Article (Scientific journals)Public health, health care sciences & servicesMultidisciplinary > MultidisciplinaryOpen AccessPeer Reviewed verified by ORBiUniversité de Liège - ULiège > Département des sciences de la santé publique > Education thérapeutique du patient au service des soins intégrésUniversité de Liège - ULiège > Département des sciences de la santé publiqueUniversité de Liège - ULiège > Département des sciences de la santé publique > Santé publique : aspects spécifiquesUniversité de Liège - ULiège > Département des sciences de la santé publiqueUniversité de Liège - ULiège > Département des sciences cliniques > Immunopathologie - Maladies infectieuses et médecine interne généraleUniversité de Liège - ULiège > Département des sciences cliniques > Immunopathologie - Maladies infectieuses et médecine interne généraleUniversité de Liège - ULiège > GIGA > GIGA Immunobiology - Immunology & Infectious DiseasesUniversité de Liège - ULiège > Département des maladies infectieuses et parasitaires (DMI) > Epidémiologie et analyse des risques appliqués aux sciences vétérinaires Université de Liège - ULiège > Département des maladies infectieuses et parasitaires (DMI) > Vaccinologie vétérinaireUniversité de Liège - ULiège > GIGA > GIGA Immunobiology - Cellular and Molecular ImmunologyUniversité de Liège - ULiège > Département des sciences de la santé publiqueUniversité de Liège - ULiège > Département des sciences de la santé publique > Santé publique : aspects spécifiquesUniversité de Liège - ULiège > Département des sciences de la santé publique > Education thérapeutique du patient au service des soins intégrésParidans, MarineDardenne, NadiaGillain, NicolasHusson, EddyMeuris, ChristelleDarcis, GillesMoutschen, MichelSaegerman, ClaudeGillet, LaurentBureau, FabriceDonneau, Anne-FrançoiseGuillaume, MichèlePétré, BenoîtCOVID-19 VaccinesUniversitiesAdultCross-Sectional StudiesIntentionSurveys and QuestionnairesYoung AdultSARS-CoV-2COVID-19/prevention & controlCOVID-19/psychologyHealth Belief ModelDSO/A000000-0002-8084-93590000-0001-5368-60590000-0001-9487-51390000-0001-8192-13510000-0002-6405-17850000-0001-9087-74360000-0002-1047-25250000-0002-5385-62890000-0002-5344-4401[en] BACKGROUND: While many studies have used the Health Belief Model (HBM) to understand vaccine intention, none claim to have used serial mediation to understand the relationship between HBM dimensions and COVID-19 vaccine intention. This study developed a serial mediation model to assess the direct and indirect effects of the latent HBM dimensions on COVID-19 primary vaccine intention. METHODS: A cross-sectional study: from 01 April to 10 June 2021, a self-administered online questionnaire on vaccine intention against COVID-19 was distributed to staff and students at the University of Liège (Belgium). Direct and indirect effects of the HBM dimensions (perceived susceptibility, severity, benefits, barriers, self-efficacy and cues to action) on vaccine intention (score 0-100) were assessed with serial mediation models. Actually, each permutation of the latent HBM dimensions, i.e., each causal chain, was assessed using partial least squares path modelling (PLS-PM) according to the order of the HBM dimensions in that particular chain. RESULTS: The sample was made up of 1256 participants. The final model revealed that the causal chain with the lowest Bayesian Information Criterion (BIC) value was barriers (Effect estimation (CI95%): -0.09 (-0.15 - -0.03)) ↘ severity (-0.13 (-0.20 - -0.07)) ↘ low self-efficacy (0.20 (0.15-0.25)) ↘ low susceptibility (-0.55 (-0.60 - -0.51)) ↘ vaccine intention (outcome). This revealed a significant indirect and direct effect (-0.20 (-0.25 - -0.15)) between barriers and vaccine intention. CONCLUSIONS: The results demonstrated that perceived barriers are a key determinant in COVID-19 primary vaccine intention. Public health practitioners need to prioritise messaging that addresses the barriers reducing vaccine intention to enable individuals to make an informed choice. These messages could form part of a mass communication campaign aimed at hesitant individuals, with evidence-based information about vaccine safety a priority in order to establish a climate of trust.D00authorauthorauthorauthorauthorauthorauthorauthorauthorauthorauthorauthorauthor40378171PLoS ONE1932-6203enPeer Reviewed verified by ORBiASJC_1000Public Library of Science (PLoS)Paridans, M.* , Dardenne, N.* , Gillain, N., Husson, E., Meuris, C., Darcis, G., Moutschen, M., Saegerman, C., Gillet, L., Bureau, F., Donneau, A.-F.* , Guillaume, M.* , & Pétré, B.*. (2025). Removing barriers to COVID-19 vaccine intention in a university population: Results of a serial mediation study through the dimensions of the Health Belief Model. <em>PLoS ONE, 20</em> (5), 0322881. doi:10.1371/journal.pone.0322881p208460p011120p004886p003425p010354p014443p001472p004825p003789p003067p004167p002541p02213910.1371/journal.pone.0322881application/pdf2268/3332702025-06-25T13:29:59Zopenalex1OCI02025