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Suryadevara M. Vaccine Confidence and Vaccine Hesitancy. Vaccines (Basel) 2021. [DOI: 10.1007/978-3-030-58414-6_38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Zhai Y, Santibanez TA, Kahn KE, Srivastav A, Walker TY, Singleton JA. Rural, urban, and suburban differences in influenza vaccination coverage among children. Vaccine 2020; 38:7596-7602. [PMID: 33071004 DOI: 10.1016/j.vaccine.2020.10.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 10/02/2020] [Accepted: 10/08/2020] [Indexed: 11/30/2022]
Abstract
Influenza vaccination is the primary way to prevent influenza, yet influenza vaccination coverage remains low in the United States. Previous studies have shown that children residing in rural areas have less access to healthcare and lower vaccination coverage for some vaccines. Influenza vaccination coverage among children 6 months-17 years by rural/urban residence during the 2011-12 through 2018-19 influenza seasons was examined using National Immunization Survey-Flu data. The Council of American Survey Research Organizations response rates for National Immunization Survey-Flu ranged from 48% to 65% (2011-12 through the 2017-18 seasons) for the landline sample and 20%-39% (2011-12 through the 2018-19 seasons) for the cellular telephone sample. Children residing in rural areas had influenza vaccination coverage that ranged from 7.9 (2012-13 season) to 12.6 (2016-17 season) percentage points lower than children residing in urban areas, and ranged from 4.5 (2012-13 season) to 7.4 (2016-17 season) percentage points lower than children residing in suburban areas. The differences in influenza vaccination coverage among rural, suburban, and urban children were consistent over the eight seasons studied. Lower influenza vaccination coverage was observed among rural children regardless of child's age, mother's education, household income, or number of children under 18 years of age in the household. Rural versus urban and suburban differences in influenza vaccination coverage remained statistically significant while adjusting for selected sociodemographic characteristics. A better understanding of the reasons for lower childhood influenza vaccination coverage for children in rural and suburban areas is needed.
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Affiliation(s)
- Yusheng Zhai
- Leidos, Inc., Atlanta, GA, USA; National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Tammy A Santibanez
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Katherine E Kahn
- Leidos, Inc., Atlanta, GA, USA; National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anup Srivastav
- Leidos, Inc., Atlanta, GA, USA; National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tanja Y Walker
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - James A Singleton
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Otsuka-Ono H, Hori N, Ohta H, Uemura Y, Kamibeppu K. A childhood immunization education program for parents delivered during late pregnancy and one-month postpartum: a randomized controlled trial. BMC Health Serv Res 2019; 19:798. [PMID: 31690298 PMCID: PMC6833181 DOI: 10.1186/s12913-019-4622-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 10/09/2019] [Indexed: 11/16/2022] Open
Abstract
Background Improved immunization rates have reduced the incidence of vaccine-preventable diseases (VPDs) in advanced nations. Japan’s unique vaccination system classifies vaccines into routine vaccines ostensibly required under the Preventive Vaccination Law and recommended but optional vaccines, although all vaccines are in fact voluntary. In Japan, low immunization rates, particularly for optional vaccines, have resulted in high rates of sequelae and death. The decision as to whether a child will receive a vaccine depends on the parents, who must obtain information, make inquiries, and make the required payment, the last of which is a major barrier. This randomized, controlled trial was conducted to evaluate the effectiveness of an immunization education program designed to meet mothers’ needs. Methods This randomized controlled trial assigned pregnant women to intervention or control groups. The intervention was individual education sessions involving the children’s fathers in shared decision-making on whether or not to immunize their child. A survey was conducted before and after the intervention. Data were analyzed using the intention-to-treat principle. Results Of 225 pregnant women, 175 (78%) participated and 171 replied to the post-survey. At age 3 months, intervention infants had higher self-reported immunization rates for hepatitis B virus vaccine (76% vs. 49%; P < 0.001) and rotavirus vaccine (84% vs. 68%; P = 0.019) than control group infants. The percentage of parents intending to vaccinate their infants was higher in the intervention group (77% vs. 52%; P < 0.01). Improvements in scores for basic knowledge (mean [SD]: 5.5 [3.6] vs. 3.0 [3.8], range: 10–30; P < 0.001), advanced knowledge (mean [SD]: 5.1 [2.4] vs. 2.8 [2.5], range: 5–15; P < 0.001), and health literacy regarding immunization (mean [SD]: 0.5 [0.8] vs. 0.2 [0.6], range: 1–5; P < 0.01) were higher in the intervention group. The rate of decision making by both parents (68% vs. 52%; P < 0.05) was higher in the intervention group. Conclusions Our findings confirmed the program’s effectiveness. The intervention improved immunization rates, the percentage of parents intending to vaccinate their infants and knowledge scores. Interventions which directly and indirectly involved fathers in shared decision-making on whether to immunize their child were effective, as were individualized interventions that provided parents with access to up-to-date information. Trial registration UMIN000012575. Registered 14 December 2013 (The study was prospectively registered).
