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  1. Vasuthevan K, Vaithilingam S, Ng JWJ
    PLoS One, 2024;19(1):e0295746.
    PMID: 38166113 DOI: 10.1371/journal.pone.0295746
    The COVID-19 pandemic has revolutionized the teaching pedagogy in higher education as universities are forecasted to increase investments in learning technology infrastructure to transition away from traditional teaching methods. Therefore, it is crucial to investigate whether academics intend to continually integrate learning technologies as part of a permanent pedagogical change beyond the COVID-19 pandemic. Drawing upon the Unified Theory of Acceptance and Use of Technology (UTAUT), and Expectation Confirmation Model (ECM), this study examines the salient determinants influencing the continuance intention of academics to use learning technologies in their teaching pedagogy during and after COVID-19. Primary data collected from a private university was analyzed using the partial least squares structural equation modelling technique (PLS-SEM). The findings revealed two sequential mediating relationships which serve as the mechanism linking the relationship between facilitating conditions and their continuance intention to use learning technologies during and beyond the COVID-19 pandemic.
  2. Vaithilingam S, Hwang LA, Nair M, Ng JWJ, Ahmed P, Musa KI
    PLoS One, 2023;18(3):e0282520.
    PMID: 36920970 DOI: 10.1371/journal.pone.0282520
    BACKGROUND: Sporadic outbreaks of COVID-19 remain a threat to public healthcare, especially if vaccination levels do not improve. As Malaysia begins its transition into the endemic phase, it is essential to identify the key determinants of COVID-19 vaccination intention amongst the pockets of the population who are still hesitant. Therefore, focusing on a sample of individuals who did not register for the COVID-19 vaccination, the current study integrated two widely used frameworks in the public health domain-the health belief model (HBM) and the theory of reasoned action (TRA)-to examine the inter-relationships of the predictors of vaccination intention amongst these individuals.

    METHODOLOGY: Primary data from 117 respondents who did not register for the COVID-19 vaccination were collected using self-administered questionnaires to capture predictors of vaccination intention amongst individuals in a Malaysian context. The partial least squares structural equation modeling (PLS-SEM) technique was used to analyze the data.

    RESULTS: Subjective norms and attitude play key mediating roles between the HBM factors and vaccination intention amongst the unregistered respondents. In particular, subjective norms mediate the relationship between cues to action and vaccination intention, highlighting the significance of important others to influence unregistered individuals who are already exposed to information from mass media and interpersonal discussions regarding vaccines. Trust, perceived susceptibility, and perceived benefits indirectly influence vaccination intention through attitude, indicating that one's attitude is vital in promoting behavioral change.

    CONCLUSION: This study showed that the behavioral factors could help understand the reasons for vaccine refusal or acceptance, and shape and improve health interventions, particularly among the vaccine-hesitant group in a developing country. Therefore, policymakers and key stakeholders can develop effective strategies or interventions to encourage vaccination amongst the unvaccinated for future health pandemics by targeting subjective norms and attitude.

  3. Hwang LA, Vaithilingam S, Ng JWJ, Nair M, Ahmed P, Musa KI
    PLoS One, 2024;19(4):e0301383.
    PMID: 38687718 DOI: 10.1371/journal.pone.0301383
    BACKGROUND: Vaccination has been one of the most effective preventive strategies to contain the COVID-19 pandemic. However, as the COVID-19 vaccines' effect wanes off after some time and given their reduced level of protection against mutation strains of the virus, the calls for boosters and second boosters signal the need for continuous vaccination for the foreseeable future. As Malaysia transitions into the endemic phase, the nation's ability to co-exist with the virus in the endemic phase will hinge on people's continuance intention to be vaccinated against the virus. Adapting the expectations confirmation model (ECM) to the public health context and in a developing country, this study integrates the ECM with the health belief model (HBM) and the theory of reasoned action (TRA) to examine the inter-relationships of the predictors of people's continuance intention to vaccinate against COVID-19.

    METHODOLOGY: Data were collected using self-administered questionnaires from 1,914 respondents aged 18 and above by a marketing consulting firm via its online panel. The partial least squares structural equation modeling (PLS-SEM) technique was used to analyze the data.

    RESULTS: Out of the 1,914 respondents, 55.9% reported having a continuance intention to vaccinate against COVID-19, similar to other developing countries. The multivariate analysis revealed that perceived usefulness and satisfaction significantly influenced individuals' continuance intention to vaccinate against COVID-19. Additionally, attitude was found to play a key role in influencing behavioral change among individuals towards their perceptions of continuously getting vaccinated against COVID-19.

    CONCLUSIONS: By integrating three theoretical frameworks (i.e., HBM, TRA and ECM), this study showed that behavioral characteristics could provide insights towards continuance vaccination intention. Hence, policymakers and key stakeholders can develop effective public health strategies or interventions to encourage vaccine booster uptake by targeting behavioral factors such as perceived usefulness, attitude, satisfaction, and subjective norms.

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