title: Homeschooling parents' practices and beliefs about childhood immunizations.
abstract: OBJECTIVE
  Concern over the rise of vaccine preventable diseases (VPD) coupled with the increasing popularity of homeschooling makes understanding the attitudes and behaviors of homeschoolers regarding immunizations a critical area of investigation. This study was a pilot to investigate the immunization attitudes of homeschooling parents and the vaccination status of their children.
  
  
  METHODS
  In the spring of 2010, online surveys were sent to a convenience sample of 707 homeschooling parents in Western Pennsylvania with children ages 0-18 years of age. Information was collected on demographic characteristics, vaccination status of children, and attitudes toward vaccination.
  
  
  RESULTS
  Surveys were returned by 18 percent of respondents, representing 396 homeschooled children. Demographic characteristics mirrored national homeschooling trends. The majority (95%) surveyed felt that education about vaccines was important. Thirty-eight percent of families had fully vaccinated children while 56% reported partial vaccination and 6% said children had received no vaccines. Respondents who fully vaccinated their children were more likely to agree that vaccinating according to the American Academy of Pediatrics was a good idea (OR: 4.8 [95% CI: 2.0-11.7]) and were more likely to comply with the recommendations of their health care provider (OR: 8.3 [95% CI: 3.6-19.1]). Respondents who vaccinated their children were more likely to believe that vaccines are safe (OR: 7.6 [95% CI: 1.0-56.2]). Beliefs about autism, thimerosal and learning disabilities did not vary significantly with vaccination status in regression analysis.
  
  
  CONCLUSIONS
  While specific factors influencing vaccination practices were not identified, this study demonstrated that recommendations of physicians and the AAP do not significantly influence homeschooling vaccination practices in the pilot population. Given the results of this pilot study, more research is called for, particularly a larger study with public school controls.
authors.affiliation: Department of General Pediatrics, Division of Pediatric Emergency Medicine, Pittsburgh, PA, United States. Elizabeth.thorpe@chp.edu
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Thorpe
authors.forename: Richard K
authors.initials: RK
authors.lastname: Zimmerman
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Steinhart
authors.forename: Kathleen N
authors.initials: KN
authors.lastname: Lewis
authors.forename: Marian G
authors.initials: MG
authors.lastname: Michaels
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004493:Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007114:Immunization / Q000523:psychology* / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D010290:Parents; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010414:Pennsylvania; D011795:Surveys and Questionnaires