title: Rural parents' perspectives about information on child immunization.
abstract: BACKGROUND
  Historically, health professionals have used information developed for parents to promote child immunization. Few studies have specifically examined the effectiveness of this information in meeting parents' needs. While the literature emphasizes the importance of clear, thorough, and unbiased information about child immunization, limited attention has been given to what this means from a parent's perspective. The aim of this study was to gain insight in parents' information needs regarding child immunization in order to improve and/or optimize information shared by rural health professionals. We explored: (1) whether any immunization information contributed to parents' decisions; and, if so, how (2) what types of information and content parents required; (3) the sources of information parents considered helpful and trustworthy; and (4) parents' suggestions on how information could be conveyed to them more effectively.
  
  
  METHODS
  This was a descriptive qualitative study, using semi-structured interviews with legal-aged mothers responsible for decisions about immunizing their infant in the past year. The mothers were from the local rural communities south of Calgary, Alberta, Canada, within the boundaries of the Calgary Health Region. Public health nurses working in this area assisted with recruitment. Thirty-nine mothers expressed interest in the study. The investigator contacted respondents to answer questions they may have had as well as to gather more socio-demographic information. This assisted in drawing a sample that reflected a variety of ages, education levels, and decisions made about immunization. Interviews were conducted by the principal investigator. Data collection and analysis took place simultaneously. Data collection continued until saturation was reached. All three investigators were involved in data analysis and data interpretation to ensure quality of the results.
  
  
  RESULTS
  Eleven interviews were conducted. Participants were all mothers, most of whom lived in a stable relationship. Five mothers made the decision to fully immunize their child. The other mothers were varied in their decisions which included waiting to immunize the child until s/he was older, choosing vaccines selectively, being undecided about immunizing, and not immunizing. There were three mothers who had made a different decision about immunization with previous children. Three mothers were first-time parents. Five major themes were identified: (1) factors influencing mothers' decisions; (2) mothers' worries in making their decision; (3) mothers' perceptions about 'good' information; (4) mothers' information needs; and (5) mothers' recommendations to health professionals who convey immunization information to parents.
  
  
  CONCLUSIONS
  The study had some limitations. Only mothers responded to the request for participation and the geographical area of the study was limited to the rural area where those particular public health nurses worked. Participants provided insightful perspectives on the subject of information on child immunization and how that information is conveyed to them. Feedback from the nurses also indicated the results were useful and thought-provoking. Future research in this area, using larger and more diverse populations, would benefit health professionals developing and conveying immunization information to parents. Key words: Canada, decision-making, immunization, infancy and childhood, information needs.
authors.affiliation: Calgary Health Region (Claresholm Health Unit), Claresholm, Alberta, Canada. nancykay.miller@calgaryhealthregion.ca
authors.forename: Nancy Kay
authors.initials: NK
authors.lastname: Miller
authors.forename: Marja
authors.initials: M
authors.lastname: Verhoef
authors.forename: Kelly
authors.initials: K
authors.lastname: Cardwell
mesh_terms: D000328:Adult; D000416:Alberta; D001294:Attitude to Health; D002662:Child Health Services; D005260:Female; D006801:Humans; D007114:Immunization / Q000523:psychology*; D007223:Infant; D007407:Interviews as Topic; D009035:Mothers / Q000523:psychology*; D011637:Public Health Nursing; D019035:Rural Health Services; D012424:Rural Population