title: Chinese immigrant parents' vaccination decision making for children: a qualitative analysis.
abstract: BACKGROUND
  While immunization coverage rates for childhood routine vaccines in Hong Kong are almost 100%, the uptake rates of optional vaccines remain suboptimal. Understanding parental decision-making for children's vaccination is important, particularly among minority groups who are most vulnerable and underserved. This study explored how a subsample of new immigrant mothers from mainland China, a rapidly-growing subpopulation in Hong Kong, made decisions on various childhood and adolescent vaccines for their offspring, and identified key influences affecting their decision making.
  
  
  METHODS
  Semi-structured in-depth interviews were conducted with 23 Chinese new immigrant mothers recruited by purposive sampling. All interviews were audio-taped, transcribed and analyzed using a Grounded Theory approach.
  
  
  RESULTS
  Participants' conversation revealed five underlying themes which influenced parents' vaccination decision-making: (1) Institutional factors, (2) Insufficient vaccination knowledge and advice, (3) Affective impacts on motivation, (4) Vaccination barriers, and (5) Social influences. The role of social norms appeared overwhelmingly salient influencing parents' vaccination decision making. Institutional factors shaped parent's perceptions of vaccination necessity. Fear of vaccine-targeted diseases was a key motivating factor for parents adopting vaccination. Insufficient knowledge about vaccines and targeted diseases, lack of advice from health professionals and, if provided, suspicions regarding the motivations for such advice were common issues. Vaccination cost was a major barrier for many new immigrant parents.
  
  
  CONCLUSIONS
  Social norms play a key role influencing parental vaccination decision-making. Insight gained from this study will help inform healthcare providers in vaccination communication and policymakers in future vaccination programme.
authors: Linda D L
authors: LD
authors: Wang
authors: Health Behaviour Research Group, Division of Behavioural Health, School of Public Health, The University of Hong Kong, 5/F William Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong. wwtlam@hku.hk.
authors: Wendy W T
authors: WW
authors: Lam
authors: Joseph T
authors: JT
authors: Wu
authors: Qiuyan
authors: Q
authors: Liao
authors: Richard
authors: R
authors: Fielding
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002651:Child Advocacy / Q000706:statistics & numerical data*; D002681:China / Q000208:ethnology; D003657:Decision Making; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology; D006723:Hong Kong; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data; D009035:Mothers / Q000523:psychology*; D053918:Papillomavirus Vaccines / Q000627:therapeutic use; D066262:Social Norms; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data*
chemical_list: D053918:Papillomavirus Vaccines