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Attitudinal and demographic predictors of measles-mumps-rubella vaccine (MMR) uptake during the UK catch-up campaign 2008-09: cross-sectional survey.

Brown K, Fraser G, Ramsay M, Shanley R, Cowley N, van Wijgerden J, Toff P, Falconer M, Hudson M, Green J, Kroll JS, Vincent C, Sevdalis N - PLoS ONE (2011)

Bottom Line: Receipt of catch-up invitation predicted uptake only in the 0 dose group (OR = 3.45, 95% CI = 1.18-10.05), whilst perceived social desirability/benefit of MMR uptake predicted uptake only in the 1 dose group (OR = 9.61, 95% CI = 2.57-35.97).Attitudes and demographics explained only 28% of MMR uptake in the 0 dose group compared with 61% in the 1 dose group.Catch-up MMR invitations may effectively move children from 0 to 1 MMR doses (unimmunised to partially immunised), whilst attitudinal interventions highlighting social benefits of MMR may effectively move children from 1 to 2 MMR doses (partially to fully immunised).

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery and Cancer, Imperial College, London, United Kingdom. Katrina.Brown@imperial.ac.uk

ABSTRACT

Background and objective: Continued suboptimal measles-mumps-rubella (MMR) vaccine uptake has re-established measles epidemic risk, prompting a UK catch-up campaign in 2008-09 for children who missed MMR doses at scheduled age. Predictors of vaccine uptake during catch-ups are poorly understood, however evidence from routine schedule uptake suggests demographics and attitudes may be central. This work explored this hypothesis using a robust evidence-based measure.

Design: Cross-sectional self-administered questionnaire with objective behavioural outcome.

Setting and participants: 365 UK parents, whose children were aged 5-18 years and had received <2 MMR doses before the 2008-09 UK catch-up started.

Main outcome measures: Parents' attitudes and demographics, parent-reported receipt of invitation to receive catch-up MMR dose(s), and catch-up MMR uptake according to child's medical record (receipt of MMR doses during year 1 of the catch-up).

Results: Perceived social desirability/benefit of MMR uptake (OR = 1.76, 95% CI = 1.09-2.87) and younger child age (OR = 0.78, 95% CI = 0.68-0.89) were the only independent predictors of catch-up MMR uptake in the sample overall. Uptake predictors differed by whether the child had received 0 MMR doses or 1 MMR dose before the catch-up. Receipt of catch-up invitation predicted uptake only in the 0 dose group (OR = 3.45, 95% CI = 1.18-10.05), whilst perceived social desirability/benefit of MMR uptake predicted uptake only in the 1 dose group (OR = 9.61, 95% CI = 2.57-35.97). Attitudes and demographics explained only 28% of MMR uptake in the 0 dose group compared with 61% in the 1 dose group.

Conclusions: Catch-up MMR invitations may effectively move children from 0 to 1 MMR doses (unimmunised to partially immunised), whilst attitudinal interventions highlighting social benefits of MMR may effectively move children from 1 to 2 MMR doses (partially to fully immunised). Older children may be best targeted through school-based programmes. A formal evaluation element should be incorporated into future catch-up campaigns to inform their continuing improvement.

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Related in: MedlinePlus

Questionnaire used to assess attitudes, demographics, past behaviour                            and receipt of MMR catch-up invitation among parents of children                            eligible to receive catch-up MMR vaccine within the 2008–09 UK MMR                            catch-up campaign.
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pone-0019381-g001: Questionnaire used to assess attitudes, demographics, past behaviour and receipt of MMR catch-up invitation among parents of children eligible to receive catch-up MMR vaccine within the 2008–09 UK MMR catch-up campaign.

Mentions: The internal consistency, test-retest reliability, concurrent and predictive validity of the questionnaire (Figure 1) has been demonstrated previously [12]. The questionnaire comprised 20 attitude items and seven demographic items all derived from the literature on factors underpinning parents' routine schedule MMR decisions [8]–[11], and a single item assessing self-reported receipt of a postal MMR catch-up invitation. Attitude items took the form of statements with which the respondent indicated their level of agreement on five-point scales (1 = strongly disagree, 5 = strongly agree), for every attitude item a higher score indicated more ‘pro-MMR’ attitude. The attitude items (except item 19 assessing practical barriers) collapsed into four scales with adequate reliability (see Table S1 for details of items in each scale. Cronbach's alphas = 0.59–0.76). Demographic data collected were parent (respondent) age, sex, highest educational qualification, ethnic group, number of children, marital status and job; responses were provided using tick-box options for all but the job item, which was free-text.


