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Bourque SL, Weikel BW, Palmer C, Cataldi JR, Blackwell S, Hwang SS. Prevalence and Predictors of Pediatric COVID-19 Vaccine Acceptance. Am J Perinatol 2023; 40:106-114. [PMID: 35554887 DOI: 10.1055/a-1850-3199] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE As pediatric COVID-19 vaccine eligibility expands, understanding predictors of vaccine intent is critical to effectively address parental concerns. Objectives included: (1) Evaluate maternal COVID-19 vaccine intent for child(ren) and associated predictors of stated intent; (2) Describe attitudes related to hypothetical vaccination policies; (3) Summarize themes associated with intention to vaccinate child(ren) for COVID-19. STUDY DESIGN Mothers enrolled in Heath eMoms, a longitudinal survey project, were recruited for this electronic COVID-19 survey. Chi-square analysis was used to compare proportions of respondent characteristics based on vaccination intent. Population survey logistic regression was used for multivariable modeling to assess the independent association between vaccine intent and demographics. RESULTS The response rate was 65.3% (n = 1884); 44.2% would choose vaccination, 20.3% would not choose vaccination, and 35.5% are unsure whether to have their child(ren) vaccinated for COVID-19. Black mothers (AOR 0.26, 95% CI 0.13, 0.54), respondents with less than high school education (AOR 0.26, 95% 0.12, 0.56) and those in rural areas (AOR 0.28, 95% CI 0.16, 0.48) were less likely to choose vaccination. Commonly cited reasons for vaccine hesitancy include the belief that the vaccine was not tested enough, is not safe, and there are concerns regarding its side effects. CONCLUSION Over 50% of respondents do not intend or are unsure about their intent to vaccinate their child(ren) for COVID-19 with variability noted by demographics. Opportunities exist for perinatal and pediatric providers to educate pregnant people, parents, and caregivers with a focus on addressing concerns regarding vaccine safety and efficacy. KEY POINTS · COVID-19 vaccination rates remain suboptimal, especially in the pediatric population, with variation across states.. · We found that the prevalence of vaccine acceptance for young children is low.. · We highlight opportunities for providers to educate parents, focusing on addressing vaccine safety and efficacy..
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Affiliation(s)
- Stephanie L Bourque
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Blair W Weikel
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Claire Palmer
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Jessica R Cataldi
- Department of Pediatrics, Section of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colorado, United States.,Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, United States
| | - Sarah Blackwell
- Colorado Department of Public Health and Environment, Aurora, Colorado, United States
| | - Sunah S Hwang
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, Colorado, United States
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Yarnall JN, Seashore C, Phillipi CA, Hatch JE, King B, Hart C, Lohr JA. Timing of Vaccine Decision-Making Among First-Time Parents. Acad Pediatr 2022; 22:551-558. [PMID: 34748968 DOI: 10.1016/j.acap.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/04/2021] [Accepted: 10/19/2021] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Decreased childhood vaccination can lead to local outbreaks of vaccine-preventable disease. In a pilot study from our group, 72% of parents of newborns reported initiating their vaccine decision-making for that child prior to conception. Since a sound understanding of the timing of parental vaccine decision-making is needed to direct educational efforts, we surveyed a national cohort of first-time parents to extend our preliminary findings. METHODS From March 2019 to March 2020, first-time parents of newborns in mother-baby units of the Better Outcomes through Research for Newborns (BORN) network completed the Vaccine Preference Development Survey (VPDS). The VPDS measures intent to vaccinate, timing of vaccine decision-making, and sources of influence. Univariate and multivariate analyses explored associations between intent to vaccinate and timing of vaccine decision-making with demographic variables. RESULTS Twenty-three sites provided surveys through site-specific nonrandom systemic sampling; 91% (1393/1524) of surveys were used in the analysis. Most parents planned to fully vaccinate (1191/1380, 86.3%) and started vaccine decision-making prior to conception (850/1378, 61.7%). Maternal age, race and ethnicity, relationship status, and education were all significantly associated with planning to fully vaccinate and preconception decision-making (P < .001). Preconception decision-making correlated strongly with intent to fully vaccinate (P < .001). Parents influenced by personal education, medical professionals, and family/friends were more likely to endorse preconception decision-making; those strongly influenced by internet/social media were less likely to allow all vaccines or start decision-making prior to conception. CONCLUSIONS Vaccine decision-making occurs preconception for most new parents. Initiating vaccine discussions during the birth hospitalization may be too late.