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Affiliation(s)
- Hiroko Otsuka-Ono
- Department of Family Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-0033, Japan.
| | - Narumi Hori
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Yukari Uemura
- Biostatistics Division, Central Coordinating Unit, Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Kiyoko Kamibeppu
- Department of Family Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-0033, Japan
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Maisonneuve AR, Witteman HO, Brehaut J, Dubé È, Wilson K. Educating children and adolescents about vaccines: a review of current literature. Expert Rev Vaccines 2018; 17:311-321. [PMID: 29569498 DOI: 10.1080/14760584.2018.1456921] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Until recently, research on vaccine hesitancy has focused primarily on parent populations. Although adolescent knowledge and views are gaining momentum within the literature, particularly with regards to the human papillomavirus and influenza, children remain a virtually unstudied population with regards to vaccine hesitancy. AREAS COVERED This review focuses on the lack of literature in this area and argues for more vaccine hesitancy research involving child and adolescent populations. It also outlines special issues to consider when framing health promotion messages for children and adolescents. Finally, we explore the use of new and existing technologies as delivery mechanisms for education on vaccines and immunizations in populations of children and adolescents. EXPERT COMMENTARY Children undergo cognitive development and experiences with vaccines (e.g. pain or education) have the potential to create future attitudes toward vaccines. This can influence future vaccine behaviour, including their participation in decision-making around adolescent vaccines, their decisions to vaccinate themselves when they are adults, and their decisions to vaccinate their own children. Interventions aimed at children, such as education, can create positive attitudes toward vaccines. These can also potentially influence parental attitudes toward vaccines as children convey this knowledge to them. Both of these impacts require further study.
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Affiliation(s)
| | - Holly O Witteman
- b Department of Family and Emergency Medicine , Université Laval , Québec , QC , Canada
| | - Jamie Brehaut
- c Ottawa Hospital Research Institute , Ottawa , ON , Canada
| | - Ève Dubé
- d Institut national de santé publique du Québec , Québec , QC , Canada
| | - Kumanan Wilson
- c Ottawa Hospital Research Institute , Ottawa , ON , Canada
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Saitoh A, Saitoh A, Sato I, Shinozaki T, Kamiya H, Nagata S. Improved parental attitudes and beliefs through stepwise perinatal vaccination education. Hum Vaccin Immunother 2017; 13:2639-2645. [PMID: 28853971 DOI: 10.1080/21645515.2017.1368601] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
This study examined the effects of providing vaccination education during the perinatal period on Japanese parents' knowledge, attitudes, and beliefs about childhood vaccination. A cluster-randomized controlled-trial method was used on a sample of 160 pregnant women recruited from 9 obstetrical sites in Niigata, Japan. The treatment group received a stepwise interactive education intervention, while the control group received a general vaccination leaflet. Changes in parental attitudes toward and beliefs about infant vaccination were assessed on the child's one-month and 6-month birthdays using paper questionnaires. Of the initial 188 participants, 160 (90.4%) completed the final post-survey questionnaire. Scores on injunctive social norms (a morally neutral perception of the behavior of the majority) and descriptive social norms (a moral perception of what individuals should do) significantly increased in the treatment group (p = .02 and p = .01, respectively). There was a significant difference between the 2 groups over time in terms of perceived benefit (efficacy of available preventive actions) (p = .03), but no significant differences in perceived severity (seriousness of a disease outcome), perceived susceptibility (likelihood of getting a disease), perceived benefits, perceived behavioral control, or descriptive social norms between the groups at any time point or in the patterns of change over time (p > .31). Thus, stepwise perinatal vaccination education was found to positively influence maternal attitudes and beliefs about infant vaccination. This study suggests the importance of vaccination education during the perinatal period.
