title: The role of parental attitudes and provider discussions in uptake of adolescent vaccines.
abstract: The purpose of this study was to examine the relationship between parental vaccine attitudes, the number of specific vaccines discussed with a provider, and immunization outcomes including discussing immunization with their teen, knowledge of adolescent vaccine schedule, and their son or daughter being up-to-date on recommended vaccines using a nationally weight sample. Parents completed an internet-based survey between December 2012 and January 2013 and we computed a vaccine attitude scale (higher scores indicating stronger and more positive attitudes toward vaccination of teen) for each parent and categorized them into one of three groups: low (n=76), medium (n=207) or high (n=215). We also constructed a vaccine discussion scale representing the number of vaccines discussed with their adolescent's physician. Parents who were identified as having high vaccine attitudes were significantly more likely to report their physician talked with them about a particular vaccine. Using logistic regression and controlling for respondent's gender and age, income, and teen's gender, we found medium as compared to low-attitude parents had a 6.21 (95%CI=3.08, 12.51) greater odds of reporting that their teen had all recommended vaccines. Similarly, high as compared to low-attitude parents reported a 23.02 (95% CI=11.27, 46.99) greater odds of having a teen who was up-to-date on recommended vaccines. We detected that for each additional vaccine discussed, there was a 1.24 (95%CI=1.11, 1.39) increase in odds of the teen having all recommended vaccines. Parental immunization attitudes and provider discussion about vaccines are key ingredients to improving immunization rates among adolescents. While some parents may be reluctant to immunize their son or daughter with a recommended vaccine, vaccine-specific discussions between physicians and parents represent an important first step to continued discussions with providers regarding vaccination. Moreover, vaccine discussions must occur within the context of ongoing conversations about health and disease prevention.
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, United States. Electronic address: vrickert@iu.edu.
authors.forename: Vaughn I
authors.initials: VI
authors.lastname: Rickert
authors.affiliation: Cleveland Clinic, Cleveland, OH, United States.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Rehm
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, United States.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Aalsma
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, United States.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Zimet
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D058015:Health Communication; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D014611:Vaccination / Q000706:statistics & numerical data*; D014612:Vaccines / Q000008:administration & dosage*
chemical_list: D014612:Vaccines
keywords: Immunization; Parental attitudes; Physician communication; Self-reported vaccination