title: The role of attitudes about vaccine safety, efficacy, and value in explaining parents' reported vaccination behavior.
abstract: OBJECTIVE
  To explain vaccine confidence as it related to parents' decisions to vaccinate their children with recommended vaccines, and to develop a confidence measure to efficiently and effectively predict parents' self-reported vaccine behaviors.
  
  
  METHODS
  A sample of parents with at least one child younger than 6 years (n = 376) was analyzed using data from the HealthStyles 2010 survey. Questions were grouped into block variables to create three confidence constructs: value, safety, and efficacy. Regression equations controlling for demographic characteristics were used to identify the confidence construct(s) that best predicted parents' self-reported vaccination decisions (accept all, some, or none of the recommended childhood vaccines).
  
  
  RESULTS
  Among the three constructs evaluated, confidence in the value of vaccines, that is the belief that vaccines are important and vaccinating one's children is the right thing to do, was the best predictor of parents' vaccine decisions, F(2, 351) = 119.199, p < .001. When combined into a block variable for analysis, two survey items measuring confidence in the value of vaccines accounted for 40% of the variance in parents' self-reported vaccine decisions. Confidence in the safety or efficacy of vaccines failed to account for additional significant variance in parent-reported vaccination behavior.
  
  
  CONCLUSIONS
  Confidence in the value of vaccines is a helpful predictor of parent-reported vaccination behavior. Attitudinal constructs of confidence in the safety and efficacy of vaccines failed to account for additional significant variance in parents' vaccination behaviors. Future research should assess the role of vaccine knowledge and tangible barriers, such as access and cost, to further explain parents' vaccination behaviors.
authors.affiliation: 1Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Katherine Hart
authors.initials: KH
authors.lastname: Lavail
authors.forename: Allison Michelle
authors.initials: AM
authors.lastname: Kennedy
mesh_terms: D000328:Adult; D000368:Aged; D002675:Child, Preschool; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D061214:Patient Safety; D012959:Socioeconomic Factors; D014611:Vaccination / Q000523:psychology*; D014612:Vaccines / Q000008:administration & dosage / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D014612:Vaccines
keywords: vaccine confidence; vaccine efficacy; vaccine safety; value