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Affiliation(s)
- Aya Saitoh
- a Department of Community Health Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine , The University of Tokyo , Tokyo , Japan
| | - Akihiko Saitoh
- b Department of Pediatrics , Niigata University Graduate School of Medical and Dental Sciences , Niigata City , Niigata , Japan
| | - Isamu Sato
- c Yoiko-no Shounika Sato , Niigata City , Niigata , Japan
| | - Tomohiro Shinozaki
- d Department of Biostatistics, School of Public Health, Graduate School of Medicine , The University of Tokyo , Tokyo , Japan
| | - Hajime Kamiya
- e Infectious Disease Surveillance Center , National Institute of Infectious Diseases , Tokyo , Japan
| | - Satoko Nagata
- a Department of Community Health Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine , The University of Tokyo , Tokyo , Japan
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Schmid P, Rauber D, Betsch C, Lidolt G, Denker ML. Barriers of Influenza Vaccination Intention and Behavior - A Systematic Review of Influenza Vaccine Hesitancy, 2005 - 2016. PLoS One 2017; 12:e0170550. [PMID: 28125629 PMCID: PMC5268454 DOI: 10.1371/journal.pone.0170550] [Citation(s) in RCA: 713] [Impact Index Per Article: 101.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 01/06/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Influenza vaccine hesitancy is a significant threat to global efforts to reduce the burden of seasonal and pandemic influenza. Potential barriers of influenza vaccination need to be identified to inform interventions to raise awareness, influenza vaccine acceptance and uptake. OBJECTIVE This review aims to (1) identify relevant studies and extract individual barriers of seasonal and pandemic influenza vaccination for risk groups and the general public; and (2) map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area. METHODS Thirteen databases covering the areas of Medicine, Bioscience, Psychology, Sociology and Public Health were searched for peer-reviewed articles published between the years 2005 and 2016. Following the PRISMA approach, 470 articles were selected and analyzed for significant barriers to influenza vaccine uptake or intention. The barriers for different risk groups and flu types were clustered according to a conceptual framework based on the Theory of Planned Behavior and discussed using the 4C model of reasons for non-vaccination. RESULTS Most studies were conducted in the American and European region. Health care personnel (HCP) and the general public were the most studied populations, while parental decisions for children at high risk were under-represented. This study also identifies understudied concepts. A lack of confidence, inconvenience, calculation and complacency were identified to different extents as barriers to influenza vaccine uptake in risk groups. CONCLUSION Many different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified. While most sociodemographic and physical variables may be significantly related to influenza vaccine hesitancy, they cannot be used to explain its emergence or intensity. Psychological determinants were meaningfully related to uptake and should therefore be measured in a valid and comparable way. A compendium of measurements for future use is suggested as supporting information.
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Affiliation(s)
- Philipp Schmid
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Dorothee Rauber
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Cornelia Betsch
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Gianni Lidolt
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Marie-Luisa Denker
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
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Koep TH, Huskins WC, Clemens C, Jenkins S, Pierret C, Ekker SC, Enders FT. Influenza knowledge, attitude, and behavior survey for grade school students: design and novel assessment methodology. J Community Health 2016; 39:1231-40. [PMID: 24859735 DOI: 10.1007/s10900-014-9884-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Despite the fact infectious diseases can spread readily in grade schools, few studies have explored prevention in this setting. Additionally, we lack valid tools for students to self-report knowledge, attitudes, and behaviors. As part of an ongoing study of a curriculum intervention to promote healthy behaviors, we developed and evaluated age-appropriate surveys to determine students' understanding of influenza prevention. Surveys were adapted from adolescent and adult influenza surveys and administered to students in grades 2-5 (ages 7-11) at two Rochester public schools. We assessed student understanding by analyzing percent repeatability of 20 survey questions and compared percent "don't know" (DK) responses across grades, gender, and race. Questions thought to be ambiguous after early survey administration were investigated in student focus groups, modified as appropriate, and reassessed. The response rate across all surveys was >87%. Survey questions were well understood; 16 of 20 questions demonstrated strong pre/post repeatability (>70%). Only 1 question showed an increase in DK response for higher grades (p < .0001). Statistical analysis and qualitative feedback led to modification of 3 survey questions and improved measures of understanding in the final survey administration. Grade-school students' knowledge, attitudes and behavior toward influenza prevention can be assessed using surveys. Quantitative and qualitative analysis may be used to assess participant understanding and refine survey development for pediatric survey instruments. These methods may be used to assess the repeatability and validity of surveys to assess the impact of health education interventions in young children.
