Evidence map›Paper›PMID 40307882›Full record

ArticleInfectious diseases of poverty2025

Reliability and validity study of the "5Cs" hesitancy scale for maternal influenza vaccination among pregnant and postpartum women.

Fanyu Zeng, Bingcheng Du, Hong Jiang, Min Zheng, Xiu Qiu, Fen Li, Nianhua Yi, Yinglan Wu, Yuanying Ma, Changhui Li and 6 more

Abstract readValidation Study
In one paragraph

Article in Infectious diseases of poverty, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Fanyu ZengSchool of Public Health, Key Laboratory of Health Technology Assessment, National Health Commission, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032, China.
Bingcheng DuDepartment of Statistics, University of Toronto, Toronto, Canada.
Hong JiangSchool of Public Health, Key Laboratory of Health Technology Assessment, National Health Commission, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032, China. h_jiang@fudan.edu.cn.ORCID http://orcid.org/0000-0002-2810-8000
Min ZhengYunnan Maternal and Child Health Care Hospital, Kunming, 650021, China.
Xiu QiuGuangzhou Women and Children's Medical Center, Guangzhou, 510623, China.
Fen LiThe First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, 710061, China.
Nianhua YiDepartment of Maternal Health Care, Huazhong University of Science and Technology Tongji Medical College Maternal and Child Health Hospital of Hubei Province, Wuhan, 430070, China.
Yinglan WuHunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, China.
Yuanying MaWomen's Hospital School of Medicine, Zhejiang University, Hangzhou, 310006, China.
Changhui LiUrumqi Youai Hospital, Urumqi, 830001, China.
Chunyi GuLiaoning Provincial Maternal and Child Health Hospital, Shenyang, 110005, China.
Lei WangObstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China.
Fengyun YangShanghai Jiading District Maternal and Child Health Care Hospital, Shanghai, 201800, China.
Longmei JinShanghai Minhang Maternal and Child Health Care Hospital, Shanghai, 201102, China.
Yanran YangDuke Kunshan University, Kunshan, 215316, China. yanran.yang@dukekunshan.edu.cn.
Xu QianSchool of Public Health, Key Laboratory of Health Technology Assessment, National Health Commission, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032, China.

Funding

Gates Foundation INV-034554Shanghai Key Discipline Construction Project GWVI-11.1-32.
6 · The paper itself

Abstract

backgroundMaternal influenza vaccine hesitancy plays a vital role in the low rates of vaccination. However, instruments to appropriately assess perinatal influenza vaccine hesitancy are unavailable. This study aimed to develop the Maternal Influenza Vaccine Hesitancy Scale based on the 5C vaccination hesitancy scale, containing the subscales of confidence, complacency, constraints, calculative, and collective responsibility, and to provide a preliminary overview of the current hesitancy on maternal influenza vaccination in China.

methodsA cross-sectional survey, from January to March 2024, was carried out among 2035 pregnant and postpartum women from nine provincial-level administrative divisions representing eastern, central, western, and northeastern areas of China. Reliability was evaluated by internal consistency reliability and split-half reliability, and a Cronbach's alpha coefficient > 0.7 was considered acceptable. Construct validity was assessed using confirmatory factor analysis (CFA), with good model fit defined as root mean square error of approximation (RMSEA) < 0.100, normed fit index (NFI) > 0.9, comparative fit index (CFI) > 0.9, and Tucker-Lewis index (TLI) > 0.9.

resultsConfirmatory factor analysis results supported the five-factor structure of the scale (RMESA = 0.098, CFI = 0.921, TLI = 0.903, NFI = 0.918). The Cronbach's alpha coefficients for the scale as well as the subscales ranged from 0.802 to 0.958. Among five subscales, collective responsibility (2.73 ± 0.63) scored highest, while complacency (2.16 ± 0.69) and constraints (2.17 ± 0.69) were the lowest.

conclusionsThe Maternal Influenza Vaccine Hesitancy Scale developed in this study is a reliable and valid instrument to measure the influenza vaccine hesitancy of pregnant and postpartum women. It is recommended that interventions including health education and improving the access to the vaccination service be carried out to reduce the maternal influenza vaccination hesitancy.

Indexed as

Influenza, HumanInfluenza VaccinesPregnant PeopleVaccinationVaccination HesitancyAdultChinaCross-Sectional StudiesFemaleHumansPostpartum PeriodPregnancyReproducibility of ResultsSurveys and QuestionnairesYoung AdultInfluenza VaccinesChildbirthInfluenza vaccinePregnancyReliabilityVaccine hesitancyValidity

Identifiers

PMID40307882
PMCPMC12042492

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.