Perceived Behavioral control And Booster Intention: Predictors of COVID-19 Booster

Hesitancy of Mapua University Senior High School Students

by

Marvin C. Cruz
Katja J. Estioko
Aubrey Nikko M. Valle

A Research Paper Submitted to the Technical Working Group of the

Office of the Institutional Quality Assurance and Governance of the
Commission on Higher Education

Local Graduate Scholarships Office

May 2022
…
 INTRODUCTION
As the COVID-19 pandemic goes on, vaccine doses were created by experts to alleviate or

minimize the effects of the virus. There were vaccines created to fit the people's needs. There are

several vaccines present here in the Philippines, namely, Pfizer, Moderna, Astrazeneca, Sinovac,

and others. Now, experts are advising the community to have their booster shots or third dose of

the vaccine they have received, but some are now having double thoughts or being hesitant about

it.

Background of the Study

As the COVID-19 crisis in the Philippines worsens, with everyday infections reaching new

heights, the Omicron variant spreads throughout the highly populated Metro Manila region.

According to Strangio, S. (2022), the country set a new daily record of 39,004 infections on

January 15, 2022, marking the sixth daily record in less than a month. This was followed by more

than 37,000 COVID-19 infections on both April 16 and 17 bringing the country's total to more

than 3.2 million, as well as 52,929 fatalities from the virus. According to the statistics as of

December 30, 2021, over 9.6 million persons in the Philippines' National Capital Region (NCR)

were fully vaccinated against the coronavirus (COVID-19). Meanwhile, around 9.34 million

individuals were still waiting for their second vaccination dosage. Cities in Metro Manila are

included in the NCR area. Sinovac is the most often used vaccination in every country (Statista

Research Department, 2022). The purpose of this study was to replicate the study “Predicting

COVID-19 booster vaccine intentions” published in November 2021. Data collected in May 2021

authored by Hagger, M., and Hamilton, K. in the Philippine context, demonstrated how COVID-

19 booster intentions of US citizens are affected by the social cognition theories. A booster dose
of vaccine is administered when the protection provided by the original doses begins to decrease.

Boosters can assist sustain the health system by enhancing protection against severe COVID-19

outcomes, particularly among the elderly and high-risk population. The Department of Health

recently announced that fully vaccinated adults aged 18 and up could "receive a single-dose

booster of COVID-19 vaccine at least three months after the second dose of AstraZeneca,

Moderna, Pfizer, Sinovac, or Sputnik vaccine, or at least two months after Janssen" beginning

December 22 (Rappler, 2021).

Review of Related Literature

COVID-19: Brief History and Current Status in the Philippines

The COVID-19 pandemic has greatly affected every country in the world, the Philippines

went through major lengths of protection such as lockdowns in every area in order to secure the

Filipino citizens. The lockdown began on March 16, 2020, when every Filipino citizen was forced

to stay indoors without having a stable supply of their basic needs, a lot of Filipinos lost their job

since most of the companies were trying to conserve and limit the people in their respective work

areas.

COVID-19 patients and death rates began to rise gradually, According to the World Health

organization 1,401 was the daily average of newly reported cases of covid patients during

December of 2020, compared to December 2021 the daily average of new covid patients is 373.

According to the Department of Health (DOH), 97.9% is the total average of individuals who
recovered from COVID-19. The data gathered displays a huge difference in how COVID-19 cases

depleted compared to last year's data.

There are currently 37.9% of Filipino individuals who are vaccinated ranging from 11-

year-old children and above, which is still not half of the population of the country. A large number

of Filipino citizens are hesitant and afraid to be vaccinated because some are fed by misinformation

from social media and other people. The phase of the vaccination may be slow but, the country is

slowly recovering from the COVID-19 pandemic since a lot of areas have begun to be available

for children.

Philippine Government Plans to Combat the COVID-19 Pandemic

The number of COVID-19 cases is expected to rise due to the new Omicron strain of

COVID-19. Despite the pandemic, the Philippine government has mapped out various initiatives

to fight the pandemic. With the predicted increase of COVID-19 cases, the guidelines established

by the government must be followed.

The government and the Inter-Agency Task Force devised strategies to battle the pandemic.

In the Philippines, the government issued a set of omnibus guidelines to implement community

quarantine. According to the rules, the government follows the minimum public health regulations

and precautions, such as wearing face masks and following social distancing protocols. The

guidelines were developed to prevent and reduce the local spread of emerging infectious diseases

by establishing or strengthening a system for screening potential patients infected with emerging

infectious diseases, contact tracing, determining the mode of virus exposure, and implementing

effective quarantine and proper isolation procedures. S. Talabis et al. (2021) stated that LGUs are
tasked to adapt, coordinate, and implement guidelines concerning COVID-19 in accordance with

provincial and local quarantine protocols released by the national government. The government's

most important initiative is vaccination. President Rodrigo Duterte stated that the Philippines is on

track to vaccinate up to 50% of the general population by the end of the year. The Philippines had

given out at least 97,237,440 doses of COVID vaccination as of December 14, 2021. If each person

requires two doses, the country's population would be vaccinated by around 45 percent.

The Philippines is currently on track to vaccinate 50% of the population by the end of the

year. COVID-19 instances may increase as a result of the new Omicron variant. As a result,

patients may require booster shots to protect individuals against more transmissible strains. This

will be explained further in the following section.

Importance of Booster Shots

Amidst the pandemic, a vaccine was made by the work of doctors and scientists. It was

rolled out through different countries almost a year after the pandemic started. Now, many people

have been inoculated. Experts suggest that people get vaccine boosters due to waning effects.

Vaccine boosters or the third dose are important and helpful to us. Krause(2021) states that

boosting could be appropriate for some individuals in whom the primary vaccination, defined here

as the original one-dose or two-dose series of each vaccine, might not have induced adequate

protection like recipients of vaccines with low efficacy or those who are immunocompromised.