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Affiliation(s)
- Tyler H Koep
- Clinical and Translational Sciences, Mayo Graduate School, Mayo Clinic, Rochester, MN, 55905, USA
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He L, Liao QY, Huang YQ, Feng S, Zhuang XM. Parents' perception and their decision on their children's vaccination against seasonal influenza in Guangzhou. Chin Med J (Engl) 2015; 128:327-41. [PMID: 25635428 PMCID: PMC4837863 DOI: 10.4103/0366-6999.150099] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Seasonal influenza epidemic occurs every year in Guangzhou, which can affect all age groups. Young children are the most susceptible targets. Parents can decide whether to vaccinate their children or not based on their own consideration in China. The aim of this study was to identify factors that are important for parental decisions on vaccinating their children against seasonal influenza based on a modified health belief model (HBM). METHODS A cross-sectional study was conducted in Guangzhou, China. A total of 335 parents who had at least on child aged between 6 months and 3 years were recruited from women and children's hospital in Guangzhou, China. Each eligible subject was invited for a face-to-face interview based on a standardized questionnaire. RESULTS Uptake of seasonal influenza within the preceding 12 months among the target children who aged between 6 months and 36 months was 47.7%. Around 62.4% parents indicated as being "likely/very likely" to take their children for seasonal influenza vaccination in the next 12 months. The hierarchical logistic regression model showed that children's age (odds ratio [OR] =2.59, 95% confidence interval [CI]: 1.44-4.68), social norm (OR = 2.08, 95% CI: 1.06-4.06) and perceived control (OR = 2.96, 95% CI: 1.60-5.50) were significantly and positively associated with children's vaccination uptake within the preceding 12 months; children with a history of taking seasonal influenza vaccine (OR = 2.50, 95% CI: 1.31-4.76), perceived children's health status (OR = 3.36, 95% CI: 1.68-6.74), worry/anxious about their children influenza infection (OR = 2.31, 95% CI: 1.19-4.48) and perceived control (OR = 3.21, 95% CI: 1.65-6.22) were positively association with parental intention to vaccinate their children in the future 12 months. However, anticipated more regret about taking children for the vaccination was associated with less likely to vaccinate children within the preceding 12 months (OR = 0.21, 95% CI: 0.08-0.52). CONCLUSIONS The modified HBM provided a good theoretical basic for understanding factors associated with parents' decisions on their children's vaccination against seasonal influenza.
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Affiliation(s)
| | - Qiu-Yan Liao
- School of Public Health, University of Hong Kong, Hong Kong, China
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Chen CH, Chiu PJ, Chih YC, Yeh GL. Determinants of influenza vaccination among young Taiwanese children. Vaccine 2015; 33:1993-8. [PMID: 25613722 DOI: 10.1016/j.vaccine.2015.01.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 01/08/2015] [Accepted: 01/12/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVE According to the Health Belief Model (HBM), individual perceptions of susceptibility, severity, benefit, barrier, self-efficacy, and cues to action are associated with health actions. In this study, we investigated the perceptions and social factors that influence the intention to vaccinate children against influenza among parents of young Taiwanese children. METHODS A nationwide survey was performed using stratified random sampling to explore the beliefs, attitudes, and intentions of parents/main caregivers with regard to vaccinating children aged 6 months to 3 years against influenza. A questionnaire was developed based on the HBM and multivariate logistic regression analyses of 1300 eligible participants were used to identify significant predictors of the intention to vaccinate. RESULTS Greater perceived benefit, cues to action, and self-efficacy of childhood vaccination against influenza were positively associated with the intention to vaccinate. Children's experience of influenza vaccinations in the past year was also a positive predictor. However, perceived susceptibility, perceived severity regarding influenza and perceived barriers to vaccination were not predictive of the intention to vaccinate. CONCLUSION In addition to perceived benefits and cues to action, self-efficacy of parents/main caregivers was significantly predictive of their intention to accept influenza vaccination for their young children. These components of the HBM could be used in formulating strategies aimed at promoting the use of influenza vaccine.
