Behavioural/attitudinal research
These projects aim to improve understanding of the factors contributing to participation in immunisation programs.
Workshop on behavioural and sociodemographic influences on immunisation uptake
This workshop (Reference 57) discussed current Australian research on factors influencing immunisation uptake. Its main conclusions were:
- Decision-making theory suggests that people do not make scientifically rational decisions;
- parents find difficulty assessing the risk of vaccines and risk of diseases;
- communication and services should be tailored to the needs of parents;
- improving parenting skills could be combined with improving parents’ health-related behaviour;
- different strategies are required to reach adolescents and adults (rather than parents), especially high-risk adolescents;
- incentives will need evaluation; and
- consumers must be informed about choices and services, and their views and rights should be respected.
Suggested interventions included:
- targeting incompletely immunised children using the ACIR;
- educating parents through their children;
- providing a wider range of information packages;
- overcoming barriers to access;
- involving consumers; and
- identifying gaps in behavioural research.
Attitudes of parents and general practitioners to vaccine reactogenicity and number of injections
This study (Reference 32) surveyed 150 parents and 150 general practitioners (GPs) about the relative importance they placed on symptoms associated with vaccines and on multiple injections at each immunisation visit. It was found that parents’ and GPs’ concerns differed. Parents were more concerned about symptoms than multiple injections. GPs preferred fewer injections. However, parents were likely to accept their GPs’ recommendations.
General practitioner attitudes and immunisation
A survey of 280 randomly selected GPs from New South Wales, conducted in collaboration with the Central Sydney Public Health Unit, showed that GPs supported many of the new initiatives aimed at increasing immunisation rates. The study also showed that GPs were concerned about biased media coverage of immunisation adverse events and wanted more educational material for parents. (Reference 51)
Use of incentives to improve immunisation
A review of the published data on the use of incentives to improve immunisation uptake was carried out. Eight incentive schemes were identified: 4 referred to incentives such as food vouchers and 4 to monetary incentives for providers (3) or parents (1). Groups receiving incentives were up to 3 times more likely to be immunised and had overall immunisation rates up to 17% higher than comparison groups. The implications for the outcome of current incentive schemes in Australia were considered; these should be evaluated. (Reference 34)
Parental attitudes to the Measles Control Campaign
During evaluation of the Measles Control Campaign the parents of more than 2000 preschool and school-aged children were interviewed by telephone about their responses to the Campaign. An analysis of the factors influencing their responses to the program has been performed, and will be reported separately to the outcomes evaluation. Most parents were very satisfied with the Campaign.
Understanding immunisation controversies
NCIRS collaborated with a team from the School of Public Health, University of Sydney, including Professor Simon Chapman, Professor Penelope Hawe and PhD candidate Julie Leask, to evaluate how information is exchanged between different parties to debates about vaccine safety, and to set out recommendations for improving communication of vaccine risk. This project was supported by an NHMRC project grant.