title: Validity and reliability of a survey to identify vaccine-hesitant parents.
abstract: OBJECTIVE
  To assess the construct validity and reliability of the Parent Attitudes about Childhood Vaccines survey.
  
  
  METHODS
  Cross-sectional survey of parents of 19-35 month old children in a closed model HMO. We used factor analysis to confirm survey sub-domains and Cronbach's α to determine the internal consistency reliability of sub-domain scales. Construct validity was assessed by linking parental responses to their child's immunization record.
  
  
  RESULTS
  Our response rate was 46% (N=230). Factor analysis identified 3 factors that explained 70% of the total variance for the 18 survey items. We deleted 3 items that failed to load highly (>.4) on an identified factor, correlated poorly with other items, or had a hesitant response that was not associated with increased under-immunization. Cronbach's α coefficients for the 3 sub-domain scales created by grouping the remaining 15 items were .74, .84, and .74, respectively. Children of parents with survey scores of 50-79 had 14% more days under-immunized from birth to 19 months (95% CI: 8.0, 20.5) than those with parents who scored <50. Scores of ≥ 80 were associated with 51% more days under-immunized (95% CI: 38.2, 63.4).
  
  
  CONCLUSIONS
  The revised survey is a valid and reliable instrument to identify vaccine-hesitant parents.
authors.affiliation: Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States. djopel@u.washington.edu
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Opel
authors.forename: James A
authors.initials: JA
authors.lastname: Taylor
authors.forename: Rita
authors.initials: R
authors.lastname: Mangione-Smith
authors.forename: Cam
authors.initials: C
authors.lastname: Solomon
authors.forename: Chuan
authors.initials: C
authors.lastname: Zhao
authors.forename: Sheryl
authors.initials: S
authors.lastname: Catz
authors.forename: Diane
authors.initials: D
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D014611:Vaccination / Q000706:statistics & numerical data*; D014612:Vaccines / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D014612:Vaccines