According to Mahase (2021), the Third dose may not be an “urgent priority”, but it can give a

strong boost to the immune response. According to Burki (2021), their article proved that people

have different opinions about this topic, but at the end of the day booster vaccines are not a
guarantee that you will be immune from the virus. Next, according to Reddy (2021), their findings

state that a third dose of the vaccine is effective in protecting people against critical/serious

COVID-19 related outcomes, including potential death, compared with getting only two doses of

the vaccine. Vogel and Duong (2021) These boosters shore up protection against more

transmissible variants. Even though some experts call it premature, the booster program is held to

stay one step ahead of breakthrough infections amongst fully vaccinated individuals.

Vaccine Boosters are beneficial to us Vogel and Duong (2021). It may not be a

requirement, but it will give additional support to reduce the risks of contracting the virus. Though

many experts claim that it is healthy, other individuals are hesitant about the boosters and even the

vaccine itself.

Causes of Vaccine Hesitancy

According to Aligato, Et al. (2021), Their research shows that fear of adverse effects

appeared as the most common reason for delaying or refusing kid vaccines and had past bad

experiences. Respondents expressed skepticism and hesitation considering the dengue vaccine

debate. Household heads opposed vaccinations, beliefs that vaccines are unnecessary, and

pressures from social and traditional media led to increased vaccine rejection and delay. According

to Arora, Et al. (2021), Experts saw the ability of social media for rapid dissemination of

knowledge through infographics. They were categorized into 3 categories: COVID19 vaccine

series, debunking myths, and others. Bautista. et al. (2021),Some vaccines are the primary factors

why respondents are willing or unwilling to get a vaccine, emphasizing the safety and effectiveness

of the vaccine and its benefits to the public. Based on Amit et al. (2021), the COVID-19 Vaccine

aids the neutralization of the virus, and stops hospitalizations and deaths. Still, there are certain
factors and events that lead to barriers that affect inoculation. It is shown that the decision to

participate in vaccination depends on individual perceptions. Mirgiño et al., (2021), states that

those who believed in the protective nature of vaccines were less likely to report vaccine hesitancy

and were nine times less likely to refuse vaccination for their children because of negative media

exposure and reasons for vaccine hesitancy were exposure to negative media information and

concerns about vaccine safety.

Vaccine Hesitancy

COVID-19 vaccinations that are effective and safe have been produced at an extraordinary

rate to curb the virus's spread and avoid hospitalizations and fatalities. However, vaccine hesitancy

and anti-vaccination sentiments, a global lack of vaccine supplies, and inequitable vaccine

distribution, particularly among low- and middle-income nations like the Philippines, are posing

challenges to COVID-19 vaccine adoption.

According to. Amit et al.(2022), within their framework of the social-ecological model.

Individual perceptions play a significant effect in the decision to vaccinate, according to our

findings. Exposure to misinformation amplified by the media, the community, and the health

system shapes such perceptions. Depending on their opinions on vaccinations, social networks

may have a beneficial or negative impact on vaccination uptake.

Vaccine brand aversion is exacerbated by political factors, resulting in immunization

delays and refusals. Perceptions of the system's inefficiency and inflexibility add to the country's
vaccination rollout challenges, particularly among vulnerable and marginalized communities. To

improve COVID-19 immunization uptake and reach, it is necessary to recognize and address issues

at all levels. Improving health literacy is an important approach to combating misinformation that

affects vaccine trust.

Paul et al.(2020) shows that Vaccine mistrust is a big national problem. Achieving the

required immunization coverage for the population immunity. Taken together, there's proof that

the majority of people form groups. Those infected with COVID-19 are more likely to become

unwell and die. who come from ethnic minorities and have lower salaries have a negative attitude

on vaccines and are less likely to receive vaccinations willing to be vaccinated for COVID-19

Women, persons who are still alive with youngsters, and those who don't follow the rules.

These unfavorable sentiments are also threatening the COVID-19 guidelines. and a refusal

to be vaccinated Others have done so. Discovered that inconsistency in public health messages and

a lack of trust in the public health system COVID-19 requires confidence in government and

science unwillingness to take the vaccine. Because of practical barriers such as lack of accessibility

and government decisions on vaccine availability, not everyone who wishes to receive a COVID-

19 vaccination will be able to do so, emphasizing the importance of improving vaccine attitudes

in the general population to improve vaccine uptake among those who are offered a vaccine and

prevent widening socioeconomic health inequalities. Vaccine safety communication should begin

now in order to improve public trust by the time a COVID-19 vaccine is ready.
 The WHO classified the Coronavirus outbreak in March 2020. By December 2020,

the epidemic had killed over 1.8 million people (WHO, 2020) and triggered the greatest worldwide

recession since the Great Depression (Financial Times, 2020). Vaccines have the potential to save

millions of lives, and vaccine uptake is critical to controlling Coronavirus illness. However,

acceptance of these vaccinations remained doubtful, with safety (Polack FP et al.,2020) and

effectiveness ( Sadoff J et al., 2021) being important issues.

Perceived behavioral control of vaccine hesitancy

Vaccination intentions were significantly predicted by attitude, norms, and perceived

behavioral control, with attitude being the largest predictor. The PBC-intention association was

strongly influenced by type of receiver, but the norm-intention correlations were significantly

modified by type of norm measurements.

Some of the variables that influence vaccination intentions against COVID-19 have been

found. These findings, on the other hand, are less consistent. Younger age, greater confidence and

collective responsibility, and less complacency among Hong Kong nurses were found to predict

willingness to get vaccinated according to Kwok et al. (2021). In a US sample, Malik et al. (2020)

discovered that being older, male, Asian, and more educated were all associated with vaccine

acceptability.

Despite the fact that the United States of America (USA) had the largest number of verified

COVID-19 cases in 2020, only half of medical students were ready to participate in a vaccine trial,

and roughly 23% were unwilling to be vaccinated (Lucia VC et al,. 2021). Similarly, just 35% of
Egyptian medical students are female (Saied SM et al,. 2021) In Europe, 45 percent of nursing

students are female (Patelarou E et al,.2021). 52.8 percent of college students in New Jersey, the

United States, said they planned to get the COVID-19 vaccination (Kecojevic A et al, 2021).

