Parental Barriers to Childhood Immunizations
Childhood immunization is one of the most successful primary preventive services, resulting in a 98-100% decrease in morbidity for most childhood vaccine-preventable diseases. Childhood immunization coverage levels are at all time highs; however, there is a growing trend toward parental refusal of vaccines through personal beliefs exemptions (PBEs) resulting in multiple vaccine-preventable disease outbreaks. From 1978 to 2013, overall California PBE rates for children entering kindergarten have increased, on average, by almost 87%. During the same time period, San Diego County PBE rates were consistently, at least 20% above state averages. Moreover, research contributing to examination of influential factors to childhood immunization uptake is paramount to the continued control and eradication of childhood vaccine-preventable diseases. When health care providers and health policy experts develop childhood vaccine education materials and immunization laws they need to obtain sound knowledge of the populations they serve. The purpose of this descriptive, cross-sectional correlational survey design study is to investigate multiple factors that influence parents’ childhood vaccination decisions.
Conceptual Basis/Aims
The social-ecological model (SEM) will guide the study. The SEM describes multiple levels of factors, i.e., intrapersonal, interpersonal, institutional, community and policy, influencing parental barriers and uptake of childhood immunizations. The study has two specific aims: 1) to describe parental barriers to childhood immunizations, and 2) to describe the relationships among parental barriers, demographic, and socio-ecological factors, parental health literacy, child’s immunization status, and parent’s intent to immunize.
Methods
The study will use a descriptive, cross-sectional correlational survey design using anonymous, postal service or Internet delivered standardized instruments, and a socio-demographic survey. Study participants will be parents with children birth to 6 years of age, living in San Diego County, California with the ability to read and write English and Spanish presenting to a pediatric, family practice or community health clinic for a well child visit. Participants will be recruited using advertisements via pre-survey postcards, flyers, posters, emails, and clinic newsletters. Based on a power analysis, the sample size was set at 220 study participants.
Pending Results
Descriptive and inferential statistics will be used to analyze the results. Bivariate and multiple regression analysis will be used to determine relationships between the Searching for Hardships and Obstacles To Shots (SHOTS) instrument’s three subscale scores and total SHOTS score, the Parental Health Literacy and Activities Test (PHLAT-8) scores, demographic factors, and socio-ecological factors.
Implications
The results are pending. The results of this study will enhance existing knowledge regarding barriers to childhood immunization allowing health care professionals and health policy makers to develop and tailor educational information and to inform the development of immunization policies.