PARENT PERSPECTIVES ON IMMUNIZATION MESSAGES

1. PARENT PERSPECTIVES ON IMMUNIZATION MESSAGES Linda Radecki, MS, Lynn M. Olson, PhD, Mary Pat Frintner, MSPH American Academy of Pediatrics, Department of Practice & Research, Elk Grove Village, IL ABSTRACT BACKGROUND and OBJECTIVES RESULTS RESULTS (con’t) • Parents valued messages that created a personal connection or could be used to facilitate further discussion …makes you feel like you and your pediatrician make the decision …I think this opens up communication with your doctor Maybe it needs something in there…’Talk to your doctor about making the choice that’s right for your child’ • SAMPLE DEMOGRAPHICS • n=24 (23 mothers, 1 father); 50% first time parents • Mean child age = 16.5 months; all had health insurance • Parents were predominantly white (88%) and educated 88% ≥ 4-year degree) • All children had received some/all recommended vaccines; several delayed vaccines • Many parents expressed concerns about vaccine safety and the schedule • Parent concerns regarding immunizations have been documented (Gust et al, 2005, Am J Prev Med) • Pediatricians seek to best address families’ information needs but little is known about parent preferences for vaccine-related communication • Objective→ Obtain parent perspectives on vaccine promotion messages Background: Amid increasing questions from parents regarding immunizations, pediatric professionals seek to best address families’ needs for guidance and information. Little is known about parent preferences for communication about immunizations. Objective: Obtain parent perspectives on vaccine promotion messages. Design/Methods: Three focus groups targeted to middle-class families were conducted to gather in-depth feedback on different types of immunization messages. Parents of children age ≤36 months of age were recruited through flyers distributed to day care facilities, libraries and parent groups. Participants were asked to review 5 messages. Discussion followed, facilitated by a standard list of questions to elicit reactions (positive and negative) to each message. Parents were also asked for ideas on ways to make statements more meaningful. Sessions were recorded and transcribed for review of key themes. Based on the primary theme conveyed, messages were categorized as scientific or emotional for analyses. Results: 23 mothers, 1 father participated. The sample was largely white (88%) and educated (88% ≥ 4-year college degree). Fifty percent were first-time parents. Most children saw a pediatrician for well-child care. All children received some/all recommended vaccines but many parents expressed concerns about safety and the schedule. Several delayed vaccines. Scientific messages: Two statements addressed autism and vaccine overload. Parents valued emphasis on scientific studies but requested further supporting information. Emotional messages: Generally, parents rejected perceived fear or guilt to promote immunizations. Statements encouraging vaccines to prevent illness or death were largely viewed as inappropriate. Parents valued messages that created a personal connection and facilitated discussion. Conclusions: Messages that lacked substantive/scientific explanation or evoked fear or guilt were generally not endorsed. Participants sought messages that respect them as parents and acknowledge concerns in a nonthreatening way. Results suggest that families value messages that provide explanation from trusted sources. While most US parents opt to vaccinate, many likely have questions and concerns. Understanding and responding to their perspectives is critical to assure public trust and support for immunizations. CONCLUSIONS DESIGN/METHODS • Parents generally did not endorsemessages that… • lacked substantive/scientific explanation • evoked fear or guilt • Parents tended to affirm messages that… • respect them as parents • acknowledge concerns in a non-threatening way • provide explanation from trusted sources with appropriate evidence and supporting information • Limitations: Results are limited to one geographic area and a primarily middle class sample • While most US parents continue to immunize their children, many likely have questions and concerns • Understanding and responding to parent perspectives is critical to assure public trust and support for vaccines • 3 focus groups targeted to middle-class families. Parents of children ≤36 months were recruited through community flyers • Parents reviewed five vaccine-promotion messages • Discussions lasted ~ 90 minutes and participants were paid $40 • A standard list of questions elicited parent reactions • Sessions were recorded/transcribed for review of key themes • Based on the message conveyed, each message was categorized as primarily scientific (S) or emotional (E) • Messages reviewed: • Scientific studies show that vaccines do not cause autism. New research shows that autism may be caused by genetics or being born prematurely. (S) • Babies’ bodies do not get overloaded by multiple vaccines. Don’t put your child at risk by delaying immunizations. (S) • Vaccinate on time, every time! Your child deserves it. (E) • Children still get sick and die from vaccine preventable diseases. Don’t let your child be one of them. Vaccinate! (E) • I'm a mother and I'm a pediatrician. I want what is best for my child and my patients, that's why I recommend vaccines. (E) • RESPONSE TO SCIENTIFIC MESSAGES • One statement addressed autism and another, concern about vaccine overload. Parents valued emphasis on scientific studies but requested further supporting evidence to make the statement more meaningful I want to know what those studies are. Where can I find them?...and why should I value those studies above others? Where’s the proof in that?...who said that? …to me, facts are more important than emotions. I’d rather hear ‘we did a study and this is what turned out It doesn’t give you ‘why’ – why is timing so important? I’ve never understood that RESPONSE TO EMOTIONAL MESSAGES • In general, parents rejected perceived use of fear or guilt to promote immunizations. Statements encouraging vaccination to prevent illness or death were viewed negatively by almost all parents …it was alarmist and negative, that might turn people off …messages about kids should be more positive You’re playing on fears RESOURCES • Childhood Immunization Support Program (CISP) http://www.cispimmunize.org • AAP Issue Kit: Immunizations http://www.aap.org/pressroom/aappr-immunization-issuekit.htm • Immunization Action Coalition http://www.immunize.org ACKNOWLEDGEMENTS • Support for this project was provided by the American Academy of Pediatrics. • Thanks to our focus group participants and to Elizabeth Sobczyk for helpful review of focus group materials and an early summary report draft