This study systematically analyzes the research that used the Health Belief Model (HBM) as a theoretical basis to examine the influence of HBM constructs on COVID-19 vaccine hesitancy. Following PRISMA guidelines, PubMed, Web of Science, Google Scholar, and Scopus were searched for quantitative studies. Sixteen studies with 30,242 participants met inclusion criteria. The prevalence of COVID-19 vaccine hesitancy was 33.23% (95% CI 24.71–41.39%). Perceived barriers and perceived benefits were the most common HBM constructs that were significantly associated with vaccine hesitancy. While perceived benefits was inversely associated, a positive association was found between perceived barriers and vaccine hesitancy. Other HBM constructs that were frequently examined and inversely associated were perceived susceptibility, cues to action, perceived severity, and self-efficacy. The most common HBM modifying factor that was directly associated with COVID-19 vaccine hesitancy was gender, followed by education, age, geographical locations, occupation, income, employment, marital status, race, and ethnicity; however, a few studies report inconsistent results. Other modifying variables that influenced vaccine hesitancy were knowledge of COVID-19, prior diagnosis of COVID-19, history of flu vaccination, religion, nationality, and political affiliation. The results show that HBM is useful in predicting COVID-19 vaccine hesitancy.

This study systematically analyzed the literature using the theory of planned behavior (TPB) as a theoretical framework to examine the influence of its constructs on vaccination intention against COVID-19. Quantitative studies were searched in PubMed, CINAHL, Web of Science, and Google Scholar following the PRISMA guidelines. The average rate of COVID-19 vaccination intention was 73.19%, ranging from 31% to 88.86%. Attitude had the strongest association with vaccination intention (r₊ = 0.487, 95% CI: 0.368–0.590), followed by subjective norms (r₊ = 0.409, 95% CI: 0.300–0.507), and perceived behavioral control (r₊ = 0.286, 95% CI: 0.198–0.369). Subgroup analyses showed that the pooled effect sizes of TPB constructs on vaccination intention varied across geographic regions and study populations. Attitude had large effect sizes in Asia, Europe, and Oceania, especially among the adult general population, parents, and patients. Subjective norms had large effect sizes in Asia and Oceania, especially among parents and patients. Perceived behavioral control was the most dominant predictor of vaccination acceptance in Africa among patients. These findings suggest that TPB provides a useful framework for predicting intention to receive a COVID-19 vaccine. Hence, public awareness and educational programs aimed at promoting COVID-19 vaccination intention should consider using TPB as a framework to achieve the goal.

This systematic review synthesizes the findings of quantitative studies examining the relationships between Health Belief Model (HBM) constructs and COVID-19 vaccination intention. We searched PubMed, Medline, CINAHL, Web of Science, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and identified 109 eligible studies. The overall vaccination intention rate was 68.19%. Perceived benefits, perceived barriers, and cues to action were the three most frequently demonstrated predictors of vaccination intention for both primary series and booster vaccines. For booster doses, the influence of susceptibility slightly increased, but the impact of severity, self-efficacy, and cues to action on vaccination intention declined. The impact of susceptibility increased, but severity’s effect declined sharply from 2020 to 2022. The influence of barriers slightly declined from 2020 to 2021, but it skyrocketed in 2022. Conversely, the role of self-efficacy dipped in 2022. Susceptibility, severity, and barriers were dominant predictors in Saudi Arabia, but self-efficacy and cues to action had weaker effects in the USA. Susceptibility and severity had a lower impact on students, especially in North America, and barriers had a lower impact on health care workers. However, cues to action and self-efficacy had a dominant influence among parents. The most prevalent modifying variables were age, gender, education, income, and occupation. The results show that HBM is useful in predicting vaccine intention.

Purpose: The purpose of this paper is to examine the indirect effects of nutritional knowledge and attitude toward food label use on food label use through self-efficacy and trust, as well as whether gender moderates this relationship. Design/methodology/approach: A sample of Indian adults with multiple chronic conditions was surveyed about their nutritional knowledge, attitude, self-efficacy and use of food labels. Hypotheses were tested using Hayes’s (2013) PROCESS macro for SPSS. Findings: The results show that nutritional knowledge and attitude toward food label use positively predict food label use through self-efficacy and trust. However, these mediation effects are moderated by gender such that the indirect relationship is stronger among men than women. Practical implications: Food marketers and government agencies engaged in nutrition education campaigns should aim to increase patients’ confidence in comprehending food label information. Social implications: Since food labels can be a valuable tool to help patients with chronic diseases to make informed decisions about their diet and lifestyle, regulators may consider mandating nutritional labels on foods to help them improve their food or dietary choices. Originality/value: This study uniquely applies Fisher and Fisher’s (1992) information–motivation–behavioral skills model as a theoretical framework to examine the influence of nutrition knowledge and attitude toward food label use on food label usage of Indian patients with multiple chronic diseases.

Background: Research confirms the negative relationship between early marriage and mothers’ and children’s health outcomes. This is why studies of the changes in age at marriage are an important task from the point of view of the health status and well-being of a mother and her offspring, especially in groups represented by extremely disadvantaged social strata in India. The results of such studies may influence the future family planning policy in the country. Objectives: This study aims to investigate the trend of age at marriage among the Scheduled Castes (SCs) women from two Indian states: Madhya Pradesh and Uttar Pradesh relative to the level of education and also to socioeconomic changes in the states. These states manifest the highest proportion of girls getting married below the age of 18 years–far above the proportion observed in entire India. Methods: Women from Scheduled Caste, N = 1,612, aged 25–65, born in 1950–1990 were investigated. A modern semiparametric regression approach was used. To capture the relationship between age at marriage and year of birth, categories of women’s level of education (illiterate; primary: 1st–5th standards; middle school: 6th–8th standards; high school: 9th–10th standards; higher secondary: 11th–12th standards), and categories of the profession (women working in the agricultural sector or the non-agricultural sector), flexible framework of the Generalized Additive Model (GAM) was applied. Results: A significant impact of the cohort defined by the year of birth (<0.001), and women’s education (<0.001) on age at marriage was noted, while the influence of women’s occupation was not significant (p = 0.642). Mean age at marriage differed significantly with different education level. Women who graduated from primary school married 0.631 years later on average than illiterate ones, while those who graduated from middle schools, high schools (9th–10th standards) and higher secondary schools married significantly later than illiterate ones by 1.454 years and 2.463 years, respectively. Age at marriage increased over time: from slightly above 15 years in the cohort of illiterate women born in 1950 to almost 19 years in quite well-educated women born in 1990. The average age at marriage estimated for four education levels in 1990 ranged between 16.39 years (95%CI: 15.29–17.50) in the group of illiterate women and 18.86 years (95%CI: 17.76–19.95) in women graduated from high and higher secondary schools. Conclusion: The rise of age at marriage can be partly explained by the increase of females enrolled in schools, the alleviation of poverty, and the implementation of social programs for women.