Award Date


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Public Health

First Committee Member

Manoj Sharma

Second Committee Member

Brian Labus

Third Committee Member

Erika Marquez

Fourth Committee Member

Chia-Liang Dai


The COVID-19 pandemic has impacted many lives around the world, leaving negative repercussions including health effects, economic downturns, and social and physical restrictions. The pandemic has also revealed many disproportionate health impacts on vulnerable populations, especially among the Hispanic and Latinx populations. The use of the three COVID-19 vaccines in the United States has presented a form of protection against additional negative impacts. However, hesitancy toward the COVID-19 vaccine has hindered its rapid uptake, preventing the country from reaching herd immunity and ultimately ending the pandemic. Current research is minimal in understanding the intentions of receiving the COVID-19 vaccine among Hispanic and Latinx populations and the sustenance of this behavior change to ensure there is a follow-up to complete the vaccination series. Additionally, there is limited research on using theory-based approaches to identifying determinants of the COVID-19 vaccine. The study aimed to use the Multi-Theory Model (MTM) of health behavior change to explain the intention of initiating and sustaining the behavior of COVID-19 vaccination, among the Hispanic and Latinx populations that expressed and did not express hesitancy towards the vaccine in Nevada. Using a quantitative cross-sectional and survey-based research study design, data were collected among Hispanics and Latinxs over the age of 18 who are currently residing in Nevada, using a 50-item questionnaire. Data were analyzed using multiple linear regression modeling. Of the 231 respondents, 36.4% (n=84) of individuals expressed hesitancy in taking the COVID-19 vaccine. Two MTM constructs of the initiation model, participatory dialogue (b = 0.113, p < 0.001) and behavioral confidence (b = 0.358, p < 0.001), and an income range of $25,000 to $49,999 (b = 0.486, p = 0.007) displayed statistically significant associations with the initiation of COVID-19 vaccine acceptance among vaccine-hesitant individuals. This model accounted for 63.0% of the variance. Similarly, the same two constructs, participatory dialogue (b = 0.072, p < 0.001) and behavioral confidence (b = 0.206, p < 0.001), and age (b = 0.017, p = 0.003) were also significantly associated with the initiation of COVID-19 vaccine acceptance among non-vaccine-hesitant individuals and accounted for 63.2% of the variance. Among vaccine-hesitant individuals, emotional transformation (b = 0.087, p < 0.001) was the only construct, along with age (b = -0.019, p = 0.004), to be significantly associated with the sustenance of COVID-19 vaccine acceptance and accounted for 37.3% of the variability. Lastly, emotional transformation (b = 0.177, p < 0.001) displayed a statistically significant association with the sustenance of COVID-19 vaccine acceptance among non-vaccine-hesitant individuals and accounted for 66.4% of the variability. Results from this study provide evidence that the MTM is a useful tool in predicting COVID-19 vaccine acceptance behavior among Hispanics and Latinxs in Nevada and should be used in intervention designs and messaging to promote vaccine uptake.


COVID-19; Hispanic/Latinx; initiation; multi-theory model of health behavior change; sustenance; vaccine acceptance


Public Health

File Format


File Size

2600 KB

Degree Grantor

University of Nevada, Las Vegas




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