A Mixed Methods Study of Parental Vaccine Decision Making and Parent–Provider Trust

Abstract Objective To describe parental vaccine decision making behaviors and characterize trust in physician advice among parents with varying childhood vaccination behaviors. Methods Between 2008 and 2011, a mixed methods study was conducted with parents of children aged <4 years who were membe...

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Published inAcademic pediatrics Vol. 13; no. 5; pp. 481 - 488
Main Authors Glanz, Jason M., PhD, Wagner, Nicole M., MPH, Narwaney, Komal J., PhD, Shoup, Jo Ann, MS, MSW, McClure, David L., PhD, McCormick, Emily V., MPH, Daley, Matthew F., MD
Format Journal Article
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Published United States Elsevier Inc 01.09.2013
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Abstract Abstract Objective To describe parental vaccine decision making behaviors and characterize trust in physician advice among parents with varying childhood vaccination behaviors. Methods Between 2008 and 2011, a mixed methods study was conducted with parents of children aged <4 years who were members of Kaiser Permanente Colorado health plan. Seven focus groups were conducted with vaccine-hesitant parents. On the basis of findings from the focus groups, a survey was developed, pilot tested, and mailed to a stratified sample of 854 parents who accepted (n = 500), delayed (n = 227), or refused (n = 127) vaccinations for one of their children. Survey results were analyzed by chi-square tests and multivariable logistic regression. Results Several themes emerged from the focus groups, including: 1) the vaccine decision-making process begins prenatally, 2) vaccine decision making is an evolving process, and 3) there is overall trust in the pediatrician but a lack of trust in the information they provided about vaccines. The survey response rate was 52% (n = 443). Parents who refused or delayed vaccines were 2 times more likely to report that they began thinking about vaccines before their child was born and 8 times more likely to report that they constantly reevaluate their vaccine decisions than parents who accepted all vaccines. Although parents tended to report trusting their pediatrician's advice on nutrition, behavior, and the physical examination, they did not believe their pediatrician provided “balanced” information on both the benefits and risks of vaccination. Conclusions These results have implications for future interventions to address parental vaccination concerns. Such interventions may be more effective if they are applied early (during pregnancy) and often (pregnancy through infancy), and cover both the risks and benefits of vaccination.
AbstractList To describe parental vaccine decision making behaviors and characterize trust in physician advice among parents with varying childhood vaccination behaviors. Between 2008 and 2011, a mixed methods study was conducted with parents of children aged <4 years who were members of Kaiser Permanente Colorado health plan. Seven focus groups were conducted with vaccine-hesitant parents. On the basis of findings from the focus groups, a survey was developed, pilot tested, and mailed to a stratified sample of 854 parents who accepted (n = 500), delayed (n = 227), or refused (n = 127) vaccinations for one of their children. Survey results were analyzed by chi-square tests and multivariable logistic regression. Several themes emerged from the focus groups, including: 1) the vaccine decision-making process begins prenatally, 2) vaccine decision making is an evolving process, and 3) there is overall trust in the pediatrician but a lack of trust in the information they provided about vaccines. The survey response rate was 52% (n = 443). Parents who refused or delayed vaccines were 2 times more likely to report that they began thinking about vaccines before their child was born and 8 times more likely to report that they constantly reevaluate their vaccine decisions than parents who accepted all vaccines. Although parents tended to report trusting their pediatrician's advice on nutrition, behavior, and the physical examination, they did not believe their pediatrician provided “balanced” information on both the benefits and risks of vaccination. These results have implications for future interventions to address parental vaccination concerns. Such interventions may be more effective if they are applied early (during pregnancy) and often (pregnancy through infancy), and cover both the risks and benefits of vaccination.
Abstract Objective To describe parental vaccine decision making behaviors and characterize trust in physician advice among parents with varying childhood vaccination behaviors. Methods Between 2008 and 2011, a mixed methods study was conducted with parents of children aged <4 years who were members of Kaiser Permanente Colorado health plan. Seven focus groups were conducted with vaccine-hesitant parents. On the basis of findings from the focus groups, a survey was developed, pilot tested, and mailed to a stratified sample of 854 parents who accepted (n = 500), delayed (n = 227), or refused (n = 127) vaccinations for one of their children. Survey results were analyzed by chi-square tests and multivariable logistic regression. Results Several themes emerged from the focus groups, including: 1) the vaccine decision-making process begins prenatally, 2) vaccine decision making is an evolving process, and 3) there is overall trust in the pediatrician but a lack of trust in the information they provided about vaccines. The survey response rate was 52% (n = 443). Parents who refused or delayed vaccines were 2 times more likely to report that they began thinking about vaccines before their child was born and 8 times more likely to report that they constantly reevaluate their vaccine decisions than parents who accepted all vaccines. Although parents tended to report trusting their pediatrician's advice on nutrition, behavior, and the physical examination, they did not believe their pediatrician provided “balanced” information on both the benefits and risks of vaccination. Conclusions These results have implications for future interventions to address parental vaccination concerns. Such interventions may be more effective if they are applied early (during pregnancy) and often (pregnancy through infancy), and cover both the risks and benefits of vaccination.