Despite the fact that the majority of university students in Italy (86.1%) were eager to get the

COVID-19 vaccination (Barello S et al,. 2021)

Vaccination is hampered by a lack of faith in healthcare and/or health professionals, according to

several research (AL-Mohaithef M et al,.2021; Al-Mohaithef M et al., 2020; Soares P et al., 2021)

Based on traditional research on perceived norms and perceived behavioral control, in a direct

method can affect behavioral intent, but even if attitudes and perceived norms are positive, if

people lack the self-efficacy, they will not engage in that behavior. (Eagly & Chaiken, 1993; Yzer,

2007). Perceived behavioral control may moderate effects on behavioral intentions. When the

relationship of attitudes and norms is strongly related to intent, intention may be higher when

perceived behavioral control is higher. (Ajzen, 2002; Yzer, 2007).

On the otherhand, generalized beliefs and individual differences have been identified as potentially

salient correlates of intentions to get vaccinated. (Debus & Tosun, 2021; Sherman et al 2021). On

top of the list is vaccination hesitancy, which means a person’s stated expectation to deny or halt

getting a vaccine. (MacDonald, 2015). Vaccination hesitancy is suggest to be a key contributor to

the deceleration of COVID-19 vaccination rates. (Sallam, 2021). Most likely vaccination

hesitancy will be an important determinant in intentions to get a vaccine booster, since some of

those who chose to get an initial vaccine, still held skeptical views with respect to the vaccine and

its efficacy. (Siegler et al, 2021).

Cronbach’s Alpha and Pearson Correlation Coefficient

Bakar & et.al (2021) utilized Cronbach’s alpha in their study, “Factors Influencing

Students Intention to Choose Career of Halal Food Industry in Malaysia using Theory of Planned

Behavior”, as a reliability test to determine how closely related the test of questions in measuring

the independent and dependent variable of the study. The independent variables in the study are

Attitude, Subjective Norm, and Perceived Behavioral Control (PBC) while the dependent variable

is the intention to choose career of halal food industry in Malaysia. The Cronbach’s alpha used

interpretation used are as follows:

Cronbach’s Alpha Value (α) Interpretation

0.91 – 0.10 Excellent

0.81 – 0.90 Good

0.71 – 0.80 Good and Acceptable

0.61 – 0.70 Acceptable

0.01 – 0.60 Non-Acceptable

Further, the study of Bakar & et.al utilizes the Pearson correlation coefficient to measure the

strength of linear association between the independent and depended variables of the study. The

value of Pearson coefficient (r) is between +1 and -1, where 0 value means no correlation or
association between the variables. A Pearson coefficient that is more than 0 means that as the value

if one variable increases, the other variable also increases. A value that is less 0 means that if one

variable increases, the other variable decreases inversely. A higher value of the coefficient

indicates high association between the variables while a low value coefficient indicates a low

association between the variables. The interpretation of Pearson correlation coefficient (r) are as

follows:

Scale of Pearson correlation coefficient Interpretation

(r)

0.00 ≤ r ≤ 0.19 Very low correlation

0.20 ≤ r ≤ 0.39 Low correlation

0.40 ≤ r ≤ 0.59 Moderate correlation

0.60 ≤ r ≤ 0.79 High correlation

0.80 ≤ r ≤ 1.00 Very high correlation

Synthesis and Research Gap

The data collected last May 2021 in the study of Hagger and Hamilton focused on US

residents who had higher educational attainment and gross monthly income, which is not
representative of the US population. The study mentioned that their findings cannot be reliably

generalized to the US population because of the background limitation of their respondents. It was

recommended by their study to replicate the model used in samples that are more representative

of the national population applied in such a study. Subgroups with lower educational attainment

and income are suggested by the study to be included as samples.

The study of Rzymski conducted last November 2021 focused on how physiological

experiences and effects of the primary dose on the respondents and people in their community

affect their booster intentions. Further, the study has limited Polish respondents other than tertiary

education attainment and who live in rural areas. The survey used in the study also used a 10-point

Likert-type scale, which has a high proneness to the subjectiveness of data gathered.

Lastly, the study by Amit, et al. last January 2022 focused only on the individual perception

of Filipinos that affect their decision on getting the primary doses of the COVID-19 vaccine. This

study only aims to understand the hesitancy of Filipinos on getting the primary doses but not the

booster shots that come after it. This is due to the data collection of the study was implemented

before booster shots were introduced to the public. Further, the study was not able to gather

representation from the A5 priority group (Indigent Population) set by the Department of Health.

This priority group covers the Filipinos who belonged to low-resource households, which are the

majority of the Philippine population.

Research Objectives

The study aims to determine if perceived behavioral control and booster intention have effects in

COVID-19 booster hesitancy of Mapua Grade 12 students. Referencing the study “Predicting

COVID-19 booster vaccine intentions” published in November 2021 and data collected in May
2021 authored by Hagger, M. and Hamilton, K. in the Philippine context, that demonstrated how

COVID-19 booster intentions of US citizens are affected by the social cognition theories, the

proponents focused on perceived behavioral control and booster intention in determining driving

forces of booster hesitancy of Mapua Grade 12 students.

Conceptual Framework

The study considers Perceived Behavioral Control and Booster Hesitancy as the independent

variables. These were set by the proponents that possibly affect their booster intentions, which is

defined as the degree that an individual feel strongly to get booster shot or not.

To gather the data from these independent variables, the researchers utilize a data-gathering

process that ensures variety in the samples, representative of the population. The survey is divided

into accordingly to these variables.

Figure 1. Conceptual Framework

To gather the data from these independent variables, the researchers will utilize a data-gathering

process that ensures variety in the samples, representative of the population. The survey is divided

into different factors of social cognition theories and other individual constructs as mentioned. All

of the questions utilize the 6-point Likert scale to measure attitudes, knowledge, perceptions,

values, and behavioral changes the questions. This is to avoid neutral answers in odd-scaled Likert

scales.
 METHODS
The research Methods are concerned to know the opinions and personal perspectives of the

people around. The research also wants to help enlighten and educate people about the vaccine

while spreading more awareness as well. This research wants to help people pertaining to their

overall well-being as well. This chapter is focused more on how the researchers will collect and

gather data in the information we may receive from the participants. Data will be gathered through

online means with the participants of the Mapua University Senior High school students. All

information gained from this study is confidential, only the researchers will be able to get it.

