in mortality-related event frequency estimation. Vaccine. 2020;38:3790–3799. doi: 10.1016/j.vaccine.2020.02.052. - DOI - PubMedde Angelis T. How APA Is Helping COVID’s Overlooked Populations. Consider Joining One of the 10 Working Groups Tasked with Culling Resources to Aid Clinicians in Working with Underserved Groups during the Pandemic 2020. [(accessed on 5 May 2022)]. Available online: https://www.apaservices.org/practice/news/covid-19-overlooked-populations.Rivera R. The Research Initiatives Working Group at the APA Interdivisional Task Force on the Pandemic. How to Advance Multidimensional COVID-19 Scholarship from a Global International Perspective. [(accessed on 5 May 2022)];Int. Psychol. Bull. 2021 25 Available online: https://div52.net/ipb-2021-25-3/#collaborations.Gallant A.J., Brown Nicholls L.A., Rasmussen S., Cogan N., Young D., Williams L. Changes in attitudes to vaccination as a result of the COVID-19 pandemic: A longitudinal study of older adults in the UK. PLoS ONE. 2021;16:e0261844. doi: 10.1371/journal.pone.0261844. - DOI - PMC - PubMedMuñiz J., Elosúa P., Padilla J.L., Hambleton R.K. Test adaptation standards for cross-lingual assessment. In: Wells C.S., Faulkner-Bond M., editors. Educational Measurement. From Foundations to Future. Guilford Press; New York, NY, USA: 2016. pp. 291–304.Raykov T. Scale construction and development using structural equation modeling. In: Hoyle R.H., editor. Handbook of Structural Equation Modeling. The Guilford Press; New York, NY, USA: 2012. pp. 472–492.Rigdon E.E., Schumacker R.E., Wothke W. A comparative review of interaction and nonlinear modeling. In: Schumacker R.E., Marcoulides G.A., editors. Interaction and Nonlinear Effects in Structural Equation Modeling. Lawrence Erlbaum; Mahwah, NJ, USA: 2017. pp. 251–294. Modern Methods for Business Research.Raykov T. Scale validity evaluation with congeneric measures in hierarchical designs. Br. J. Math. Stat. Psychol. 2011;64:427–438. doi: 10.1348/000711009X484286. - DOI - PubMedKline R.B. Principles and Practice of Structural Equation Modeling. 4th ed. Guilford Press; New York, NY, USA: 2016.Raykov T., Marcoulides G.A. Introduction to Psychometric Theory. Routledge Ltd.; New York, NY, USA: 2011.Jöreskog K.G. On the estimation of polychoric correlations and their asymptotic covariance matrix. Psychometrika. 1994;59:381–389. doi: 10.1007/BF02296131. - DOICheung G.W., Rensvold R.B. Evaluating goodness-of-fit indexes for testing measurement invariance. Struct. Equ. Model. 2002;9:233–255. doi: 10.1207/S15328007SEM0902_5. - DOIMuthén L.K., Muthén B. Mplus User’s Guide. 8th ed. Muthén & Muthén; Los Angeles, CA, USA: 2017Bedford H., Attwell K., Danchin M., Marshall H., Corben P., Leask J. Vaccine hesitancy, refusal and access barriers: The need for clarity in terminology. Vaccine. 2018;36:6556–6558. doi: 10.1016/j.vaccine.2017.08.004. - DOI - PubMedValentini F., Damásio B.F. Average Variance Extracted and Composite Reliability: Reliability Coefficients. Psicol. Teor. E Pesqui. 2016;32:1–7. doi: 10.1590/0102-3772e322225. - DOIYeh Y.C., Chen I.H., Ahorsu D.K., Ko N.Y., Chen K.L., Li P.C., Yen C.F., Lin C.Y., Griffiths M.D., Pakpour A.H. Measurement invariance of the drivers of COVID-19 vaccination acceptance scale: Comparison between taiwanese and mainland chinese-speaking populations. Vaccines. 2021;9:297. doi: 10.3390/vaccines9030297. - DOI - PMC - PubMedFischer R., Karl J.A. Predicting Behavioral Intentions to Prevent or Mitigate COVID-19: A Cross-Cultural Meta-Analysis of Attitudes, Norms, and Perceived Behavioral Control Effects. Soc. Psychol. Personal. Sci. 2022;13:264–276. doi: 10.1177/19485506211019844. - DOIVaccine hesitancyVaccine refusalConfirmatory factor analysisStructural equation modelingMeasurement invarianceConcurrent validityPsychometric propertiesCovid-19Evidence of Validity and Measurement Invariance by Gender of the Vaccination Attitudes Examination (VAX) Scale in Colombian University StudentsArtículos Científicosinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_2df8fbb1http://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleAtribución – No comercialinfo:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2PublicationORIGINAL2022_evidence_validity2022_evidence_validityArtículoapplication/pdf1167300https://repository.ucc.edu.co/bitstreams/ba2a866b-c313-46d0-9bef-b3e3058daa89/download4757944370424014df201708b0261d78MD51LICENSElicense.txtlicense.txttext/plain; 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