title: The behind-the-scenes activity of parental decision-making discourse regarding childhood vaccination.
abstract: BACKGROUND
  Vaccine compliance has long been a cause for concern for health authorities throughout the world. However very little effort has been made to examine parental discourse during the decision-making process.
  
  
  METHODS
  An online survey was conducted (N = 437) to examine predictors of parents' attitudes regarding childhood vaccination.
  
  
  RESULTS
  Hesitant parents were 4 times more likely to conduct intrafamily discussion regarding vaccination compared with provaccination parents (Exp[B] = 4.26). There were no significant differences between hesitant and antivaccination parents with respect to intrafamily discussion. Hesitant parents were also 4 times more likely than provaccination parents to report intrafamily disagreements regarding vaccination (Exp[B] = 4.27). They were also twice as likely as antivaccination parents to express disagreements regarding vaccination within their families (Exp[B] = 2.33). Likewise, Jewish parents were significantly more likely to define themselves as vaccination-hesitant, whereas Muslim parents were significantly more likely to be provaccination.
  
  
  CONCLUSIONS
  To improve the way health organizations communicate information about vaccines and increase parental trust in immunization programs, we should not only look at the level of understanding, perceptions, and biases of different groups, but also thoroughly examine parents' decision-making processes and the discourse during this process. We must communicate risk to all groups, including the provaccination group, to improve parents' decision making and the process of informed consent.
authors.affiliation: School of Public Health, University of Haifa, Haifa, Israel. Electronic address: ageser@univ.haifa.ac.il.
authors.forename: Anat
authors.initials: A
authors.lastname: Gesser-Edelsburg
authors.affiliation: Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Walter
authors.affiliation: University of Haifa, Haifa, Israel; Sammy Ofer School of Communication, IDC Herzliya, Herzliya, Israel.
authors.forename: Yaffa
authors.initials: Y
authors.lastname: Shir-Raz
authors.affiliation: Department of Communication, University of Haifa, Haifa, Israel.
authors.forename: Oshrat
authors.initials: O
authors.lastname: Sassoni Bar-Lev
authors.affiliation: School of Public Health, University of Haifa, Haifa, Israel.
authors.forename: Shira
authors.initials: S
authors.lastname: Rosenblat
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000523:psychology*
keywords: Antivaccination parents; Hesitant parents; Provaccination