Decision Making of Parents to Vaccinate Children

说明（由申请人提供）：在儿童接种疫苗方面，卫生保健提供者对父母有很大的影响。儿童卫生保健提供者的特点可能比儿童或家庭的特点更能影响疫苗接种的决定。学校工作人员对家长是否给孩子接种疫苗的决定也有影响，因为学校工作人员与疫苗有关的知识、态度和信念与家长是否接种疫苗的决定有关。生物恐怖主义问题提高了我们对公众和卫生保健提供者对疫苗的误解的认识。对预防生物威胁的免疫接种的认识可能不同于对针对自然发生疾病的疫苗的认识。提供者和一般公众可能更愿意接受罕见的、与疫苗相关的严重不良事件，以预防已知会导致严重发病率和死亡率的疾病，而不是接受疫苗以预防理论上有风险的疾病。

DESCRIPTION (provided by applicant): Health care providers have a great deal of influence on parents with regard to vaccination of children. The characteristics of a child's health care provider may be more influential on vaccination decisions than the characteristics of the child or family. School personnel also have influence on the decisions of parents to vaccinate their children as the vaccine related knowledge, attitudes and beliefs of school personnel have been associated with parental decisions to vaccinate. Bioterriorism issues have heightened our awareness of vaccine misperceptions among the public and health care providers. Perception of immunization to prevent biological threats may differ from perceptions of vaccines targeting naturally occurring diseases. Providers and the general public may be more willing to accept rare, serious vaccine associated adverse events to prevent diseases known to cause significant morbidity and mortality than for vaccines to prevent diseases that are of theoretical risk. The study's specific aims are to: (1) Conduct a controlled evaluation of two interventions for school nurses/personnel and parents considering or requesting an exemption regarding state immunization requirements, vaccine preventable diseases, vaccine safety and efficacy, and vaccine related misconceptions; (2) Compare the knowledge, attitudes, beliefs and practices regarding vaccines of health care providers for children who are not fully vaccinated (exempt) with health care providers for fully vaccinated children; and (3) Determine if vaccine related knowledge, attitudes and beliefs of health care providers are associated with vaccine related knowledge, attitudes and beliefs of parents. In order to address these aims, an intervention study will be conducted in Washington State of school personnel and parents considering or requesting a school immunization exemption. Additionally, a survey will be conducted of 1,000 health care providers identified by the parents of fully vaccinated and non-vaccinated (exempt) children. Health care provider surveys will be linked to parental surveys that have already been completed. Throughout this grant I will improve my training in the theories, application and statistical methods of behavioral science, risk assessment and risk communication. I will be guided by my primary mentor, Dr. Neal Halsey, from Johns Hopkins University Bloomberg School of Public Health, and a Advisory Council of mentors, including Professor Teret and Drs. Roter, Curbow, Latkin, and Celentano from the Johns Hopkins Bloomberg School of Public Health, Dr. Bostrom from Georgia Institute of Technology, Dr. Fischhoff from Carnegie Mellon University, and Dr. Marcuse from Children's Hospital in Seattle and the University of Washington. These mentors will work with me through a combination of coursework, directed readings and supervised research over the course of this award.