title: Knowledge, attitudes, beliefs, and behaviors of parents and healthcare providers before and after implementation of a universal rotavirus vaccination program.
abstract: OBJECTIVE
  In Canada, rotavirus vaccine is recommended for all infants, but not all provinces/territories have publicly funded programs. We compared public and healthcare provider (HCP) knowledge, attitudes, beliefs, and behaviors in a province with a public health nurse-delivered, publicly funded rotavirus vaccination program to a province with a publicly funded, physician-delivered program. A third province with no vaccination program acted as a control.
  
  
  METHODS
  Information about knowledge, attitudes, beliefs, and behaviors of parents whose children were eligible for the universal program and healthcare providers responsible for administering the vaccine were collected through the use of two validated surveys distributed in public health clinics, physicians' offices, and via e-mail. Early and postvaccine-program survey results were compared.
  
  
  RESULTS
  A total of 722 early implementation and 709 postimplementation parent surveys and 180 early and 141 postimplementation HCP surveys were analyzed. HCP and public attitudes toward rotavirus vaccination were generally positive and didn't change over time. More parents postprogram were aware of the NACI recommendation and the vaccination program and reported that their healthcare provider discussed rotavirus infection and vaccine with them. Prior to the program across all sites, more physicians than nurses were aware of the national recommendation regarding rotavirus vaccine. In the postprogram survey, however, more nurses were aware of the national recommendation and their provincial universal rotavirus vaccination program. Nurses had higher knowledge scores than physicians in the postprogram survey (p<0.001). Parents of young infants were also more knowledgeable about rotavirus and rotavirus vaccine in the two areas where universal programs were in place (p<0.001).
  
  
  CONCLUSIONS
  Implementation of a universal rotavirus vaccination program was associated with an increase in knowledge and more positive attitudes toward rotavirus vaccine amongst parents of eligible infants. Nurses involved in a public health-delivered vaccination program were more knowledgeable and had more positive attitudes toward the vaccine than physicians in a jurisdiction where vaccine was physician-delivered.
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, NS, Canada; School of Nursing, St. Francis Xavier University, Antigonish, NS, Canada.
authors.forename: Donna M
authors.initials: DM
authors.lastname: MacDougall
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, NS, Canada; School of Nursing, Dalhousie University, Halifax, NS, Canada; Department of Pediatrics, Dalhousie University, Halifax, NS, Canada.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Halperin
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, NS, Canada; Department of Pediatrics, Dalhousie University, Halifax, NS, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Langley
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, NS, Canada.
authors.forename: Donna
authors.initials: D
authors.lastname: MacKinnon-Cameron
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, NS, Canada.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, NS, Canada; Department of Pediatrics, Dalhousie University, Halifax, NS, Canada; Department of Microbiology & Immunology, Dalhousie University, Halifax, NS, Canada. Electronic address: scott.halperin@dal.ca.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Halperin
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs; D008297:Male; D008875:Middle Aged; D009509:New Brunswick; D009674:Nova Scotia; D064689:Nurses, Public Health / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D010820:Physicians / Q000523:psychology*; D011325:Prince Edward Island; D012400:Rotavirus Infections / Q000517:prevention & control; D022243:Rotavirus Vaccines / Q000008:administration & dosage; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D022243:Rotavirus Vaccines
keywords: Knowledge, attitudes, beliefs, and behaviors; Rotavirus vaccine; Survey; Universal vaccination program