Research article
Parent Attitudes Toward Immunizations and Healthcare Providers: The Role of Information

https://doi.org/10.1016/j.amepre.2005.04.010Get rights and content

Background

Lack of information has been associated with patient anxiety or concern in a number of healthcare areas.

Objectives

(1) Identify the proportion of parents who agreed, were neutral, and disagreed that they had access to enough information to make a decision about immunizing their child; (2) examine how parents who agreed and disagreed differed with respect to sociodemographic characteristics, and their attitudes about immunizations, their child’s healthcare provider, immunization requirements/exemptions, and immunization policymakers; and (3) identify if differences exist in specific immunization concerns.

Methods

A sample of parents with at least one child aged ≤6 years (n=642) was analyzed using data from the HealthStyles survey conducted during July and August 2003. Odds ratios and the Mantel-Haenszel chi-square test were used for analysis.

Results

Response rate for HealthStyles was 69% (4035/5845). The largest proportion of parents agreed they had access to enough information (67%) compared to parents who were neutral (20%) or who disagreed (13%). Compared to parents who agreed, parents who disagreed were more likely to be less confident in the safety of childhood vaccines (odds ratio [OR]=5.4, 95% confidence interval [CI]=3.3–8.9), and to disagree that their child’s main healthcare provider is easy to talk to (OR=10.3, 95% CI=3.7–28.1). There was a significant linear trend in the percentage of parents expressing immunization concerns among those who agreed, were neutral, and who disagreed they had access to enough information (p<0.05; df=1).

Conclusions

While most parents agreed that they had access to enough immunization information, approximately a third did not. Perceived lack of information was associated with negative attitudes about immunizations and toward healthcare providers. Basic information about the benefits and risks of vaccines presented by a trusted provider could go a long way toward maintaining and/or improving confidence in the immunization process.

Introduction

We have entered a new era of immunizations in the United States. Most parents have little or no firsthand knowledge of the diseases that childhood vaccines prevent and many physicians have not cared for children with vaccine-preventable diseases. Moreover, because of high immunization coverage and an expanded childhood immunization schedule, reports of post-immunization adverse events, both vaccine related and coincidental, have increased 46% for children aged ≤6 years of age from 1991 to 2001 (Centers for Disease Control and Prevention [CDC], unpublished data, 2005). This has contributed to an increased focus on vaccine safety.1

Associated with the decline in disease prevalence is an increase in the visibility and perhaps number of advocacy groups that question the safety of vaccines. The internet has helped to promote the messages of these groups. In assessing the likelihood of finding an antivaccination site on the internet, Davies et al.2 found that of 100 sites that carried vaccination messages, 43% were antivaccination, as defined by emphasizing the dangers of vaccination or encouraging vaccination refusal. Concurrently, there has been a changing culture of physician-patient interaction wherein most people want to be informed about their illnesses.3 Providing information has been shown to be one factor in positively influencing a sense of control in patients with rheumatoid arthritis,4 while conversely, lack of information in patients with cancer may cause anxiety and negative treatment outcomes.5

Because of the above factors associated with this new era, healthcare providers need to understand if patients or their parents are satisfied with the immunization information they receive. The purpose of this study was to (1) identify the proportion of parents who agreed, were neutral, and disagreed that they had access to enough immunization information to make a decision about immunizing their child; (2) examine how parents who agreed and parents who disagreed that they had access to enough information differed regarding sociodemographic characteristics, and their attitudes about immunizations, their child’s healthcare provider, immunization requirements/exemptions, and immunization policymakers; and (3) identify whether differences existed among parents who agreed, were neutral, and who disagreed that they had access to enough information regarding their specific immunization concerns.

Section snippets

Surveys

Data are based on responses to questions administered through the 2003 HealthStyles mail survey. HealthStyles has been administered every year since 1995 by Porter Novelli, a public relations firm, as a follow-up survey to consumer mail panel surveys (e.g., ConsumerStyles), and takes place during July and August.6 The ConsumerStyles survey covers a wide variety of consumer behaviors including shopping habits, media choices, and general health attitudes, while the HealthStyles survey supplements

Response Rate

The response rate for the 2003 ConsumerStyles survey was 59% (5873/10,000), and for the 2003 HealthStyles survey was 69% (4035/5845) (Figure 1). The smaller denominator for the HealthStyles survey was caused by attrition (e.g., some respondents were lost because they moved between surveys). Parents who had at least one child aged ≤6 years numbered 642 (weighted) (15.9% of sample).

Parents and Perceived Access to Enough Immunization Information

Responses to the question of interest, “I have access to all the information I need to make good decisions about

Discussion

This study found that 67% of parents agreed that they had access to enough information to make a good decision about immunizing their children. However, this study also found that 33% of parents disagreed or were neutral. As the findings repeatedly illustrated, a number of important and significant differences existed between parents who believed that they had access to enough information to make a good decision about immunizing their children and parents who did not.

These differences in

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