Ethical considerations are always present in this research may it be in the questionnaire or the

paper itself.

Research Design

The study adapted the cross-sectional correlational research design according to Johnson’s Non-

experimental quantitative research. The data gathered are representation of a single point in time.

The researchers observe and describe the characteristics of Filipinos that exist in Metro Manila at

a given point in time which used to infer relationships between the possible driving factors on

booster intentions. Cross-sectional studies capture a specific moment in time. The study is

considered as correlational for the study aims to determine the relationship between the

independent and dependent variables. Further, the study tries to identify if changes in Perceived

Behavioral Control and Booster Hesitancy predict Booster Intention of respondents.

The researchers investigate and seeks for patterns in the Perceived Behavioral Control and

Booster Hesitancy of the respondents that may explain their effects on their booster intentions.
The techniques and methods used in this study are geared towards finding out the causes (IV) of

certain phenomena or occurrences (DV) that is currently happening in the environment, such as

hesitancy towards booster shots. In other words, the goal of the researchers is to determine

whether the independent variable affected the outcome, or dependent variable, by comparing two

or more groups of individuals.Techniques and methods used in this study are geared towards

finding out the causes (IV) of certain phenomena or occurrences (DV) that are currently

happening in the environment, such as hesitancy towards booster shots. In other words, the goal

of the researchers is to determine whether the independent variable affected the outcome, or the

dependent variable, by comparing two or more groups of individuals.

Setting

The study is conducted within the Metro Manila, Philippines, which has the most recorded

COVID-19 cases in PH, considered as “virus epicenter” in the country (Magsambol, 2022). The

diversity on the background of Filipinos in the location gives the study recruited samples that are

representative of the population. Using convenience sampling technique, having Metro Manila as

the setting of the study ensures that the samples taken from the location is relevant on the objective

of the study.

Participants and Sampling Technique

Adapting the cross-sectional and correlational research design, participants of the study are eighty

(80) Senior High school students who are currently studying in Mapua University and are currently
residing in Metro Manila. These students are those who are naturally-born Filipino that are

completely vaccinated with currently residing in Metro Manila are recruited by the proponents. To

be eligible for inclusion, participants should have received both doses of a two-dose (i.e. Sinovac,

Sinopharm, Sputnik V, Astrazeneca, Moderna, Pfizer/BioNTech), or one dose of a single-dose (i.e.

Johnson & Johnson/Janssen), FDA and DOH-approved COVID-19 booster with End-User License

Agreement (EULA) approved for administration of the general public in the Philippines but has

yet to be administered with any COVID-19 booster. Data from the respondents are taken in April

2022.

To determine the samples of the population, the researchers adapt the convenience sampling

technique. Lavrakas (2008) mentioned that this sampling method chooses participants who are

considered as “convenient” sources of data for researchers Samples are chosen based on how they

are accessible with the proponents. Grade 12 students who are currently studying in Mapua

University are convenient to the proponents given the timeframe and accessibility constraints of

thetudentts. This is also used to efficiently conduct the study by choosing samples that are within

the proximity of the proponents (Glen, n.d.). Thus, this chosen non-probability sampling method

selects samples that are chosen by the judgment of the researchers. The proponents gathered 80

participants for this study as representation of the Mapua Grade 12 students in Metro Manila

Data Gathering Tools

Prior to administration of the questionnaire, the researchers contact potential participants to invite

them to be respondents of the study. Importance of their participation in the study is emphasized

to motivate them that they have crucial roles in the study. Then, the online questionnaire is given

through their MS Teams Account or Messenger. Significance of study is further emphasized and

confidentiality of the information to be gathered is explained. Then the participant proceeds in

answering the survey. After the target number of participants has been reached, the researchers

proceed to organize the data collected from the questionnaire.

The researchers utilize the responses of participants as the primary data source of the study. With

the restrictions in place due to the ongoing COVID-19 Pandemic in the country and the efficiency

of gathering data, a questionnaire is designed by the researchers. An online form creation platform,

Google Forms, is used to create the questionnaire since it is secure and only the owner of the

questionnaire will be able to see it, thus, giving the right confidentiality to the participants

Research Procedures

Senior High School students of Mapua living in Metro Manila. They were informed that

they were being asked to participate in a survey on COVID-19 boosters. They were subsequently

provided with information outlining study requirements. Proponents informed the participants of

their right to decline participation at any point and to have their data deleted. They were then

required to provide opt-in consent to participate prior to advancing to the survey.

Data Analysis

A six (6) – Likert scale is used to measure the independent variables. The Likert-type scale

utilized involves a series of statements that respondents may choose from in order to rate their

responses to evaluative questions. The most of the questions used Likert scale with the measure

as follows:

:
 Figure 2. 6-Type Likert Scale

The items assessing perceived behavioral control were based on guidelines provided by Ajzen and

Madden (1986). As stated by Ajzen (2006), perceived behavioral control was measured on the

basis of two terms namely capability and controllability. Capability had 4 items while

controllability had 3 items and were rated a 6-point Likert scale. On the other hand, the item

assessing vaccine hesitancy, was adapted from Freeman et al. (2021) and was measured using a

single item with responses provided on a 6-point scale.