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Affiliation(s)
- Chang-Hsun Chen
- Centers for Disease Control, R.O.C. (Taiwan); Department of Health Promotion and Health Education, National Taiwan Normal University (Taiwan)
| | - Po-Ju Chiu
- Centers for Disease Control, R.O.C. (Taiwan)
| | | | - Gwo-Liang Yeh
- Department of Health Promotion and Health Education, National Taiwan Normal University (Taiwan)
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Chan TC, Fu YC, Wang DW, Chuang JH. Determinants of receiving the pandemic (H1N1) 2009 vaccine and intention to receive the seasonal influenza vaccine in Taiwan. PLoS One 2014; 9:e101083. [PMID: 24971941 PMCID: PMC4074160 DOI: 10.1371/journal.pone.0101083] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 06/02/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The paper examines the factors associated with both receiving pandemic (H1N1) 2009 vaccines and individuals' intentions to get the next seasonal influenza vaccine in Taiwan. METHODS We conducted a representative nationwide survey with in-person household interviews during April-July 2010. Multivariate logistic regression incorporated socio-demographic background, household characteristics, health status, behaviors, and perceptions of influenza and vaccination. RESULTS We completed interviews with 1,954 respondents. Among those, 548 (28.0%) received the pandemic (H1N1) 2009 vaccination, and 469 (24.0%) intended to get the next seasonal influenza vaccine. Receipt of the H1N1 vaccine was more prevalent among schoolchildren, the elderly, those who had contact with more people in their daily lives, and those who had received influenza vaccinations in previous years. In comparison, the intention to receive the next seasonal influenza vaccine tended to be stronger among children, the elderly, and those who reported less healthy status or lived with children, who received a seasonal influenza vaccination before, and who worried more about a possible new pandemic. CONCLUSIONS Children, the elderly, and those who had gotten seasonal flu shots before in Taiwan were more likely to both receive a pandemic H1N1 vaccination and intend to receive a seasonal influenza vaccine.
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Affiliation(s)
- Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan, Republic of China
| | - Yang-chih Fu
- Institute of Sociology, Academia Sinica, Taipei, Taiwan, Republic of China
| | - Da-Wei Wang
- Institute of Information Science, Academia Sinica, Taipei, Taiwan, Republic of China
| | - Jen-Hsiang Chuang
- Deputy Director-General’s Office, Centers for Disease Control, Taipei, Taiwan, Republic of China
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan, Republic of China
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Gargano LM, Herbert NL, Painter JE, Sales JM, Vogt TM, Morfaw C, Jones LM, Murray D, DiClemente RJ, Hughes JM. Development, theoretical framework, and evaluation of a parent and teacher-delivered intervention on adolescent vaccination. Health Promot Pract 2014; 15:556-67. [PMID: 24440920 DOI: 10.1177/1524839913518222] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Advisory Committee on Immunization Practices recommended immunization schedule for adolescents includes three vaccines (tetanus, diphtheria, and acellular pertussis [Tdap]; human papillomavirus [HPV] vaccine; and meningococcal conjugate vaccine [MCV4]) and an annual influenza vaccination. Given the increasing number of recommended vaccines for adolescents and health and economic costs associated with nonvaccination, it is imperative that effective strategies for increasing vaccination rates among adolescents are developed. This article describes the development, theoretical framework, and initial first-year evaluation of an intervention designed to promote vaccine acceptance among a middle and high school-based sample of adolescents and their parents in eastern Georgia. Adolescents, parents, and teachers were active participants in the development of the intervention. The intervention, which consisted of a brochure for parents and a teacher-delivered curriculum for adolescents, was guided by constructs from the health belief model and theory of reasoned action. Evaluation results indicated that our intervention development methods were successful in creating a brochure that met cultural relevance and the literacy needs of parents. We also demonstrated an increase in student knowledge of and positive attitudes toward vaccines. To our knowledge, this study is the first to extensively engage middle and high school students, parents, and teachers in the design and implementation of key theory-based educational components of a school-based, teacher-delivered adolescent vaccination intervention.
