title: Barriers to immunizations: Multiethnic parents of under- and unimmunized children speak.
abstract: OBJECTIVE
  Childhood immunizations are one of the greatest pubic health success stories. Despite the fact that many children receive immunizations according to the recommended schedule, there are many that lag behind. The purpose of this study was to explore the barriers to immunizations in parents whose children are not fully immunized by age 2.
  
  
  METHODS
  Thirteen focus groups, on four different islands (Oahu, Kauai, Maui, Hawaii) were held with a total of 64 parents. Verbatim transcripts were utilized for content analysis.
  
  
  CONCLUSIONS
  Five core themes emerged as barriers to childhood immunizations, parental, transportation, financial, child, and organization. The majority of responses were in the parental core theme, which included the sub-themes of issues, beliefs, knowledge, and fears.
  
  
  CONCLUSIONS
  Recommendations included identification of specific barriers to target immunization interventions strategies, public policy changes, identification and case management of high risk families, and minimization of organizational barriers.
authors.affiliation: School of Nursing and Dental Hygiene, University of Hawaii and Manoa, Honolulu, Hawaii 96822, USA. niederha@hawaii.edu
authors.forename: Victoria P
authors.initials: VP
authors.lastname: Niederhauser
authors.forename: Malama
authors.initials: M
authors.lastname: Markowitz
mesh_terms: D002648:Child; D002675:Child, Preschool; D018864:Cultural Diversity; D005239:Fear; D005260:Female; D017144:Focus Groups; D006254:Hawaii; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007115:Immunization Schedule; D008297:Male; D008489:Medical Indigency; D020380:Needs Assessment; D015404:Nursing Methodology Research; D033282:Parental Consent / Q000523:psychology; D010290:Parents / Q000193:education / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D014186:Transportation; D014611:Vaccination / Q000009:adverse effects / Q000523:psychology* / Q000706:statistics & numerical data