Demonstrated below are the items and response scales for variables of the model used by the

proponents:

Table 1. Summary Variables

Summary Variable Item(s) Scale

Perceived Behavioral Control 4 1-6

(Perceived Capacity / Capability)

Perceived Behavioral Control 3 1-6

(Perceived Autonomy –
Controllability)

Booster Hesitancy 1 1-6

 Booster Intention 3 1-6

Table 2. Variables of Survey

Variable Item(s)/measure Scale

Perceived It is mostly up to me whether I get a COVID-19 1 = Strongly Disagree,

Behavioral booster vaccine when it is offered to me. 6 = Strongly Agree
Control
(Perceived For me, to get vaccinated with COVID-19 1 = Impossible
Capacity/ booster is… 6 = Possible
Capability)
If I wanted to, I could be vaccinated with 1 = Definitely False
COVID-19 Booster once it is offered to me 6 = Definitely True

I am confident that I can get COVID-19 booster 1 = Definitely False

once it is offered to me. 6 = Definitely True
 Perceived I have complete control over whether I get a 1 = Strongly Disagree,
Behavioral COVID-19 booster vaccine when it is offered to 6 = Strongly Agree
Control me.
(Perceived
Autonomy - How much control do I believe that I have over 1 = No Control
Controllability) getting COVID-19 booster vaccine once it is 6 = Complete Control
offered to me?

1 = Strongly Disagree,
It is mostly up to me whether or not I get
6 = Strongly Agree
vaccinated with COVID-19 booster when it is
offered to me.

Booster Overall, how hesitant are you about getting a 1 = Not at all,
Hesitancy COVID-19 booster vaccine? 6 = Very much

Booster Intention I intend to get the COVID-19 vaccine when it is 1 = strongly disagree,
offered to me. 6 = strongly agree

I plan to get the COVID-19 vaccine when it is 1 = strongly disagree,

offered to me. 6 = strongly agree

It is likely I will get the COVID-19 vaccine 1 = strongly disagree,

when it is offered 6 = strongly agree

The value of Cronbach’s Alpha (∝) should be ≥ 0.7, which means that internal consistency

is at least with Acceptable rating. Cronbach’s Alpha is used by the proponents to determine if the

multiple Likert Scale questions of the survey is reliable to meet the purpose of the study.
 From the data gathered from the survey, the proponents used the correlational analysis to

determine if there is a relationship between social cognition theories and other individual

constructs with the COVID-19 booster intentions of Mapua Senior High school student.

Further, correlational analysis benefits from the use of surveys in data collection. Results

derived from this method uses the correlation coefficients to determine if correlation is positive,

negative, or zero. Positive correlation has the value that is nearest to 1.00 which shows that

variables increase and decrease at the same time. Negative correlation has the value of nearest to

-1.00 which means that when one variable is increasing, the other variable is decreasing and vice

versa. While zero (0) value is considered that there is no correlation or relationship between the

two (2) variables.

Ethical Considerations

The researchers will ensure that all information gained from this research is confidential

and no information will be publicized. The participants may choose whether or not they will

participate without pressuring them. Further, information that will be gathered in the study will

not be used outside the purpose and scope of the study without the written and verbal consent of

all of the proponents. Raw data that will be gathered from the survey will only be accessible among

the proponents and personal information will not form any generalizations or biases about the

proponents. The researchers will keep an open mind at all times and will not disclose anything said

by the participants. There will be no discrimination in this process, no matter the participant’s

gender, age, opinion, beliefs, and religion.

 RESULTS AND FINDINGS

This section presents the findings of the study based on the gathered result of the Cronbach’s Alpha

and Pearson Correlation Coefficient. The results and findings form the basis in deriving the

conclusion at the latter part of the study. As indicated in the Data Gathering Tools under Methods,

Cronbach’s Alpha (α) is used to measure the reliability of the survey tool while Pearson Correlation

Coefficient (r) serves as the measure of relationship between the independent and dependent

variable of the study. The numerical values of α and r are interpreted to determine the degree of

reliability of the tool and degree correlation or relationship between the variables.

The study conducted by Bakar & et.al. (2021), entitled “Factors Influencing Students

Intention to Choose Career of Halal Food Industry in Malaysia using Theory of Planned

Behavior”,[NV1] Perceived Behavioral Control (PBC) is also observed and investigated, among other

psychological constructs (i.e. Attitude and Subjective Norm), to determine if PBC and other

constructs under Theory of Planned Behavior determine if these variables predict certain behavior,

that is career preference in Halal Food in Malaysia. The study of Bakar & et.al. has similarities

with this study as independent variables is measured to determine if such constructs have effect on

the dependent variable. The values and interpretation of Cronbach’s Alpha and Pearson

Correlation Coefficient in the study of Bakar & et.al. is used as the interpretation of values of α

and r. he Cronbach’s alpha used interpretation used are as follows:

 Cronbach’s Alpha Value (α) Interpretation

0.91 – 0.10 Excellent

0.81 – 0.90 Good

0.71 – 0.80 Good and Acceptable

0.61 – 0.70 Acceptable

0.01 – 0.60 Non-Acceptable

Further, the study of Bakar & et.al utilizes the Pearson correlation coefficient to measure the

strength of linear association between the independent and depended variables of the study. The

value of Pearson coefficient (r) is between +1 and -1, where 0 value means no correlation or

association between the variables. A Pearson coefficient that is more than 0 means that as the value

if one variable increases, the other variable also increases. A value that is less 0 means that if one

variable increases, the other variable decreases inversely. A higher value of the coefficient

indicates high association between the variables while a low value coefficient indicates a low

association between the variables. The interpretation of Pearson correlation coefficient (r) are as

follows:
 Scale of Pearson correlation coefficient (r) Interpretation

0.00 ≤ r ≤ 0.19 Very low correlation

0.20 ≤ r ≤ 0.39 Low correlation

0.40 ≤ r ≤ 0.59 Moderate correlation

0.60 ≤ r ≤ 0.79 High correlation

0.80 ≤ r ≤ 1.00 Very high correlation

Cronbach’s Alpha

The Cronbach’s Alpha of the questionnaire is at 0.830 with 11 items. As indicated in the study of

Bakar & et.al. (2021), 0.830 is considered as good reliability on measuring constructs in the

study. This means that the survey tool used is reliable in measuring the independent and

dependent variables, which are the Perceived Behavioral Control (Perceived Capability and

Perceived Autonomy). Booster Intention, and Booster Hesitancy.