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Affiliation(s)
| | | | | | | | - Tara M Vogt
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Saitoh A, Nagata S, Saitoh A, Tsukahara Y, Vaida F, Sonobe T, Kamiya H, Naruse T, Murashima S. Perinatal immunization education improves immunization rates and knowledge: a randomized controlled trial. Prev Med 2013; 56:398-405. [PMID: 23524116 PMCID: PMC6450531 DOI: 10.1016/j.ypmed.2013.03.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 02/19/2013] [Accepted: 03/09/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine if providing perinatal immunization education positively changes the immunization status of infants, influences the infant immunization knowledge, attitudes and beliefs of mothers and affects the intent to vaccinate children in Japan where immunization education is limited. METHODS Pregnant women were recruited from three sites in Tokyo, Japan and were assigned to two intervention (pre- or postnatal education) groups and a control group. The immunization status of infants was assessed and a written survey was performed before and after the intervention. RESULTS Among 119 study participants, 106 subjects replied to the post-survey. The intervention groups (34.3%) had higher immunization rates in infants at three months of age than the control group (8.3%) (P=0.005); however, no differences were observed between the prenatal (29.4%) and postnatal groups (38.9%) (P=0.40). The percentage of women intended to vaccinate their infants was higher in the intervention groups (61.4%) compared to the control group (33.3%) (P=0.01). The improvement in score for basic knowledge was higher in the intervention groups, particularly in the prenatal group (mean±S.D.: 3.4±1.8) compared to the control (1.9±1.9) (P=0.003). CONCLUSIONS Perinatal immunization education improved the immunization status of infants, increased the women's knowledge on immunization and intention to vaccinate their infants.
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Affiliation(s)
- Aya Saitoh
- Department of Community Health Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Japan.
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Bates BR, Graham D, Striley K, Patterson S, Arora A, Hamel-Lambert J. Examining antecedents of caregivers' access to early childhood developmental screening: implications for campaigns promoting use of services in Appalachian Ohio. Health Promot Pract 2013; 15:413-21. [PMID: 23479038 DOI: 10.1177/1524839913479955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although developmental delays are common in the United States, only about one third of developmental delays are identified before a child enters school. As challenging as use of developmental screening is on a national basis, the Appalachian region faces extreme lack of screening, diagnosis, and treatment for developmental delay. Local health care providers attribute this lack to poor parent understanding and have called for communication interventions to educate caregivers. This investigation sought to understand the antecedents of Appalachian caregivers' intentions to access developmental screening and services for their children as formative research for a communication-based intervention. The investigation was grounded by the health belief model. Surveys completed by 366 caregivers were used to model antecedents to behavioral intention. Perceived severity, perceived benefits, and self-efficacy were found to be the strongest predictors of intention to access developmental screening. Implications for a communication-based intervention are provided.
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Comparison of knowledge and attitudes about vaccination between Belgian and immigrant adolescents. J Infect Public Health 2012; 6:1-9. [PMID: 23290087 DOI: 10.1016/j.jiph.2012.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 10/28/2012] [Accepted: 10/29/2012] [Indexed: 11/20/2022] Open
Abstract
Immigrant adolescents have different beliefs and attitudes about health and disease compared to Belgian adolescents. The aim of this study was to compare the knowledge of Belgian and immigrant adolescents concerning vaccination. In March 2009, adolescents between the ages of 14 and 17 years from three schools with a mixed Belgian and immigrant population in Antwerp completed a written questionnaire concerning vaccination. In total, 186 adolescents (88 immigrants and 98 Belgians) completed the questionnaire. Knowledge about vaccinations was slightly lower among immigrant adolescents (P<0.001). In both groups, the family physician and the school were the most important information sources for vaccination. Parents played a less important role among immigrant adolescents (50%) compared to Belgian adolescents (80%) (P=0.002). The physician, the school and the parents played key roles in the vaccination of both immigrants and Belgian adolescents.
