Decision Making of Parents to Vaccinate Children

描述(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。儿童保健提供者的特征可能比儿童或家庭的特征对疫苗接种决定的影响更大。学校工作人员对家长为子女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、态度和信念与家长接种疫苗的决定有关。生物恐惧症问题提高了我们对公众和卫生保健提供者对疫苗误解的认识。人们对预防生物威胁的免疫接种的看法可能不同于对针对自然发生的疾病的疫苗的看法。与疫苗预防理论上有风险的疾病相比，疫苗提供者和普通公众可能更愿意接受罕见的、与疫苗相关的严重不良事件，以预防已知会导致重大发病率和死亡率的疾病。 这项研究的具体目的是：(1)对考虑或请求豁免国家免疫要求、疫苗可预防疾病、疫苗安全性和有效性以及疫苗相关误解的学校护士/工作人员和家长的两种干预措施进行受控评估；(2)比较未完全接种(豁免)儿童的卫生保健提供者和完全接种儿童的卫生保健提供者关于疫苗的知识、态度、信念和做法；以及(3)确定卫生保健提供者的疫苗相关知识、态度和信念是否与父母的疫苗相关知识、态度和信念有关。 为了实现这些目标，将在华盛顿州对考虑或要求学校免疫豁免的学校工作人员和家长进行干预研究。此外，还将对完全接种疫苗和未接种疫苗(豁免)儿童的父母确定的1000名卫生保健提供者进行调查。卫生保健提供者调查将与已经完成的父母调查相联系。 通过这笔赠款，我将改进我在行为科学、风险评估和风险沟通的理论、应用和统计方法方面的培训。我的主要导师是约翰霍普金斯大学彭博公共卫生学院的尼尔·哈尔西博士，以及一个导师咨询委员会，他们包括约翰霍普金斯大学彭博公共卫生学院的特雷特教授和罗特、柯博、拉特金和塞伦塔诺博士，佐治亚理工学院的博斯特罗姆博士，卡内基梅隆大学的费施霍夫博士，以及西雅图儿童医院和华盛顿大学的马尔库塞博士。在这个奖项的过程中，这些导师将通过课程作业、定向阅读和指导研究来与我合作。

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.