title: Vaccination decision-making of immigrant parents in the Netherlands; a focus group study.
abstract: BACKGROUND
  Although the vaccination coverage in most high income countries is high, variations in coverage rates on the national level among different ethnic backgrounds are reported. A qualitative study was performed to explore factors that influence decision-making among parents with different ethnic backgrounds in the Netherlands.
  
  
  METHODS
  Six focus groups were conducted with 33 mothers of Moroccan, Turkish and other ethnic backgrounds with at least one child aged 0-4 years. Data were analysed using thematic analysis.
  
  
  RESULTS
  Parents had a positive attitude towards childhood vaccination and a high confidence in the advices of Child Vaccine Providers (CVPs). Vaccinating their children was perceived as self-evident and important. Parents do perceive a language barrier in understanding the provided NIP-information, and they had a need for more NIP- information, particularly about the targeted diseases. Another barrier parents perceived was the distance to the Child Welfare Center (CWC), especially when the weather was bad and when they had no access to a car.
  
  
  CONCLUSIONS
  More information about targeted diseases and complete information regarding benefits and drawbacks of the NIP should be provided to the parents. To fulfill parents' information needs, NIP information meetings can be organized at CWCs in different languages. Providing NIP information material in Turkish, Arabic and Berber language with easy access is also recommended. Providing information tailored to these parents' needs is important to sustain high vaccination participation, and to ensure acceptance of future vaccinations.
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, P.O. Box 1 3720, BA, Bilthoven, The Netherlands. ireneharmsen@gmail.com.|Department of Work & Social Psychology, Maastricht University, Universiteitssingel 40, 6200, MD, Maastricht, The Netherlands. ireneharmsen@gmail.com.
authors.forename: Irene A
authors.initials: IA
authors.lastname: Harmsen
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, P.O. Box 1 3720, BA, Bilthoven, The Netherlands. helien_bos@hotmail.com.|Department of Earth and Life Sciences, VU University of Amsterdam, De Boelelaan 1085-1087, 1081, HV, Amsterdam, The Netherlands. helien_bos@hotmail.com.
authors.forename: Helien
authors.initials: H
authors.lastname: Bos
authors.affiliation: Department of Work & Social Psychology, Maastricht University, Universiteitssingel 40, 6200, MD, Maastricht, The Netherlands. r.ruiter@maastrichtuniversity.nl.
authors.forename: Robert A C
authors.initials: RA
authors.lastname: Ruiter
authors.affiliation: TNO (Netherlands Organization for Applied Scientific Research), Healthy Living, Wassenaarseweg 56, NL-2333, AL, Leiden, The Netherlands. theo.paulussen@tno.nl.
authors.forename: Theo G W
authors.initials: TG
authors.lastname: Paulussen
authors.affiliation: Department of Work & Social Psychology, Maastricht University, Universiteitssingel 40, 6200, MD, Maastricht, The Netherlands. g.kok@maastrichtuniversity.nl.
authors.forename: Gerjo
authors.initials: G
authors.lastname: Kok
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, P.O. Box 1 3720, BA, Bilthoven, The Netherlands. hester.de.melker@rivm.nl.
authors.forename: Hester E
authors.initials: HE
authors.lastname: de Melker
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, P.O. Box 1 3720, BA, Bilthoven, The Netherlands. liesbeth.mollema@rivm.nl.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Mollema
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002675:Child, Preschool; D003657:Decision Making; D054242:Emigrants and Immigrants; D005006:Ethnicity; D005260:Female; D017144:Focus Groups; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers; D009426:Netherlands; D010290:Parents; D010465:Perception; D036301:Qualitative Research; D014611:Vaccination