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Head KJ, Cohen EL. Young women's perspectives on cervical cancer prevention in Appalachian Kentucky. QUALITATIVE HEALTH RESEARCH 2012; 22:476-87. [PMID: 22068039 DOI: 10.1177/1049732311425053] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Human papillomavirus (HPV) vaccination coupled with routine Papanicolaou (Pap) tests can prevent pervasive HPV infections causing cervical cancer. However, both HPV vaccination rates and Pap testing rates in Appalachian Kentucky are lower among all age groups than the rest of the United States. We recruited 19 young women residing in Appalachian Kentucky from university-based and rural clinical settings for group and individual interviews. After considering an integrated behavioral framework, we illustrate these women's perspectives by detailing five themes, including (a) experiential beliefs pose barriers to performing behaviors, (b) three vaccine doses complicate vaccination intention, (c) women have misunderstandings about HPV and the HPV vaccination function, (d) normative influences cue action (and inaction), and (e) specific environmental and contextual barriers exist to performing cervical cancer prevention behaviors in Appalachian Kentucky. These findings related to cervical cancer prevention in Appalachian Kentucky have implications for health-message design and clinical practice.
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Byrne C, Walsh J, Kola S, Sarma KM. Predicting intention to uptake H1N1 influenza vaccine in a university sample. Br J Health Psychol 2011; 17:582-95. [PMID: 22107685 DOI: 10.1111/j.2044-8287.2011.02057.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Global pandemic H1N1 was atypical of influenza in that it was associated with high symptom severity among young adults. Higher education institutions were therefore understandably concerned about the potential for high infection rates among students. This study examined intention to uptake H1N1 vaccine between November and December 2009, when the virus was classified by the World Health Organization (WHO) as being in the pandemic phase. DESIGN A cross-sectional survey design was employed. METHOD Two hundred university students completed a questionnaire battery comprised of health, belief/attitudes, and behavioural intention measures. RESULTS Findings suggested that non-intention to vaccinate is associated with a strong disbelief in its efficacy, in negative attitudes towards vaccinations, and in lack of perceived threat, which is underscored by a disinterest in others' opinions, including authoritative bodies. Findings also suggested that there is resistance to the idea of vaccinations being mandatory. CONCLUSIONS Vaccination intent is in some way linked to a range of attitudes and beliefs. The implication for health practitioners is that behaviour intent may be open to influence where psycho-education can create pro-vaccine attitudes and beliefs.
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Affiliation(s)
- Claire Byrne
- School of Psychology, NUI Galway, Republic of Ireland
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Gargano LM, Pazol K, Sales JM, Painter JE, Morfaw C, Jones LM, Weiss P, Buehler JW, Murray DL, Wingood GM, Orenstein WA, DiClemente RJ, Hughes JM. Multicomponent interventions to enhance influenza vaccine delivery to adolescents. Pediatrics 2011; 128:e1092-9. [PMID: 21987709 PMCID: PMC3387882 DOI: 10.1542/peds.2011-0453] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To compare school- versus provider-based approaches to improving influenza vaccination coverage among adolescents in rural Georgia. METHODS We used a nonrandomized, 3-armed design: (1) a middle- and high school-based influenza vaccination intervention in 1 county; (2) a provider-based influenza vaccination intervention in a second county; and (3) a standard-of-care condition in a third county. Interventions also included distribution of an educational brochure, school presentations, and community-based outreach to enhance vaccine knowledge and awareness among adolescents and their parents. RESULTS During the 2008-2009 influenza season, 70 (19%) of 370 students were vaccinated in the school-based county and 110 (15%) of 736 students were vaccinated in the provider-based county, compared with 71 (8%) of 889 students in the standard-of-care county (risk ratio [RR](school): 2.4 [95% confidence interval (CI): 1.7-3.2]; RR(provider): 1.9 [95% CI: 1.4-2.5]). During 2009-2010, seasonal influenza vaccination coverage was 114 (30.4%) of 375 of students in the school-based county, 122 (16.9%) of 663 of students in the provider-based county, and 131 (15.2%) of 861 students in the standard-of-care county (RR(school): 2.3 [95% CI: 1.9-2.9]; RR(provider): 1.2 [95% CI: 0.97-1.5]). CONCLUSIONS Special efforts to promote influenza vaccination among rural, predominantly black students were associated with increased vaccination coverage. The school-based influenza vaccination intervention was associated with the highest levels of vaccination coverage. This study revealed the efficacy of school-based influenza education to improve vaccination rates among adolescents.
