title: Urban and Rural Differences in Parental Attitudes About Influenza Vaccination and Vaccine Delivery Models.
abstract: OBJECTIVE
  To assess and compare among parents of healthy children in urban and rural areas: (1) reported influenza vaccination status; (2) attitudes regarding influenza vaccination; and (3) attitudes about collaborative models for influenza vaccination delivery involving practices and public health departments.
  
  
  METHODS
  A mail survey to random samples of parents from 2 urban and 2 rural private practices in Colorado from April 2012 to June 2012.
  
  
  RESULTS
  The response rate was 58% (288/500). In the prior season, 63% of urban and 41% of rural parents reported their child received influenza vaccination (P < .001). No differences in attitudes about influenza infection or vaccination between urban and rural parents were found, with 75% of urban and 73% of rural parents agreeing their child should receive an influenza vaccine every year (P = .71). High proportions reported willingness to participate in a collaborative clinic in a community setting (59% urban, 70% rural, P = .05) or at their child's provider (73% urban, 73% rural, P = .99) with public health department assisting. Fewer (36% urban, 53% rural, P < .01) were likely to go to the public health department if referred by their provider. Rural parents were more willing for their child to receive vaccination outside of their provider's office (70% vs. 55%, P = .01).
  
  
  CONCLUSIONS
  While attitudes regarding influenza vaccination were similar, rural children were much less likely to have received vaccination. Most parents were amenable to collaborative models of influenza vaccination delivery, but rural parents were more comfortable with influenza vaccination outside their provider's office, suggesting that other venues for influenza vaccination in rural settings should be promoted.
authors.affiliation: Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado.|The Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Sean T
authors.initials: ST
authors.lastname: O'Leary
authors.affiliation: The Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Juliana
authors.initials: J
authors.lastname: Barnard
authors.affiliation: The Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Steven
authors.initials: S
authors.lastname: Lockhart
authors.affiliation: Centers for Disease Control and Prevention, National Center for Immunizations and Respiratory Diseases, Atlanta, Georgia.
authors.forename: Maureen
authors.initials: M
authors.lastname: Kolasa
authors.affiliation: The Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Doron
authors.initials: D
authors.lastname: Shmueli
authors.affiliation: The Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado.|Colorado Health Outcomes Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
authors.forename: L Miriam
authors.initials: LM
authors.lastname: Dickinson
authors.affiliation: The Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Deidre
authors.initials: D
authors.lastname: Kile
authors.affiliation: The Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Eva
authors.initials: E
authors.lastname: Dibert
authors.affiliation: Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado.|The Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado.|Colorado Health Outcomes Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
authors.forename: Allison
authors.initials: A
authors.lastname: Kempe
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002648:Child; D003120:Colorado; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control / Q000523:psychology*; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: health services research; influenza; rural; utilization of health services; vaccine