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Affiliation(s)
- J Nathan Yarnall
- Emory University School of Medicine (JN Yarnall), Atlanta, Ga; Children's Healthcare of Atlanta (JN Yarnall), Atlanta, Ga.
| | - Carl Seashore
- University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC; UNC Health - Children's (C Seashore, C Hart), Chapel Hill, NC
| | | | - Joseph E Hatch
- University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC
| | - Beth King
- Academic Pediatric Association (B King), McLean, Va
| | - Chayla Hart
- University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC; UNC Health - Children's (C Seashore, C Hart), Chapel Hill, NC
| | - Jacob A Lohr
- University of North Carolina School of Medicine (C Seashore, JE Hatch, C Hart, and JA Lohr), Chapel Hill, NC
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Moon RY, LoCasale-Crouch J, Turnbull KLP, Colson E, Kellams A, Heeren T, Kerr S, Hauck FR, Corwin MJ. Investigating Mechanisms for Maternal Education Disparities in Enacting Health-Promoting Infant Care Practices. Acad Pediatr 2020; 20:926-933. [PMID: 32201345 PMCID: PMC7483851 DOI: 10.1016/j.acap.2020.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/10/2020] [Accepted: 03/14/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Although higher education and healthier practices are positively associated, the explanatory mechanisms for this association remain unclear. The purpose of this study was to better understand mechanisms underlying this association by examining maternal adherence to 2 health-promoting infant care practices: supine placement and breastfeeding. METHODS We analyzed nationally representative data from the Study of Attitudes and Factors Effecting Infant Care, which surveyed US mothers after infant birth and 2 months thereafter. Using the Theory of Planned Behavior as a framework, we used structural equation models to elucidate mediational pathways from maternal education to supine infant placement or any breastfeeding. RESULTS Data from 3297 mothers demonstrated 77.0% of infants usually were placed supine, and 57.8% received any breastfeeding. The overall direct effect of maternal educational level on supine placement and any breastfeeding was odds ratio (OR) 1.31 (95% confidence interval [CI] 1.11-1.54) and OR 2.82 (95% CI 2.35-3.37), respectively. In pathway analyses, the strongest associations with both supine position and breastfeeding were seen with positive attitudes (supine: aOR 18.96, 95% CI 9.00-39.92; breastfeeding: aOR 3.86, 95% CI 2.19-6.82) and positive social norms (supine: aOR 6.69, 95% CI 4.52-9.89; breastfeeding: aOR 5.17, 95% CI 4.28-6.23). Mothers with more education had higher odds of both positive attitudes and positive norms for the 2 practices. CONCLUSIONS The associations linking educational attainment with health practices are intricate, with multiple mediating pathways. Attitudes and social norms are powerful forces that mediate the association between maternal educational attainment and both infant supine positioning and breastfeeding, and may be important mediators for other health behaviors.
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Affiliation(s)
- Rachel Y Moon
- Department of Pediatrics, University of Virginia School of Medicine (RY Moon and A Kellams), Charlottesville, Va.
| | - Jennifer LoCasale-Crouch
- Curry School of Education and Human Development, University of Virginia (J LoCasale-Crouch and KLP Turnbull), Charlottesville, Va
| | - Khara L P Turnbull
- Curry School of Education and Human Development, University of Virginia (J LoCasale-Crouch and KLP Turnbull), Charlottesville, Va
| | - Eve Colson
- Department of Pediatrics, Washington University School of Medicine (E Colson), St. Louis, Mo
| | - Ann Kellams
- Department of Pediatrics, University of Virginia School of Medicine (RY Moon and A Kellams), Charlottesville, Va
| | - Timothy Heeren
- Slone Epidemiology Center, Boston University (T Heeren, S Kerr, and MJ Corwin), Boston, Mass; Department of Biostatistics, Boston University School of Public Health (T Heeren), Boston, Mass
| | - Stephen Kerr
- Slone Epidemiology Center, Boston University (T Heeren, S Kerr, and MJ Corwin), Boston, Mass
| | - Fern R Hauck
- Department of Family Medicine, University of Virginia School of Medicine (FR Hauck), Charlottesville, Va
| | - Michael J Corwin
- Slone Epidemiology Center, Boston University (T Heeren, S Kerr, and MJ Corwin), Boston, Mass
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4
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Dyda A, King C, Dey A, Leask J, Dunn AG. A systematic review of studies that measure parental vaccine attitudes and beliefs in childhood vaccination. BMC Public Health 2020; 20:1253. [PMID: 32807124 PMCID: PMC7433363 DOI: 10.1186/s12889-020-09327-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/02/2020] [Indexed: 12/13/2022] Open
Abstract
