title: School-located immunization programs: do parental preferences predict behavior?
abstract: BACKGROUND
  Little is known about parental attitudes regarding school-located immunization programs and their effect on program participation behaviors.
  
  
  OBJECTIVE
  To determine the relationship between attitudes of middle school parents regarding school-located immunization programs and subsequent consent behaviors when such a program becomes available.
  
  
  METHODS
  Primarily Hispanic, middle school parents completed questionnaires about school-located immunization programs. After questionnaire collection, immunization consent/refusal packets (English/Spanish) for a program providing Tdap and MCV4 vaccines were distributed at five Houston middle schools in low-income, urban areas. Responses regarding demographics, enrollment in a medical home, immunization location preferences, and knowledge of immunization recommendations were analyzed from questionnaires returned by those who later returned consent or refusal forms for school-located program participation. Frequency and chi square statistics were calculated using SPSS 18.0.
  
  
  RESULTS
  Of 475 parents who completed the questionnaire and later sent a consent or refusal form, 289 (61%) consented to ≥1 vaccines for their child. Among those who consented: 71% were enrolled in a medical home; 42% had previously indicated that they did NOT prefer school as an immunization location; 32% had stated that they wanted to be present for their child's shots. Of those who sent refusal forms indicating they would access the vaccines from their own providers, 70% stated they wanted to be present for their child's vaccination.
  
  
  CONCLUSIONS
  A significant proportion of Hispanic, low-income middle school parents participating in a school-located immunization program had previously indicated that schools were not a preferred immunization site. Despite the availability of a medical home, a lack of preference for schools as a site, and the desire to be present during their child's injections when asked prior to program availability, these parents participated in the program when it was made available. Preferences noted in pre-program questionnaires may not predict parental consent behaviors for school-located immunizations.
authors.affiliation: Adolescent Medicine and Sports Medicine Section, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA. amym@bcm.edu
authors.forename: Amy B
authors.initials: AB
authors.lastname: Middleman
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Tung
mesh_terms: D000293:Adolescent; D002648:Child; D006630:Hispanic or Latino; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D033282:Parental Consent / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D012572:School Health Services / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013781:Texas; D014611:Vaccination / Q000706:statistics & numerical data