Cronbach's
N of Items
Alpha

.830 11

Table x: Cronbach’s Alpha at the 11-item questionnaire

For items that measures the independent and dependent variables, which are items # 4 to #14, the

Cronbach’s alpha for each item, if such item is deleted, remains ≥ 0.71, with 0.792 as the

minimum alpha. This means that the survey and its items remain with a good and acceptable

reliability despite removing an item.

Scale Corrected Cronbach's

Scale Mean if Variance if Item-Total Alpha if Item

Item Deleted Item Deleted Correlation Deleted

PBC-PC_Q4 46.69 61.066 .547 .813

PBC-PC_Q5 46.44 59.175 .691 .801

PBC-PC_Q6 46.63 58.311 .702 .799

PBC-PC_Q7 46.60 58.142 .711 .798

PBC-PA_Q8 46.72 61.006 .585 .810

PBC-PA_Q9 46.67 63.000 .529 .815

PBC- 46.79 60.518 .570 .811

PA_Q10

DV_Q11 48.40 83.042 -.417 .913

BI_Q12 46.86 56.219 .757 .792

BI_Q13 46.81 56.603 .768 .792

BI_Q14 46.81 56.203 .731 .794

Table x: Cronbach’s Alpha per Survey Item

Further, it is verified that with the 81 respondents of the survey questionnaire, all of them

answered the survey completely without any exclusion.

 N %

Valid 81 100.0

Excludeda 0 .0

Total 81 100.0

Table x: Number of Valid Items and Excluded Items

Age Group

All respondents shared and indicated their respective age in the survey. There are no

incidences of missing response from this item.

Q2_Age

N Valid 81

Missing 0

Table x: Number of Respondents for Age

There are 20 respondents (24.69%) that are 17 years old, 49 (60.49%) that are 18 years old,

and 12 (14.81%) that are 19 years old, arriving at the total of 81 respondents. The age mean of the

respondents is 17.90, where 18 years old has the highest frequency, 18 years old as the youngest,
and 19 as the eldest. The age distribution of the respondents corresponds to the nature of the normal

curve.

Mean 17.90

Median 18.00

Mode 18

Std. Deviation .625

Minimum 17

Maximum 19

Percentiles 25 17.50

50 18.00

75 18.00

Table x: Statistics of the Age Distribution

Table

x:

Age

Distribution vis-à-vis Normal Curve

Sex at birth

All respondents shared and indicated their respective sex at birth in the survey. There are

no incidences of missing response from this item.

Q3_Sex

N Valid 81

Missing 0

Table x: Number of Respondents for Sex at Birth

 There are 33 respondents (40.70%) that is female, 48 (59.30%) that is male. Most of the

respondents are male but does not significantly dominate the population. There is significant

number of female respondents, which is representative of the population.

Valid Cumulative

Frequency Percent Percent Percent

Valid Female 33 40.7 40.7 40.7

Male 48 59.3 59.3 100.0

Total 81 100.0 100.0

Table x: Statistics of the Sex at Birth Distribution

There are 20 respondents (24.69%) that are 17 years, old, 49 (60.49%) that are 18 years

old, and 12 (14.81%) that are 19 years old, arriving at the total of 81 respondents. The age mean

of the respondents is 17.90, where 18 years old has the highest frequency, 18 years old as the

youngest and 19 as the eldest. The age distribution of the respondents corresponds to the nature of

the normal curve.

 Table x: Sex at Birth Distribution of Respondents

Pearson Correlation Coefficient (r) between Perceived Behavioral Control: Perceived

Capability (PBC-PC) and Booster Hesitancy (DV-BH)

For items # 4 to #7, which measures the Perceived Behavioral Control: Perceived

Capability of the respondents (PBC-PC), their mean was calculated to determine the overall level

of PBC-PC of each respondent. Between the PBC-PC (IV) and Booster Hesitancy (DV), r=-0.434

where the correlation is at the 0.01 level. The r value of -0.434 is interpreted as Moderate

Correlation between PBC-PC and DV-BH.

 AVE_PBC- DV-

PC BH_Q11

AVE_PBC- Pearson 1 -.434**

PC Correlation

Sig. (2-tailed) .000

N 81 81

DV-BH_Q11 Pearson -.434** 1

Correlation

Sig. (2-tailed) .000

N 81 81

**. Correlation is significant at the 0.01 level (2-tailed).

Table x: Pearson Correlation Coefficient (r) between PBC-PC and DV-BH

Pearson Correlation Coefficient (r) between Perceived Behavioral Control: Perceived

Autonomy (PBC-PA) and Booster Hesitancy (DV-BH)

For items #8 to #10, which measures the Perceived Behavioral Control: Perceived

Autonomy of the respondents (PBC-PA), their mean was calculated to determine the overall level

of PBC-PC of each respondent. Between the PBC-PA (IV) and Booster Hesitancy (DV), r=-0.127

where the correlation is at the 0.01 level. The r value of -0.127 is interpreted as Very Low

Correlation between PBC-PA and DV-BH.

 AVE_PBC- DV-

PA BH_Q11

AVE_PBC- Pearson 1 -.127

PA Correlation

Sig. (2-tailed) .260

N 81 81

DV-BH_Q11 Pearson -.127 1

Correlation

Sig. (2-tailed) .260

N 81 81

**. Correlation is significant at the 0.01 level (2-tailed).

Table x: Pearson Correlation Coefficient (r) between PBC-PA and DV-BH

Pearson Correlation Coefficient (r) between Overall Level of Perceived Behavioral Control

(AVE_PBC) and Booster Hesitancy (DV-BH)

From the means of Perceived Capability (PBC-PC) and Perceived Autonomy (PBC-PA),

their means were calculated to determine the overall level of Perceived Behavioral Control

(AVE_PBC) of each respondent. Between the AVE_PBC (IV) and Booster Hesitancy (DV), r=-
0.318 where the correlation is at the 0.01 level. The r value of -0.318 is interpreted as Low

Correlation between AVE_PBC and DV-BH.

AVE_PB

C BH-DV

AVE_PB Pearson 1 -.318**

C Correlation

Sig. (2-tailed) .004

N 81 81

BH-DV Pearson -.318** 1

Correlation

Sig. (2-tailed) .004

N 81 81

**. Correlation is significant at the 0.01 level (2-

tailed).

Table x: Pearson Correlation Coefficient (r) between AVE-BH and DV-BH

Pearson Correlation Coefficient (r) between Booster Intention (AVE_BI) and Booster

Hesitancy (DV-BH)

For items #12 to #14, which measures the Booster Intention of the respondents (AVE_BI),

their mean was calculated to determine the overall level of Booster Intention (AVE_BI) of each
respondent. Between the AVE_BI (IV) and Booster Hesitancy (DV), r=-0.457 where the

correlation is at the 0.01 level. The r value of -0.457 is interpreted as Moderate Correlation between

AVE_BI and DV-BH.

DV-

AVE_BI BH_Q11

AVE_BI Pearson 1 -.457**

Correlation

Sig. (2-tailed) .000

N 81 81

DV-BH_Q11 Pearson -.457** 1

Correlation

Sig. (2-tailed) .000

N 81 81

**. Correlation is significant at the 0.01 level (2-tailed).

Table x: Pearson Correlation Coefficient (r) between PBC-PA and DV-BH

Pearson Correlation Coefficient (r) between Overall Level of Perceived Behavioral Control

and Booster Intention (AVE-IV) and Booster Hesitancy (DV-BH)

From the means of the Overall Level of Perceived Behavioral Control (AVE_PBC) and

Overall Level of Booster Intention (AVE_BI), their means were calculated to determine the overall

level of both independent variables (AVE_IV) of each respondent. Between the overall level of
the independent variable and level of Booster Hesitancy (DV), r=-0.437 where the correlation is

at the 0.01 level. The r value of -0.437 is interpreted as Moderate Correlation between AVE_IV

and DV-BH.

AVE-IV BH-DV

AVE-IV Pearson 1 -.437**

Correlation

Sig. (2-tailed) .000

N 81 81

DV- Pearson -.437** 1

BH_Q11 Correlation

Sig. (2-tailed) .000

N 81 81

**. Correlation is significant at the 0.01 level (2-

tailed).

Table x: Pearson Correlation Coefficient (r) between AVE-IV and DV-BH

 DISCUSSION

This section focuses on the interpretation of findings of the statistical results, as indicated

from the previous section. As a summary, below are the r-values that was used to determine the

level of correlation between the independent variables and booster hesitancy.

Perceived
PBC: PBC: Independent
Behavioral Booster
Perceived Perceived Variables
Control Intention
Capability Autonomy (In General)
(PBC)

Booster Pearson
-0.434** -0.127** -0.318** -0.457** -0.437**
Hesitancy Correlation

Sig
0.000 0.260 0.004 0.000 0.000
(2-tailed)

N 81 81 81 81 81

**. Correlation is significant at the 0.01 level (2-tailed).

Table x: Summary of Pearson Correlation Coefficient (r) of Independent Variables with

Dependent Variable (Booster Hesitancy)

Interpretation of Results based on relationship of Perceived Behavioral Control: Perceived

Capacity (PBC-PC) and Booster Hesitancy (BH) of Grade 12 Mapua Senior High School

Students
 The Pearson Correlation Coefficient (r) of Perceived Behavioral Control: Perceived

Capacity (PBC-PC) and Booster Hesitancy (BH) of Grade 12 Mapua Senior High School Student

is at -0.434, which means that there is a moderate correlation or effect between these two (2)

variables. This means that if Grade 12 Mapua Senior High School Students have a high level of

perceived ability to take booster shots, they are significantly less hesitant to take booster shots.

Interpretation of Results based on relationship of Perceived Behavioral Control: Perceived

Autonomy (PBC-PA) and Booster Hesitancy (BH) of Grade 12 Mapua Senior High School

Student

The Pearson Correlation Coefficient (r) of Perceived Behavioral Control: Perceived

Autonomy (PBC-PA) and Booster Hesitancy (BH) of Grade 12 Mapua Senior High School Student

is at -0.127, which means that there is a very low correlation or effect between these two (2)

variables. This means that the degree of feeling of Grade 12 Mapua Senior High School Students

to have control on getting booster shots does not have significant effect on the degree of hesitancy

of getting booster shots.

Interpretation of Results based on relationship of Overall Perceived Behavioral Control and

Booster Hesitancy (BH) of Grade 12 Mapua Senior High School Student

Given that the Pearson Correlation Coefficient (r) of the overall Perceived Behavioral

Control of Grade 12 Mapua Senior High School Student is at -0.318, it is interpreted with low

correlation or effect
Interpretation of Results based on relationship of Overall Booster Intention and Booster

Hesitancy (AVE_BI) of Grade 12 Mapua Senior High School Student

The Pearson Correlation Coefficient (r) of Booster Intention (BI) and Booster Hesitancy

(BH) of Grade 12 Mapua Senior High School Student is at -0.457, which means that there is a

moderate correlation or effect between these two (2) variables. This means that if Grade 12

Mapua Senior High School Students have a strong intention and reason to get booster shot,

they are significantly less hesitant to take booster shots.

Interpretation of Results based on relationship of Overall Perceived Behavioral Control and

Booster Intention and Booster Hesitancy (BH) of Grade 12 Mapua Senior High School Student

Considering both of the means of the Perceived Behavioral Control and Booster Intention,

the Pearson Correlation Coefficient (r) is at -0.437. This means that there is a moderate

correlation or effect between the independent variables and dependent variable. This is in contrast

in with the interpretation and r-value of Perceived Behavioral Control: Perceived Autonomy (PBC-

PA).

