title: Parent attitudes about adolescent school-located vaccination and billing.
abstract: OBJECTIVE
  School-located vaccination programs may need to bill health insurance to be sustainable. This mixed methods study assessed parent attitudes about school-located vaccination and billing.
  
  
  METHODS
  Seven public schools in Denver, Colorado, participated in a school-located adolescent vaccination program that billed students' insurance. From April through June 2010, a survey was administered to parents of 1,000 randomly selected sixth to eighth grade students in these schools. In March and April 2011, focus groups were conducted with a sample of parents of adolescents attending these schools to further explore and help explain patterns emergent in the survey data.
  
  
  RESULTS
  Survey response rate was 66%. Among survey respondents, 56% strongly supported and 29% somewhat supported school-located vaccination. Forty-two percent reported concern about receiving a bill if their child participated in a school-located vaccination program that billed insurance, and 23% did not want to provide insurance information to the school. Four focus groups were conducted with English-speaking (n = 17) and Spanish-speaking (n = 14) parents. Focus group participants indicated strong support for school-located vaccination, emphasizing the convenience of the program for both parents and adolescents. These parents also appreciated the affordability of the program and reported feeling comfortable with in-school vaccination delivery. Very few participants indicated concerns about providing health insurance information to the school, but some expressed concern about potential record scatter.
  
  
  CONCLUSIONS
  Although some parents expressed concerns about billing health insurance for school-located vaccination, most parents indicated strong support for school-located vaccination.
authors.affiliation: Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado; Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado; Colorado Health Outcomes Program, University of Colorado Denver, Aurora, Colorado.
authors.forename: Karen
authors.initials: K
authors.lastname: Albright
authors.affiliation: Department of Pediatrics, University of Colorado Denver, Aurora, Colorado; Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado. Electronic address: Matthew.F.Daley@kp.org.
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Daley
authors.affiliation: Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado; Colorado Health Outcomes Program, University of Colorado Denver, Aurora, Colorado; Department of Pediatrics, University of Colorado Denver, Aurora, Colorado.
authors.forename: Allison
authors.initials: A
authors.lastname: Kempe
authors.affiliation: Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pyrzanowski
authors.affiliation: Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Andrea
authors.initials: A
authors.lastname: Jimenez-Zambrano
authors.affiliation: Colorado Health Outcomes Program, University of Colorado Denver, Aurora, Colorado.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Campagna
authors.affiliation: Denver Public Health, Denver, Colorado; Department of Family Medicine, University of Colorado Denver, Aurora, Colorado.
authors.forename: Judith C
authors.initials: JC
authors.lastname: Shlay
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003120:Colorado; D005260:Female; D017144:Focus Groups; D006801:Humans; D017589:Immunization Programs / Q000191:economics / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D033282:Parental Consent; D010290:Parents; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012572:School Health Services / Q000191:economics / Q000458:organization & administration*; D014612:Vaccines / Q000008:administration & dosage* / Q000191:economics
chemical_list: D014612:Vaccines
keywords: Adolescent; Billing; Mixed methods; Parent attitudes; School-located vaccination; Vaccine