# Factors influencing COVID-19 vaccination intentions and the moderating effect of perceived behavioral control among pregnant women: a cross-sectional study applying the revised Theory of Planned Behavior

## TL;DR

This study examines what influences pregnant women's intentions to get a COVID-19 vaccine and how perceived control affects these intentions.

## Contribution

The study applies the revised Theory of Planned Behavior to understand vaccination intentions among pregnant women and identifies a moderating role of perceived behavioral control.

## Key findings

- Attitudes and subjective norms significantly influence vaccination intentions among pregnant women.
- Perceived behavioral control moderates the effect of subjective norms on vaccination intentions.
- Programs should focus on improving attitudes and perceived control to increase vaccination intentions.

## Abstract

This study explored factors that influence coronavirus disease 2019 (COVID-19) vaccination intentions during pregnancy and examined the moderating effect of perceived behavioral control based on the revised Theory of Planned Behavior.

This cross-sectional online survey recruited 227 Korean pregnant women from an online community. Data were collected from December 2021 to January 2022 and analyzed using independent t-test, analysis of variance, Pearson correlation coefficients, and multiple regression analysis. The PROCESS macro (model 1) and simple slope analysis were used to investigate the moderating effect of perceived behavior control.

Attitudes (β=.44, p<.001) and subjective norms (β=.36, p<.001) were identified as factors influencing COVID-19 vaccination intentions during pregnancy. In the final regression model, the total explanatory power of the variables was 44% (F=90.47, p<.001). The moderating effect of perceived behavioral control in the relationship between attitudes and vaccination intention was not statistically significant (B=0.07, p=.382). However, it showed a significant moderating effect in the relationship between subjective norms and vaccination intentions (B=0.06, p=.046). For simple slope analysis, perceived behavioral control was classified into three levels (low, moderate, and high), and the effect of subjective norms on vaccination intention was analyzed. Pregnant women with a high level of perceived behavioral control showed the strongest relationship (b=0.45, p<.001), indicating a moderating effect of perceived behavioral control.

To increase vaccination intention among pregnant women, it is imperative to implement programs that focus on improving pregnant women’s attitudes, subjective norms, and perceived behavioral control toward vaccination, with particular attention to those with low perceived behavioral control.