title: Exploring childhood immunization uptake with First Nations mothers in north-western Ontario, Canada.
abstract: BACKGROUND
  Childhood immunization is an important component of preventive health care for young children. Successful control of vaccine-preventable diseases depends on high levels of immunization coverage. Immunization statistics show that on-reserve First Nations (Native Indian) children have lower vaccination coverage than children in the general Canadian population. There has been little research, however, conducted with First Nations populations on this topic.
  
  
  OBJECTIVE
  This study explored First Nations parents' beliefs about childhood immunizations and examined factors influencing immunization uptake.
  
  
  METHODS
  This study used a qualitative descriptive design to explore the issue of childhood immunization uptake. Twenty-eight mothers from two First Nations communities in north-western Ontario, Canada, were interviewed about their perceptions of childhood immunizations and vaccine-preventable diseases. The interviews were transcribed and content analysis was used to examine the data.
  
  
  RESULTS
  Data analysis revealed the following six themes: (1) the fear of disease; (2) the efficacy of immunizations; (3) the immunization experience; (4) the consequences of immunization; (5) interactions with health professionals; and (6) barriers to immunizations. Participants were motivated to seek immunizations for their children by a fear of vaccine preventable diseases. A small proportion of mothers, however, questioned the effectiveness of vaccines in preventing disease. Traumatic immunization experiences, vaccine side-effects and sequelae, negative interactions with health professionals, and barriers such as time constraints and childhood illnesses all served as deterrents to immunization.
  
  
  CONCLUSIONS
  The research outcomes highlight the varied beliefs of First Nations parents about childhood immunizations and the numerous factors that both positively and negatively influence immunization uptake. Further research is needed to explore the issue of childhood immunizations in First Nations communities and to determine strategies to improve uptake.
authors.affiliation: Department of Nursing Studies, Faculty of Medicine, University of Hong Kong, Hong Kong, China. tarrantm@hkucc.hku.hk
authors.forename: Marie
authors.initials: M
authors.lastname: Tarrant
authors.forename: David
authors.initials: D
authors.lastname: Gregory
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data; D002669:Child Welfare; D002675:Child, Preschool; D005239:Fear; D005260:Female; D006801:Humans; D007114:Immunization / Q000523:psychology / Q000706:statistics & numerical data*; D007198:Indians, North American / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D008425:Maternal Behavior / Q000523:psychology; D009035:Mothers / Q000523:psychology*; D009864:Ontario / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D011369:Professional-Patient Relations; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists