title: How rural and urban parents describe convenience in the context of school-based influenza vaccination: a qualitative study.
abstract: BACKGROUND
  Seasonal influenza vaccine uptake among school-age children has been low, particularly among rural children, even in jurisdictions in Canada where this immunization is publicly funded. Providing this vaccination at school may be convenient for parents and might contribute to increased vaccine uptake, particularly among rural children. We explore the construct of convenience as an advantage of school based influenza vaccination. We also explore for rural urban differences in this construct.
  
  
  METHODS
  Participants were parents of school-aged children from Alberta, Canada. We qualitatively analyzed focus group data from rural parents using a thematic template that emerged from prior work with urban parents. Both groups of parents had participated in focus groups to explore their perspectives on the acceptability of adding an annual influenza immunization to the immunization program that is currently delivered in Alberta schools. Data from within the theme of 'convenience' from both rural and urban parents were then further explored for sub-themes within convenience.
  
  
  RESULTS
  Data were obtained from nine rural and nine urban focus groups. The template of themes that had arisen from prior analysis of the urban data applied to the rural data. Convenience was a third level theme under Advantages. Five fourth level themes emerged from within convenience. Four of the five sub-themes were common to both rural and urban participants: reduction of parental burden to schedule, reduction in parental lost time, decrease in parental stress and increase in physical access points for influenza immunization. The fifth subtheme, increases temporal access to influenza immunization, emerged uniquely from the rural data.
  
  
  CONCLUSIONS
  Both rural and urban parents perceived that convenience would be an advantage of adding an annual influenza immunization to the vaccinations currently given to Alberta children at school. Improving temporal access to such immunization may be a more relevant aspect of convenience to rural than to urban parents.
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Alberta, T2N 1N4, Canada. cylind@ucalgary.ca.
authors.forename: Candace
authors.initials: C
authors.lastname: Lind
authors.affiliation: Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Canada. mlrussel@ucalgary.ca.
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Russell
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Alberta, T2N 1N4, Canada. ramonacollins@shaw.ca.
authors.forename: Ramona
authors.initials: R
authors.lastname: Collins
authors.affiliation: Alberta Health Services & Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Canada. Judy.MacDonald@albertahealthservices.ca.
authors.forename: Judy
authors.initials: J
authors.lastname: MacDonald
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Alberta, T2N 1N4, Canada. christinefrank@hotmail.com.
authors.forename: Christine J
authors.initials: CJ
authors.lastname: Frank
authors.affiliation: University of Calgary, Calgary, Canada. amy.davis121@gmail.com.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D000328:Adult; D000416:Alberta; D002648:Child; D005260:Female; D017144:Focus Groups; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007252:Influenza Vaccines / Q000008:administration & dosage; D007251:Influenza, Human / Q000517:prevention & control; D008297:Male; D010290:Parents; D036301:Qualitative Research; D012424:Rural Population; D012574:Schools; D014505:Urban Population; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines