Perceived social support and self-stigma as factors of COVID-19 booster vaccination behavior and intention via cognitive coping and emotion regulation among people infected with COVID-19 in Hong Kong
Abstract Background It is imperative to promote behavior/intention of taking up booster COVID-19 vaccination (BI-BV) among people who have ever contracted COVID-19 (PECC). The aims were to investigate the prevalence of BI-BV and its associations with perceived social support. Guided by the stress co...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-02-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-025-21899-x |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849724207928180736 |
|---|---|
| author | Xiaoying Zhang Yiming Luan Yihan Tang Mason M. C. Lau Yanqiu Yu Jing Gu Joseph T. F. Lau |
| author_facet | Xiaoying Zhang Yiming Luan Yihan Tang Mason M. C. Lau Yanqiu Yu Jing Gu Joseph T. F. Lau |
| author_sort | Xiaoying Zhang |
| collection | DOAJ |
| description | Abstract Background It is imperative to promote behavior/intention of taking up booster COVID-19 vaccination (BI-BV) among people who have ever contracted COVID-19 (PECC). The aims were to investigate the prevalence of BI-BV and its associations with perceived social support. Guided by the stress coping theory, we tested mediators between perceived social support and BI-BV via self-stigma, active coping, and maladaptive emotion regulation (rumination and catastrophizing). Methods A random population-based telephone survey was conducted among adult PECC having completed the primary series of COVID-19 vaccination prior to the diagnosis; 230 participants were interviewed from June to August 2022 during the fifth (last) major outbreak in Hong Kong. The associations between the independent variables and BI-BV were tested by logistic regression analysis. A structural equation model (SEM) tested the indirect effects of the latent variables of self-stigma, active coping, and maladaptive emotion regulation between the latent variable of perceived social support and BI-BV. Results The prevalence of BI-BV was 62.2%. It was associated with age, marital status, full-time employment, and chronic disease status. The logistic regression analysis found that BI-BV was positively associated with perceived social support (ORc = 1.31, 95% CI: 1.12– 1.54), active coping (ORc = 1.40, 95% CI: 1.10– 1.79), rumination (ORc = 1.75, 95% CI: 1.13– 2.70), and catastrophizing (ORc = 3.12, 95% CI: 1.49– 6.51) and negatively associated with self-stigma (ORc = 0.80, 95% CI: 0.72– 0.88). In the SEM analysis, the positive association between perceived social support and BI-BV was fully mediated: 1) via self-stigma (β = 0.07, 95% CI: 0.03– 0.14), 2) via active coping (β = 0.06, 95% CI: 0.02– 0.12), and 3) via self-stigma and then active coping (β = 0.01, 95% CI: 0.002– 0.04). Two of these indirect paths involved active coping. The indirect paths involving maladaptive emotion regulation were all non-significant. Conclusions Perceived social support was associated with BI-BV, and was mediated via self-stigma, active coping, and serially self-stigma then active coping but not emotion maladaptation. The data supported the stress cognitive coping model in explaining the association between perceived social support and BI-BV. Interventions promoting BI-BV may consider modifying the observed significant factors. Future longitudinal studies are warranted to confirm the findings. |
| format | Article |
| id | doaj-art-21af73a3ef04487f862f73c1f4b5a673 |
| institution | DOAJ |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-21af73a3ef04487f862f73c1f4b5a6732025-08-20T03:10:49ZengBMCBMC Public Health1471-24582025-02-0125111210.1186/s12889-025-21899-xPerceived social support and self-stigma as factors of COVID-19 booster vaccination behavior and intention via cognitive coping and emotion regulation among people infected with COVID-19 in Hong KongXiaoying Zhang0Yiming Luan1Yihan Tang2Mason M. C. Lau3Yanqiu Yu4Jing Gu5Joseph T. F. Lau6College of Public Health, Shanghai University of Medicine and Health SciencesMeilong Community Health Center of Minhang DistrictSchool of Public Health, Sun Yat-Sen UniversityJockey Club School of Public Health and Primary Care, The Chinese University of Hong KongSchool of Public Health, Fudan UniversitySchool of Public Health, Sun Yat-Sen UniversityPublic Mental Health Center, School of Mental Health, Wenzhou Medical UniversityAbstract Background It is imperative to promote behavior/intention of taking up booster COVID-19 vaccination (BI-BV) among people who have ever contracted COVID-19 (PECC). The aims were to investigate the prevalence of BI-BV and its associations with perceived social support. Guided by the stress coping theory, we tested mediators between perceived social support and BI-BV via self-stigma, active coping, and maladaptive emotion regulation (rumination and catastrophizing). Methods A random population-based telephone survey was conducted among adult PECC having completed the primary series of COVID-19 vaccination prior to the diagnosis; 230 participants were interviewed from June to August 2022 during the fifth (last) major outbreak in Hong Kong. The associations between the independent variables and BI-BV were tested by logistic regression analysis. A structural equation model (SEM) tested the indirect effects of the latent variables of self-stigma, active coping, and maladaptive emotion regulation between the latent variable of perceived social support and BI-BV. Results The prevalence of BI-BV was 62.2%. It was associated with age, marital status, full-time employment, and chronic disease status. The logistic regression analysis found that BI-BV was positively associated with perceived social support (ORc = 1.31, 95% CI: 1.12– 1.54), active coping (ORc = 1.40, 95% CI: 1.10– 1.79), rumination (ORc = 1.75, 95% CI: 1.13– 2.70), and catastrophizing (ORc = 3.12, 95% CI: 1.49– 6.51) and negatively associated with self-stigma (ORc = 0.80, 95% CI: 0.72– 0.88). In the SEM analysis, the positive association between perceived social support and BI-BV was fully mediated: 1) via self-stigma (β = 0.07, 95% CI: 0.03– 0.14), 2) via active coping (β = 0.06, 95% CI: 0.02– 0.12), and 3) via self-stigma and then active coping (β = 0.01, 95% CI: 0.002– 0.04). Two of these indirect paths involved active coping. The indirect paths involving maladaptive emotion regulation were all non-significant. Conclusions Perceived social support was associated with BI-BV, and was mediated via self-stigma, active coping, and serially self-stigma then active coping but not emotion maladaptation. The data supported the stress cognitive coping model in explaining the association between perceived social support and BI-BV. Interventions promoting BI-BV may consider modifying the observed significant factors. Future longitudinal studies are warranted to confirm the findings.https://doi.org/10.1186/s12889-025-21899-xBooster COVID-19 vaccinesPerceived social supportSelf-stigmaRuminationCatastrophizingActive coping |
| spellingShingle | Xiaoying Zhang Yiming Luan Yihan Tang Mason M. C. Lau Yanqiu Yu Jing Gu Joseph T. F. Lau Perceived social support and self-stigma as factors of COVID-19 booster vaccination behavior and intention via cognitive coping and emotion regulation among people infected with COVID-19 in Hong Kong BMC Public Health Booster COVID-19 vaccines Perceived social support Self-stigma Rumination Catastrophizing Active coping |
| title | Perceived social support and self-stigma as factors of COVID-19 booster vaccination behavior and intention via cognitive coping and emotion regulation among people infected with COVID-19 in Hong Kong |
| title_full | Perceived social support and self-stigma as factors of COVID-19 booster vaccination behavior and intention via cognitive coping and emotion regulation among people infected with COVID-19 in Hong Kong |
| title_fullStr | Perceived social support and self-stigma as factors of COVID-19 booster vaccination behavior and intention via cognitive coping and emotion regulation among people infected with COVID-19 in Hong Kong |
| title_full_unstemmed | Perceived social support and self-stigma as factors of COVID-19 booster vaccination behavior and intention via cognitive coping and emotion regulation among people infected with COVID-19 in Hong Kong |
| title_short | Perceived social support and self-stigma as factors of COVID-19 booster vaccination behavior and intention via cognitive coping and emotion regulation among people infected with COVID-19 in Hong Kong |
| title_sort | perceived social support and self stigma as factors of covid 19 booster vaccination behavior and intention via cognitive coping and emotion regulation among people infected with covid 19 in hong kong |
| topic | Booster COVID-19 vaccines Perceived social support Self-stigma Rumination Catastrophizing Active coping |
| url | https://doi.org/10.1186/s12889-025-21899-x |
| work_keys_str_mv | AT xiaoyingzhang perceivedsocialsupportandselfstigmaasfactorsofcovid19boostervaccinationbehaviorandintentionviacognitivecopingandemotionregulationamongpeopleinfectedwithcovid19inhongkong AT yimingluan perceivedsocialsupportandselfstigmaasfactorsofcovid19boostervaccinationbehaviorandintentionviacognitivecopingandemotionregulationamongpeopleinfectedwithcovid19inhongkong AT yihantang perceivedsocialsupportandselfstigmaasfactorsofcovid19boostervaccinationbehaviorandintentionviacognitivecopingandemotionregulationamongpeopleinfectedwithcovid19inhongkong AT masonmclau perceivedsocialsupportandselfstigmaasfactorsofcovid19boostervaccinationbehaviorandintentionviacognitivecopingandemotionregulationamongpeopleinfectedwithcovid19inhongkong AT yanqiuyu perceivedsocialsupportandselfstigmaasfactorsofcovid19boostervaccinationbehaviorandintentionviacognitivecopingandemotionregulationamongpeopleinfectedwithcovid19inhongkong AT jinggu perceivedsocialsupportandselfstigmaasfactorsofcovid19boostervaccinationbehaviorandintentionviacognitivecopingandemotionregulationamongpeopleinfectedwithcovid19inhongkong AT josephtflau perceivedsocialsupportandselfstigmaasfactorsofcovid19boostervaccinationbehaviorandintentionviacognitivecopingandemotionregulationamongpeopleinfectedwithcovid19inhongkong |