The mediating effect of E-health literacy on health belief model-based vaccine attitudes among parents in Türkiye: a cross-sectional study

Abstract

BACKGROUND: Vaccination constitutes one of the most efficacious public health interventions, preventing millions of fatalities annually. Nevertheless, vaccine hesitancy persists as a significant challenge, particularly among parents. The dissemination of misinformation via the internet, notably through social media platforms, has contributed to the escalation of vaccine hesitancy. E-health literacy, defined as the capacity to locate and utilize online health information, possesses the potential to influence vaccine attitudes. This study aimed to investigate the relationships among education level, e-health literacy and childhood vaccination attitude among parents. METHODS: The cross-sectional study design was used. This study was guided by STROBE. Convenience sampling recruited 699 parents in Türkiye with an online survey. The data tools used in the study were the parental information form, Public Attitudes Towards Vaccination - Health Belief Model Scale (PAV-HBM) and E-health Literacy Scale. The collected data were analyzed using SPSS version 25.0, and the PROCESS macro in SPSS was employed to estimate path coefficients and assess the adequacy of the model. The mediating effects of e-health literacy on the pathway in which education level of the parents affects childhood vaccination were verified using model 4 of the SPSS PROCESS macro proposed by Hayes. RESULTS: The E-Health literacy had significantly mediate the relationship between educational level and the PAVS-HBM sub-dimensions of perceived susceptibility (B = 0.044, 95% CI= [0.023-0.071]), severity (B = 0.045, 95% CI= [0.023-0.070]), benefits (B = 0.054, 95% CI= [0.029-0.086]), and health motivation (B = 0.045, 95% CI= [0.023-0.071]). However, e-health literacy did not mediate the relationship between education level and perceived barriers (B = - 0.013, 95% CI= [- 0.049- -0.023]). CONCLUSION: The results revealed that education level among parents affect all vaccine attitudes without perceived barriers and the level of e-health literacy mediates this relationship. Therefore, health communication strategies, such as the development of e-health literacy by health authorities and the provision of reliable information about vaccination on digital platforms, including social media, may have potential benefits in promoting positive vaccination attitudes in the community. CLINICAL TRIAL NUMBER: Not applicable.

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