The findings of the study provide the evidence that hesitancy of Mapua Grade 12 students in

COVID-19 booster shots is associated with their Perceived Behavioral Control and Booster

Intention. Perceived behavioral control and Booster intention got the largest size of effects on the

individuals, indicating that the degree of belief of an individual to perform a behavior and the

concrete plan to do a certain action, getting booster shot in the case of study, could dictate their

level of hesitancy in getting booster shot. These findings confirm the perspective of Hagger and

Hamilton (2021) in their study that these constructs serve as sources of information when
individuals estimate their beliefs and willingness with respect to getting a booster vaccine when

offered in the near future. Further, the findings affirm the theoretical perspective that Kaushal &

et al. (2021)[NV2] found in their study that self-control beliefs play an important role in supporting the

action of an individual, which in return, also strengthen their beliefs. The findings of the study,

especially the moderate correlation of booster intention with booster hesitancy, coincides with the

investigation findings of Kaushal & et al. that an individual’s behavior are product of functions of

intention, habit, and planning. The concrete planning of doing a certain action (also known as

“intention”) significantly affects if such behavior will be observed or not. Intention actually scored

higher than other constructs on the exercises conduced in the study of Kaushal & et.al.

It is also important to take note that the constructs investigated in the study and their

correlations with the booster hesitancy of Grade 12 Mapua students are not the only bases on which

individuals estimate and consider their degree of hesitancy in taking a certain action (getting a

booster shot in the case of the study). Other constructs that affect the individual’s hesitancy towards

the action are normative and non-conscious beliefs, which have been shown correlative to health

behaviors in the context of the COVID-19 pandemic (Keatley et al., 2012[NV3]). This suggest that the

current model of the study was insufficient in accounting all of the constructs that affect the booster

hesitancy of individuals, or hesitancy in taking an action in general. Such beliefs or constructs

investigated in the study are only limited compared to constructs and components of human

behavior that may influence a behavior.

The findings of the study are actually indicative that there is correlation in these constructs

of human behavior towards taking an health-related action in the context of the COVID-19

pandemic. These findings are consistent with prior research applying the theory of perceived

behavioral control (Britt, 2014) and self-control beliefs (Kaushal & et.al., 2021) that predict
intention and hesitancy in taking an action. In other words, even though there are studies that have

similar correlation, there are likely other important context-specific considerations that affect

individuals' vaccine intentions and hesitancy in specific contexts like getting a COVID-19 booster

vaccine.
 CONCLUSION

Given the results of the Pearson Correlation Coefficient (r) of each independent variables,

and their respective means, and Booster Hesitancy, it is therefore concluded that Perceived

Behavioral Control, specifically, Perceived Capacity and Perceived Autonomy, and booster

intention have effects on the booster hesitancy of Mapua Grade 12 students. It is conclusive that

Perceived Capacity and Booster Intention have the most significant effect on booster hesitancy

given all of the independent variables measured.

However, it is important to take note that the survey tool was only able to generate a

maximum of moderate correlation interpretation only, with -0.457 as the highest r-value and no

strong correlation observed among the independent variables. Further, the survey tool only consists

of 11 questions related to the three (3) variables. The items asked for Perceived Behavioral Control

were only limited to seven (7) questions, which could cause lack of depth of conclusion that can

be derived from Perceived Behavioral Control. Two (2) constructs of Perceived Behavioral

Control (PBC) were only used in the study where there are other constructs of PBC that could be

included in the study.

On the other hand, the question that states “Overall, how hesitant are you about getting a

COVID-19 booster vaccine?” is the only item that measures the dependent variable of the study,

Booster Hesitancy. It only asks the respondent the degree of hesitancy they feel on getting the

booster vaccine and no other additional items to expound on this. Moreover, it has been observed

that all of the questions of the survey tool were positively phrased except the item no. 11. This

difference of the phrasing of the item results to an opposite scale compared to other items where
they have negative to positive extremes. The problem with item no. 11 could cause confusion on

the respondents, which affects the r-values of the correlational analysis.

 RECOMMENDATION

With the conclusions and observed limitations of the study, the proponents gathered action points

or recommendations that other researches could undertake and consider for future research studies.

To further understand the motivational and risk factors of getting a COVID-19 booster vaccine,

the following recommendations are proposed:

1. Include additional Perceived Behavioral Control constructs and psychological theories as

dependent variables

a. To further understand the factors, lead to the decision of the an individual to get

COVID-19 booster shots, it is important to consider other theories and constructs.

b. The independent variables in the study only focuses on few individual motivational

forces. Theories and constructs that considers the contextual and environmental

influences shall also be considered and observed.

2. Increase the overall reliability and consistency of the survey tool

a. The number of items that measure the independent and dependent variables are only

very limited. It is important that more items measure each variable. Increasing the

number of independent variables to other constructs and theories entail more items

should be included in the survey tool.

b. Number of items in measuring the booster hesitancy (DV) should not only limited

to one (1) item. More related items should be included to measure booster

hesitancy. These shall increase the reliability of the tool based on the value of the

Cronbach’s Alpha.

c. Items with an inverse Likert scale or negatively phrased questions should be

grouped together in each variable. Disclaimers or additional instruction in the

 question itself could be included like “Read this question carefully before

answering”. This avoids any possible confusion by the respondents and mistakes in

answering the survey tool.

3. Increase the scope of target participants

a. The study is only limited to Mapua Grade 12 students, which makes the study only

limited to a handful of students. With the accessibility of internet connection in

Metro Manila and remains as the main channel of instruction, participant can be

further expanded to all Grade 12 and college students currently residing in Metro

Manila.

b. College students can also be included in future studies to have an overview and

understanding on the motivational and risk factors of Senior High School and

College students in Metro Manila in taking booster shots.

c. The study can also be replicated on older age groups where there is lacking number

of inoculation of booster shots.

4. Consider other variables (i.e. marketing, political, and legal) that could affect Vaccine

Hesitancy, especially on the second dose of booster shots this year of 2022.

a. Brand perception and manufacturing origins could also be considered as the

reputation of different brands of booster shots could affect the feelings and

decisions of individuals to get booster shots.

As the economy opens and restrictions are at peak of leniency, it is important to contextualize and

identify other variables that may have arisen this 2022. Leniency of the restriction could affect the

preference and hesitancy of individuals of still availing the second inoculation of COVID-19

booster shot.
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