Self-perception and COVID-19 vaccination self-efficacy among Chinese adults: A moderated mediation model of mental health and trust

BACKGROUND: Optimal Corona Virus Disease 2019 (COVID-19) vaccination coverage is necessary to achieve community protection, and self-efficacy independently predict vaccination behavior. The current study examined the effect of self-perception on COVID-19 vaccination self-efficacy as well as potential mechanisms among Chinese adults. METHODS: A cross-sectional survey was conducted from four cities in China (n = 6781). Models 4 and 8 in Hayes' PROCESS macro were used to test models. RESULTS: Self-perception (β = 0.128, 95 % CI: 0.093, 0.163) and self-perception ∗ mental health (β = 0.009, 95 % CI: 0.003, 0.014) were positively associated with trust in doctors and vaccine developers, while mental health was negatively related to trust in doctors and vaccine developers (β = −0.483, 95 % CI: −0.629, –0.337). Self-perception (β = 0.149, 95 % CI: 0.138, 0.161), trust in doctors and vaccine developers (β = 0.185, 95 % CI: 0.177, 0.194) and self-perception ∗ mental health (β = 0.003, 95 % CI: 0.002, 0.005) were positively associated with COVID-19 vaccination self-efficacy. Mental health was negatively related to COVID-19 vaccination self-efficacy (β = −0.101, 95 % CI: −0.151, –0.051). LIMITATIONS: This cross-sectional study collected data through online questionnaires. CONCLUSIONS: Our results demonstrated that the relationship between self-perception and COVID-19 vaccination self-efficacy was partially mediated by trust in doctors and vaccine developers. Both the correlation between self-perception and COVID-19 vaccination self-efficacy, and the relationship between self-perception and trust in doctors and vaccine developers were moderated by mental health. Findings confirm that increasing COVID-19 vaccination self-efficacy would be facilitated by improvements in self-perception, mental health, and trust in doctors and vaccine developers.