Background Acceptance of vaccines is an important predictor of vaccine uptake. This has public health implications as those who are not vaccinated are at a higher risk of infection from vaccine preventable diseases. We aimed to examine how parental attitudes and beliefs towards childhood vaccination were measured in questionnaires through a systematic review of the literature. Methods We systematically reviewed the literature to identify primary research studies using tools to measure vaccine attitudes and beliefs, published between January 2012 and May 2018. Studies were included if they involved a quantitative survey of the attitudes and beliefs of parents about vaccinations recommended for children. We undertook a synthesis of the results with a focus on evaluating the tools used to measure hesitancy. Results A total of 116 studies met the inclusion criteria, 99 used a cross sectional study design, 5 used a case control study design, 4 used a pre-post study design and 8 used mixed methods study designs. Sample sizes of included studies ranged from 49 to 12,259. The most commonly used tool was the Parent Attitudes about Childhood Vaccines (PACV) Survey (n = 7). The most common theoretical framework used was the Health Belief Model (n = 25). Questions eliciting vaccination attitudes and beliefs varied widely. Conclusions There was heterogeneity in the types of questionnaires used in studies investigating attitudes and beliefs about vaccination in parents. Methods to measure parental attitudes and beliefs about vaccination could be improved with validated and standardised yet flexible instruments. The use of a standard set of questions should be encouraged in this area of study.
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Affiliation(s)
- Amalie Dyda
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia. .,Department of Health Systems and Populations, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.
| | - Catherine King
- National Centre for Immunisation Research & Surveillance, Sydney, NSW, Australia.,The University of Sydney, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, Sydney, NSW, Australia
| | - Aditi Dey
- National Centre for Immunisation Research & Surveillance, Sydney, NSW, Australia.,The University of Sydney, School of Medicine, Faculty of Medicine and Health, Sydney, NSW, Australia
| | - Julie Leask
- National Centre for Immunisation Research & Surveillance, Sydney, NSW, Australia.,The University of Sydney, Susan Wakil School of Nursing and Midwifery, Sydney, NSW, Australia
| | - Adam G Dunn
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.,The University of Sydney, Discipline of Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, Sydney, NSW, Australia
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Kellams A, Hauck FR, Moon RY, Kerr SM, Heeren T, Corwin MJ, Colson E. Factors Associated With Choice of Infant Sleep Location. Pediatrics 2020; 145:e20191523. [PMID: 32034081 PMCID: PMC7049941 DOI: 10.1542/peds.2019-1523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess the prevalence of and factors associated with actual recent practice and near-future intention for infant sleep location in a national sample. METHODS There were 3260 mothers from 32 US hospitals who responded to a survey at infant age 2 to 6 months regarding care practices, including usual and all infant sleep locations in the previous 2 weeks and intended location for the next 2 weeks. Mothers were categorized as (1) having practiced and/or intending to practice exclusive room-sharing without bed-sharing, (2) having practiced anything other than exclusive room-sharing but intending to practice exclusive room-sharing, (3) intending to have the infant sleep in another room; and (4) intending to practice bed-sharing all night or part of the night. Multivariable multinomial logistic regression examined associations between sleep-location category, demographics, feeding method, doctor advice, and theory of planned behavior domains (attitudes, social norms, and perceived control). RESULTS Fewer than half (45.4%) of the mothers practiced and also intended to practice room-sharing without bed-sharing, and 24.2% intended to practice some bed-sharing. Factors associated with intended bed-sharing included African American race and exclusive breastfeeding; however, the highest likelihood of bed-sharing intent was associated with perceived social norms favoring bed-sharing (adjusted odds ratio [aOR] 5.84; 95% confidence interval [CI] 4.14-8.22) and positive attitudes toward bed-sharing (aOR 190.1; 95% CI 62.4-579.0). Women with a doctor's advice to room-share without bed-sharing intended to practice bed-sharing less (aOR 0.56; 95% CI 0.36-0.85). CONCLUSIONS Sleep-location practices do not always align with the recommendation to room-share without bed-sharing, and intention does not always correspond with previous practice. Attitudes, perceived social norms, and doctor advice are factors that are amenable to change and should be considered in educational interventions.
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Affiliation(s)
| | - Fern R Hauck
- Family Medicine, University of Virginia, Charlottesville, Virginia
| | | | - Stephen M Kerr
- Slone Epidemiology Center, Boston University, Boston, Massachusetts; and
| | - Timothy Heeren
- Department of Biostatistics, School of Public Health and
| | - Michael J Corwin
- Slone Epidemiology Center, Boston University, Boston, Massachusetts; and
| | - Eve Colson
- Department of Pediatrics, School of Medicine, Washington University in St Louis, St Louis, Missouri
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Moon RY, Corwin MJ, Kerr S, Heeren T, Colson E, Kellams A, Geller NL, Drake E, Tanabe K, Hauck FR. Mediators of Improved Adherence to Infant Safe Sleep Using a Mobile Health Intervention. Pediatrics 2019; 143:e20182799. [PMID: 31015374 PMCID: PMC6564062 DOI: 10.1542/peds.2018-2799] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To determine mediators of improvements in infant safe-sleep (SS) practices in a mobile health intervention. METHODS In a cluster-randomized controlled trial, mothers received SS intervention or breastfeeding control videos for 60 days. Maternal responses about infant sleep position and location (outcomes) and mediators (attitudes, perceived social norms, and perceived control) from the theory of planned behavior were assessed. Intervention effects on mediators and association between mediators and outcomes were examined. RESULTS Of 1600 recruited, 1263 mothers participated. Mothers receiving SS videos were more likely to have positive attitudes and norms for supine sleep (attitudes: adjusted odds ratio [aOR] = 2.35 [95% confidence interval (CI) 1.72 to 3.20]; norms: aOR = 1.75 [95% CI 1.27 to 2.42]) and recommended sleep location (attitudes: aOR = 1.91 [95% CI 1.54 to 2.36]; norms: aOR = 1.37 [95% CI 1.13 to 1.66]). Positive attitudes and norms toward supine sleep and room-sharing without bed-sharing were associated with higher odds of both practices (supine: aOR = 8.25 [95% CI 4.72 to 14.43] for positive attitudes and aOR = 6.67 [95% CI 4.25 to 10.46] for norms; room-sharing: aOR = 7.14 [95% CI 5.35 to 9.53] for positive attitudes and aOR = 4.44 [95% CI 3.03 to 6.51] for norms). Both positive attitudes and positive norms mediated the effect of the intervention. CONCLUSIONS The intervention achieved success in improving adherence to SS recommendations by changing maternal attitudes and norms about supine sleeping and room-sharing without bed-sharing. Recognition that these attitudes and norms appear to be the main drivers of mothers' choices regarding infant-sleep practices should inform health messaging strategies to promote SS.
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Affiliation(s)
| | | | | | - Timothy Heeren
- Slone Epidemiology Center and
- Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts; and
| | - Eve Colson
- Department of Pediatrics, Yale University, New Haven, Connecticut
| | | | | | - Emily Drake
- Department of Family, Community, and Mental Health Systems, School of Nursing, University of Virginia, Charlottesville, Virginia
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McLenon J, Rogers MAM. The fear of needles: A systematic review and meta-analysis. J Adv Nurs 2018; 75:30-42. [PMID: 30109720 DOI: 10.1111/jan.13818] [Citation(s) in RCA: 240] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/20/2018] [Accepted: 07/14/2018] [Indexed: 11/30/2022]
Abstract
AIMS The aim of this study was to evaluate the prevalence of needle fear and summarize the characteristics of individuals who exhibit this fear. BACKGROUND Injections are among the most common medical procedures, yet fear of needles can result in avoidance of preventive measures and treatment. DESIGN Systematic review and meta-analysis. DATA SOURCES MEDLINE (1966-2017), Embase (1947-2017), PsycINFO (1967-2017), and CINAHL (1961-2017) were searched, with no restrictions by age, gender, race, language, or country. REVIEW METHODS The prevalence of needle fear was calculated and restricted maximum likelihood random effects models were used for meta-analysis and meta-regression. RESULTS The search yielded 119 original research articles which are included in this review, of which 35 contained sufficient information for meta-analysis. The majority of children exhibited needle fear, while prevalence estimates for needle fear ranged from 20-50% in adolescents and 20-30% in young adults. In general, needle fear decreased with increasing age. Both needle fear and needle phobia were more prevalent in females than males. Avoidance of influenza vaccination because of needle fear occurred in 16% of adult patients, 27% of hospital employees, 18% of workers at long-term care facilities, and 8% of healthcare workers at hospitals. Needle fear was common when undergoing venipuncture, blood donation, and in those with chronic conditions requiring injection. CONCLUSIONS Fear of needles is common in patients requiring preventive care and in those undergoing treatment. Greater attention should be directed to interventions which alleviate fear in high-risk groups.
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Affiliation(s)
- Jennifer McLenon
- School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Mary A M Rogers
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
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Loyal J, Taylor JA, Phillipi CA, Goyal NK, Wood KE, Seashore C, King B, Colson E, Shabanova V, Shapiro ED. Factors Associated With Refusal of Intramuscular Vitamin K in Normal Newborns. Pediatrics 2018; 142:e20173743. [PMID: 30030367 PMCID: PMC6317553 DOI: 10.1542/peds.2017-3743] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Refusal of intramuscular (IM) vitamin K administration by parents is an emerging problem. Our objective was to assess the frequency of and factors associated with refusal of IM vitamin K administration in well newborns in the United States. METHODS We determined the number of newborns admitted to well newborn units whose parents refused IM vitamin K administration in the Better Outcomes through Research for Newborns network and, in a nested patient-control study, identified factors associated with refusal of IM vitamin K administration by using a multiple logistic regression model. RESULTS Of 102 878 newborns from 35 Better Outcomes through Research for Newborns sites, parents of 638 (0.6%) refused IM vitamin K administration. Frequency of refusal at individual sites varied from 0% to 2.3%. Exclusive breastfeeding (adjusted odds ratio [aOR] = 3.4; 95% confidence interval [CI]: 2.1-5.5), non-Hispanic white race and/or ethnicity (aOR = 1.7; 95% CI: 1.2-2.4), female sex (aOR = 1.6; 95% CI: 1.2-2.3), gestational age (aOR = 1.2; 95% CI: 1.1-1.4), and mother's age (aOR = 1.05; 95% CI: 1.02-1.08) were significantly associated with refusal of IM vitamin K administration. Refusal of the administration of both ocular prophylaxis and hepatitis B vaccine was also strongly associated with refusal of IM vitamin K administration (aOR = 88.7; 95% CI: 50.4-151.9). CONCLUSIONS Refusal of IM vitamin K by parents of newborns is a significant problem. Interventions to minimize risks to these newborns are needed.
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Affiliation(s)
- Jaspreet Loyal
- Department of Pediatrics, Yale University, New Haven, Connecticut;
| | - James A Taylor
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Carrie A Phillipi
- Department of Pediatrics, Oregon Health and Science University, Portland, Oregon
| | - Neera K Goyal
- Department of Pediatrics, Nemours, Philadelphia, Pennsylvania
| | - Kelly E Wood
- Stead Family Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa
| | - Carl Seashore
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
| | - Beth King
- Academic Pediatric Association, McLean, Virginia
| | - Eve Colson
- Department of Pediatrics, Yale University, New Haven, Connecticut
| | | | - Eugene D Shapiro
- Department of Pediatrics, Yale University, New Haven, Connecticut
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Niederhauser VP, Lindley LC, Farabollini B. Changes in parental barriers to immunizations. Public Health Nurs 2018; 35:379-385. [PMID: 29877583 DOI: 10.1111/phn.12523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/24/2018] [Accepted: 04/27/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to explore if parental barriers to childhood immunizations change over time. DESIGN AND SAMPLE Using secondary data, a pretest post-test design was employed to measure changes in parental barriers to childhood immunizations in the first 7 months of life. Thirty-nine parent/infant dyads were included in this study. MEASURES The Searching for Hardship and Obstacles to Shots (SHOTS) Survey was completed by a parent when their infant was between one and 28 days old (prior to their first immunizations) and again when the child was 6-7 months of age. RESULTS In this study, parental barriers to immunizations decreased over time. Specifically, six individual items related to accessing immunizations decreased from baseline to 7 months of age. In addition, the Access to Shots subscale decreased significantly (p = 0.010) between the two time periods. In less educated parents, the Importance of Immunizations subscale decreased over time. CONCLUSION Given the findings and trends in changes identified in this study, more exploration is necessary to understand what parental barriers change over time and how these changes affect immunization rates in early infancy.
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Affiliation(s)
| | - Lisa C Lindley
- College of Nursing, University of Tennessee, Knoxville, Knoxville, Tennessee
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