Award Date

5-15-2026

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Committee Member

Brian Labus

Second Committee Member

Courtney Coughenour

Third Committee Member

Maxim Gakh

Fourth Committee Member

Lung-Chang Chien

Fifth Committee Member

Ian Mcdonough

Number of Pages

81

Abstract

Trust in healthcare providers is one of the strongest predictors of vaccine hesitancy in the literature, yet it has not been examined as an independent predictor of COVID-19 vaccine hesitancy in Nevada. Nevada ranks last nationally in healthcare providers per capita and is among the lowest in immunization coverage for both adults and children. The COVID-19 pandemic exacerbated negative vaccine attitudes, and vaccine hesitancy continues to be a central public health issue. Prior Nevada analyses identified vaccine hesitancy across racial, political, educational, and economic groups but did not assess the role of provider trust in vaccine hesitancy. This cross-sectional study conducted a secondary analysis of data from a statewide COVID-19 telephone survey of 1,002 Nevada adults collected between January and February 2022. The study used the Health Belief Model (HBM) as a conceptual framework. Trust in healthcare providers was conceptualized as a cue to action, and eight variables were treated as HBM modifying variables. Bivariate chi-square tests, univariable and multivariable binary logistic regression, and moderation analyses using the PROCESS macro for SPSS were conducted to assess the adjusted association between provider trust and COVID-19 vaccine hesitancy and whether this association was moderated by age, gender, race/ethnicity, educational attainment, household income, urbanicity, conservative ideology, and liberal ideology. The results showed that 17.7% were classified as vaccine-hesitant. Trust was the strongest binary predictor of lower hesitancy (aOR = 0.16, p < 0.0010). Educational attainment was significant and inversely associated at all levels, with graduate degree holders having the lowest odds (aOR = 0.13). Conservative ideology (aOR = 2.88), liberal ideology (aOR = 0.22), and older age (aOR = 0.38) were also significant. No single moderator altered the relationship between trust and vaccine hesitancy. An exploratory two-moderator analysis identified a significant interaction between trust, age, and education. These findings partially support the HBM: provider trust strongly predicted lower hesitancy through the cue-to-action pathway. However, this association was consistent across all demographic and political ideologies tested, suggesting that trust-building interventions may broadly benefit Nevada’s population.

Keywords

Health communication; Medical mistrust; Patient provider relationship; Preventive health behavior; Vaccine acceptance; Vaccine confidence

Disciplines

Epidemiology | Medicine and Health Sciences | Public Health

File Format

PDF

File Size

1008 KB

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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Epidemiology Commons

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