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Affiliation(s)
| | | | - Jessica M. Sales
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Julia E. Painter
- School of Medicine and ,Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Christopher Morfaw
- Department of Community Health, East Central Health District, Augusta, Georgia; and
| | - LaDawna M. Jones
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Paul Weiss
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - James W. Buehler
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Dennis L. Murray
- Department of Pediatrics, Medical College of Georgia, Augusta, Georgia
| | - Gina M. Wingood
- Rollins School of Public Health, Emory University, Atlanta, Georgia
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Painter JE, Gargano LM, Sales JM, Morfaw C, Jones LM, Murray D, DiClemente RJ, Hughes JM. Correlates of 2009 H1N1 influenza vaccine acceptability among parents and their adolescent children. HEALTH EDUCATION RESEARCH 2011; 26:751-760. [PMID: 21536717 PMCID: PMC3202907 DOI: 10.1093/her/cyr025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Accepted: 03/15/2011] [Indexed: 05/30/2023]
Abstract
School-aged children were a priority group for receipt of the pandemic (2009) H1N1 influenza vaccine. Both parental and adolescent attitudes likely influence vaccination behaviors. Data were collected from surveys distributed to middle- and high-school students and their parents in two counties in rural Georgia. Multivariable logistic regression analyses were conducted to assess correlates of parental acceptance of H1N1 influenza vaccination for their children and adolescents' acceptance of vaccination for themselves. Concordance analyses were conducted to assess agreement between parent-adolescent dyads regarding H1N1 influenza vaccine acceptance. Parental acceptance of H1N1 influenza vaccination for their children was associated with acceptance of the vaccine for themselves and feeling motivated by the H1N1 influenza pandemic to get a seasonal influenza vaccine for their child. Adolescents' acceptance was associated with receipt of a seasonal influenza vaccine in the past year, fear of getting H1N1 influenza, feeling comfortable getting the vaccine and parental acceptance of H1N1 influenza vaccine. Half (50%) of parent-adolescent pairs included both a parent and child who expressed H1N1 influenza vaccine acceptance, and 19% of pairs would not accept the vaccine. This research highlights the need for interventions that target factors associated with H1N1 influenza vaccine acceptance among both parents and adolescents.
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Affiliation(s)
- Julia E Painter
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road, Room 558, Atlanta, GA 30322, USA.
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Gargano LM, Painter JE, Sales JM, Morfaw C, Jones LM, Weiss P, Murray D, DiClemente RJ, Hughes JM. Correlates of 2009 pandemic H1N1 influenza vaccine acceptance among middle and high school teachers in rural Georgia. THE JOURNAL OF SCHOOL HEALTH 2011; 81:297-303. [PMID: 21592124 DOI: 10.1111/j.1746-1561.2011.00594.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Teachers play an essential role in the school community, and H1N1 vaccination of teachers is critical to protect not only themselves but also adolescents they come in contact within the classroom through herd immunity. School-aged children have a greater risk of developing H1N1 disease than seasonal influenza. The goal of this study was to assess the relationship between attitudes toward H1N1 vaccination and vaccine acceptance among middle and high school teachers in rural Georgia. METHODS Participants were recruited from 2 counties participating in a school-based influenza vaccination intervention in rural Georgia. Data were collected from surveys distributed to middle and high school teachers in participating counties in September 2009 prior to implementing the interventions to increase vaccination against seasonal influenza. Multivariate logistic regression was used to assess the association between teachers' attitudes toward H1N1 vaccination and H1N1 vaccine acceptance, controlling for demographic variables. RESULTS Among participants, 52.9% indicated that they would get the H1N1 vaccine. In multivariate analyses, H1N1 vaccine acceptance was associated with male gender (odds ratio[OR] = 3.67, p = .016), fear of contracting H1N1 (OR = 3.18, p = .025), and receipt of a seasonal influenza vaccine in the past year (OR = 3.07, p = .031). H1N1 vaccine acceptance was not significantly associated with age, race, perceived severity of H1N1, belief that the H1N1 vaccine would cause illness, or talking about H1N1 with friends. CONCLUSIONS Teachers may play a pivotal role in school-based H1N1 vaccinations. Understanding and addressing teachers' attitudes toward H1N1 vaccination may assist in future immunization efforts.
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Affiliation(s)
- Lisa M Gargano
- Emory University, 1462 Clifton Road, Atlanta, GA 30322, USA.
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