College students' influence on COVID-19 vaccination uptake among seniors in China: a protocol of combined cross-sectional and experimental study

BMC Public Health. 2023 Jul 10;23(1):1322. doi: 10.1186/s12889-023-16209-2.


Background: College students generally have good knowledge about COVID-19 and may facilitate COVID-19 vaccination in family. The purpose of this study is to understand college students' willingness to persuade their grandparents to initiate COVID-19 vaccination and the effect of their persuasion.

Methods: A combined cross-sectional and experimental study will be conducted online. In the cross-sectional study (Phase I), eligible participants are college students who are aged ≥ 16 years and have at least one living grandparent aged ≥ 60 years who has/have not completed the COVID-19 vaccination. Participants self-complete Questionnaire A to collect information on the socio-demographics of themselves and their grandparents, their knowledge about older adults' COVID-19 vaccination, as well as Health Belief Model (HBM) and Theory of Planned Behavior (TPB) predictor variables. The primary outcome at Phase I is college students' willingness to persuade grandparents to receive COVID-19 vaccines. Those who are willing to persuade grandparents and participate in a follow-up survey will be invited to participate in a randomized controlled trial (Phase II). At Phase II, eligible participants are those who have at least one living grandparent aged ≥ 60 years who completed the COVID-19 initial vaccination series but has/have not received a booster dose. At the baseline, participants self-complete Questionnaire B to collect information on individual grandparents' COVID-19 vaccination status, attitude towards and intention to COVID-19 booster dose. Participants will then be randomly allocated 1:1 to either intervention arm (one-week smartphone-based health education on older adults' COVID-19 vaccination plus two weeks' waiting period) or control arm (three weeks' waiting period). At the end of week three, participants in both arms self-complete Questionnaire C to collect information on their grandparents' COVID-19 vaccination status. The primary outcome at Phase II is the uptake rate of COVID-19 booster dose among grandparents. Secondary outcomes include grandparents' attitude and intention to get a COVID-19 booster dose.

Discussion: No previous study had measured the effect of college students' persuasion on COVID-19 vaccination uptake in older adults. Findings from this study will provide evidence for innovative and potentially feasible interventions that further promote COVID-19 vaccination in older adults.

Trial registration: Chinese Clinical Trial Registry: ChiCTR2200063240. Registered 2 September 2022.

Keywords: COVID-19; China; College students; Older adults; Vaccination.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Aged
  • COVID-19 Vaccines
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • China / epidemiology
  • Clinical Trials, Phase II as Topic
  • Cross-Sectional Studies
  • Humans
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Students


  • COVID-19 Vaccines