OBJECTIVETo describe parental vaccine decision making behaviors and characterize trust in physician advice among parents with varying childhood vaccination behaviors. METHODSBetween 2008 and 2011, a mixed methods study was conducted with parents of children aged <4 years who were members of Kaiser Permanente Colorado health plan. Seven focus groups were conducted with vaccine-hesitant parents. On the basis of findings from the focus groups, a survey was developed, pilot tested, and mailed to a stratified sample of 854 parents who accepted (n = 500), delayed (n = 227), or refused (n = 127) vaccinations for one of their children. Survey results were analyzed by chi-square tests and multivariable logistic regression. RESULTSSeveral themes emerged from the focus groups, including: 1) the vaccine decision-making process begins prenatally, 2) vaccine decision making is an evolving process, and 3) there is overall trust in the pediatrician but a lack of trust in the information they provided about vaccines. The survey response rate was 52% (n = 443). Parents who refused or delayed vaccines were 2 times more likely to report that they began thinking about vaccines before their child was born and 8 times more likely to report that they constantly reevaluate their vaccine decisions than parents who accepted all vaccines. Although parents tended to report trusting their pediatrician's advice on nutrition, behavior, and the physical examination, they did not believe their pediatrician provided "balanced" information on both the benefits and risks of vaccination. CONCLUSIONSThese results have implications for future interventions to address parental vaccination concerns. Such interventions may be more effective if they are applied early (during pregnancy) and often (pregnancy through infancy), and cover both the risks and benefits of vaccination.
To describe parental vaccine decision making behaviors and characterize trust in physician advice among parents with varying childhood vaccination behaviors. Between 2008 and 2011, a mixed methods study was conducted with parents of children aged <4 years who were members of Kaiser Permanente Colorado health plan. Seven focus groups were conducted with vaccine-hesitant parents. On the basis of findings from the focus groups, a survey was developed, pilot tested, and mailed to a stratified sample of 854 parents who accepted (n = 500), delayed (n = 227), or refused (n = 127) vaccinations for one of their children. Survey results were analyzed by chi-square tests and multivariable logistic regression. Several themes emerged from the focus groups, including: 1) the vaccine decision-making process begins prenatally, 2) vaccine decision making is an evolving process, and 3) there is overall trust in the pediatrician but a lack of trust in the information they provided about vaccines. The survey response rate was 52% (n = 443). Parents who refused or delayed vaccines were 2 times more likely to report that they began thinking about vaccines before their child was born and 8 times more likely to report that they constantly reevaluate their vaccine decisions than parents who accepted all vaccines. Although parents tended to report trusting their pediatrician's advice on nutrition, behavior, and the physical examination, they did not believe their pediatrician provided "balanced" information on both the benefits and risks of vaccination. These results have implications for future interventions to address parental vaccination concerns. Such interventions may be more effective if they are applied early (during pregnancy) and often (pregnancy through infancy), and cover both the risks and benefits of vaccination.
Author Glanz, Jason M., PhD
Shoup, Jo Ann, MS, MSW
Wagner, Nicole M., MPH
Daley, Matthew F., MD
Narwaney, Komal J., PhD
McClure, David L., PhD
McCormick, Emily V., MPH
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2013 Academic Pediatric Association
Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
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Issue 5
Keywords vaccine refusal
vaccine decision making
mixed methods
immunization
Language English
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Snippet Abstract Objective To describe parental vaccine decision making behaviors and characterize trust in physician advice among parents with varying childhood...
To describe parental vaccine decision making behaviors and characterize trust in physician advice among parents with varying childhood vaccination behaviors....
OBJECTIVETo describe parental vaccine decision making behaviors and characterize trust in physician advice among parents with varying childhood vaccination...
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StartPage 481
SubjectTerms Child, Preschool
Decision Making
Female
Focus Groups
Humans
immunization
Infant
Logistic Models
Male
mixed methods
Multivariate Analysis
Neonatal and Perinatal Medicine
Parents - psychology
Pediatrics
Professional-Family Relations
Treatment Refusal - psychology
Trust - psychology
Vaccination - psychology
vaccine decision making
vaccine refusal
Title A Mixed Methods Study of Parental Vaccine Decision Making and Parent–Provider Trust
URI https://www.clinicalkey.es/playcontent/1-s2.0-S1876285913001563
https://dx.doi.org/10.1016/j.acap.2013.05.030
https://www.ncbi.nlm.nih.gov/pubmed/24011751
https://search.proquest.com/docview/1431294510
https://pubmed.ncbi.nlm.nih.gov/PMC3767928
Volume 13
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