Determinants of community pharmacists’ intention to provide pharmacist-driven vaccination services in selected Arabic-speaking countries: a theory of planned behaviour-based structural equation modelling study

Background Community pharmacists are increasingly recognised as accessible healthcare providers who can contribute to immunisation programmes and improve vaccine coverage. However, pharmacist-driven vaccination services remain underutilised in many Arabic-speaking countries, and factors influencing pharmacists' intention to provide these services are not fully understood.Objective To translate, culturally adapt, validate, and evaluate the Pharmacist-Driven Vaccination Service Intention Model (PDV-SIM) among community pharmacists in the United Arab Emirates, Saudi Arabia, and Qatar and identify factors influencing their intention to provide pharmacist-driven vaccination services.Methods A cross-sectional online survey was conducted among community pharmacists practicing in Arabic-speaking countries between February 2024 and November 2024. The PDV-SIM was translated and culturally adapted using a forward-backward translation process. Confirmatory factor analysis and structural equation modelling were performed using EQS 6.4. Reliability, convergent validity, and discriminant validity were assessed using Cronbach's alpha, composite reliability, average variance extracted, and the Fornell-Larcker criterion.Results A total of 305 pharmacists participated. The measurement model demonstrated acceptable fit under robust estimation (CFI = 0.936, IFI = 0.937, NNFI = 0.918, RMSEA = 0.066). Reliability and convergent validity were satisfactory across all constructs. The structural model also showed acceptable fit (CFI = 0.934, IFI = 0.935, TLI = 0.918, RMSEA = 0.065). Personal development attitude was the strongest predictor of intention to provide pharmacist-driven vaccination services (β = 0.724, p p p Conclusion Professional development attitude, subjective norm, and perceived behavioural control significantly influenced pharmacists' intention to provide vaccination services. Strengthening training, professional support, and regulatory frameworks may facilitate implementation of pharmacist-driven vaccination services across Arabic-speaking countries.