title: Influenza among healthy young children: changes in parental attitudes and predictors of immunization during the 2003 to 2004 influenza season.
abstract: BACKGROUND
  In Colorado, the 2003 to 2004 influenza season was unusually early and severe and received substantial media attention.
  
  
  OBJECTIVE
  Among parents of healthy young children, to determine how parental knowledge and attitudes regarding influenza infection and immunization changed during the 2003 to 2004 influenza season and to identify factors predictive of influenza immunization.
  
  
  METHODS
  The study was conducted in 5 metropolitan Denver pediatric practices. A total of 839 healthy children age 6 to 21 months and their parents were randomly selected for participation. Parents were surveyed by telephone before (August 18 to October 7, 2003) and after (March 31 to June 10, 2004) the influenza season.
  
  
  RESULTS
  Among 828 eligible parents, 472 (57%) completed the preseason survey; 316 (67%) of these parents subsequently completed the postseason survey. All analyses were performed for the 316 subjects who completed both preseason and postseason surveys. Compared with their attitudes before the influenza season, 48% of parents interviewed after the season viewed their child as more susceptible to influenza, 58% viewed influenza infections as more severe, and 66% perceived fewer risks associated with influenza vaccine. Ninety-five percent of parents reported hearing in the media about Colorado's influenza outbreak, and having heard about the outbreak in the media was associated with viewing influenza infections as more severe. A total of 258 parents (82%) immunized their child against influenza. In multivariate analyses, positive predictors of immunization included a physician recommendation for immunization and a preseason to postseason increase in the perception that immunization was the social norm. Negative predictors of immunization included high perceived barriers to immunization, less parental education, and preseason intention not to immunize.
  
  
  CONCLUSIONS
  Parent attitudes about influenza infection and immunization changed substantially during the 2003 to 2004 influenza season, with changes favoring increased parental acceptance of influenza vaccination for young children. During an intensively publicized influenza outbreak, a physician recommendation of vaccination was an important predictor of influenza immunization.
authors.affiliation: Pediatrics, University of Colorado, Health Sciences Center, Denver, Colorado, USA. daley.matthew@tchden.org
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Daley
authors.forename: Lori A
authors.initials: LA
authors.lastname: Crane
authors.forename: Vijayalaxmi
authors.initials: V
authors.lastname: Chandramouli
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Beaty
authors.forename: Jennifer
authors.initials: J
authors.lastname: Barrow
authors.forename: Norma
authors.initials: N
authors.lastname: Allred
authors.forename: Stephen
authors.initials: S
authors.lastname: Berman
authors.forename: Allison
authors.initials: A
authors.lastname: Kempe
mesh_terms: D003120:Colorado / Q000453:epidemiology; D003625:Data Collection; D004196:Disease Outbreaks; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D010290:Parents / Q000523:psychology*; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data