title: Parents' experiences discussing pediatric vaccination with healthcare providers: a survey of Canadian naturopathic patients.
abstract: BACKGROUND
  Parents who choose to selectively vaccinate or avoid vaccination for their children may do so at risk of compromising relations with their family physician or pediatrician. Groups that are associated with reduced rates of pedicatic vaccination, such as parents who access naturopathic care, may be particularly vulnerable to this issue.
  
  
  RESULTS
  In March through September 2010, we administered a 26-item cross-sectional survey to 129 adult patients, all of whom were parents with children ≤ 16 years of age, presenting for naturopathic care in Ontario, Canada. Ninety-five parents completed the survey (response rate 74%), and only 50.5% (48 of 95) reported that their children had received all recommended vaccines. Most parents (50.5%; 48 of 95) reported feeling pressure to vaccinate from their allopathic physician and, of those who discussed vaccination with their physician, 25.9% (21 of 81) were less comfortable continuing care as a result. Five percent (4 of 81) of respondents were advised by their physician that their children would be refused care if they decided against vaccination. In our adjusted generalized linear model, feeling pressure to vaccinate (odds ratio [OR] = 3.07; 95% confidence interval [CI] = 1.14 to 8.26) or endorsing a naturopathic physician as their most trusted source of information regarding vaccination (OR = 3.57; 95% CI = 1.22 to 10.44) were associated with greater odds of having a partially vaccinated or unvaccinated child. The majority (69.6%; 32 of 46) of parent's with partially vaccinated or unvaccinated children reported a willingness to re-consider this decision.
  
  
  CONCLUSIONS
  Use of naturopathic care should be explored among parents in order to identify this high-risk group and engage them in discussion regarding pediatric vaccination to encourage evidence-based, shared decision making. Physicians should ensure that discussions regarding vaccination are respectful, even if parents are determined not to vaccinate their children.
authors.affiliation: Institute for Work & Health, Toronto, Ontario, Canada. jbusse@iwh.on.ca
authors.forename: Jason W
authors.initials: JW
authors.lastname: Busse
authors.forename: Rishma
authors.initials: R
authors.lastname: Walji
authors.forename: Kumanan
authors.initials: K
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007114:Immunization; D007223:Infant; D009324:Naturopathy; D010290:Parents / Q000523:psychology*; D011368:Professional-Family Relations; D011795:Surveys and Questionnaires