Attitudinal and demographic predictors of measles-mumps-rubella vaccine (MMR) uptake during the UK catch-up campaign 2008-09: cross-sectional survey.

Brown K, Fraser G, Ramsay M, Shanley R, Cowley N, van Wijgerden J, Toff P, Falconer M, Hudson M, Green J, Kroll JS, Vincent C, Sevdalis N - PLoS ONE (2011)

Questionnaire used to assess attitudes, demographics, past behaviour                            and receipt of MMR catch-up invitation among parents of children                            eligible to receive catch-up MMR vaccine within the 2008–09 UK MMR                            catch-up campaign.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3094347&req=5

pone-0019381-g001: Questionnaire used to assess attitudes, demographics, past behaviour and receipt of MMR catch-up invitation among parents of children eligible to receive catch-up MMR vaccine within the 2008–09 UK MMR catch-up campaign.
Mentions: The internal consistency, test-retest reliability, concurrent and predictive validity of the questionnaire (Figure 1) has been demonstrated previously [12]. The questionnaire comprised 20 attitude items and seven demographic items all derived from the literature on factors underpinning parents' routine schedule MMR decisions [8]–[11], and a single item assessing self-reported receipt of a postal MMR catch-up invitation. Attitude items took the form of statements with which the respondent indicated their level of agreement on five-point scales (1 = strongly disagree, 5 = strongly agree), for every attitude item a higher score indicated more ‘pro-MMR’ attitude. The attitude items (except item 19 assessing practical barriers) collapsed into four scales with adequate reliability (see Table S1 for details of items in each scale. Cronbach's alphas = 0.59–0.76). Demographic data collected were parent (respondent) age, sex, highest educational qualification, ethnic group, number of children, marital status and job; responses were provided using tick-box options for all but the job item, which was free-text.

Bottom Line: Receipt of catch-up invitation predicted uptake only in the 0 dose group (OR = 3.45, 95% CI = 1.18-10.05), whilst perceived social desirability/benefit of MMR uptake predicted uptake only in the 1 dose group (OR = 9.61, 95% CI = 2.57-35.97).Attitudes and demographics explained only 28% of MMR uptake in the 0 dose group compared with 61% in the 1 dose group.Catch-up MMR invitations may effectively move children from 0 to 1 MMR doses (unimmunised to partially immunised), whilst attitudinal interventions highlighting social benefits of MMR may effectively move children from 1 to 2 MMR doses (partially to fully immunised).

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery and Cancer, Imperial College, London, United Kingdom. Katrina.Brown@imperial.ac.uk

ABSTRACT

Background and objective: Continued suboptimal measles-mumps-rubella (MMR) vaccine uptake has re-established measles epidemic risk, prompting a UK catch-up campaign in 2008-09 for children who missed MMR doses at scheduled age. Predictors of vaccine uptake during catch-ups are poorly understood, however evidence from routine schedule uptake suggests demographics and attitudes may be central. This work explored this hypothesis using a robust evidence-based measure.

Design: Cross-sectional self-administered questionnaire with objective behavioural outcome.

Setting and participants: 365 UK parents, whose children were aged 5-18 years and had received <2 MMR doses before the 2008-09 UK catch-up started.

Main outcome measures: Parents' attitudes and demographics, parent-reported receipt of invitation to receive catch-up MMR dose(s), and catch-up MMR uptake according to child's medical record (receipt of MMR doses during year 1 of the catch-up).

Results: Perceived social desirability/benefit of MMR uptake (OR = 1.76, 95% CI = 1.09-2.87) and younger child age (OR = 0.78, 95% CI = 0.68-0.89) were the only independent predictors of catch-up MMR uptake in the sample overall. Uptake predictors differed by whether the child had received 0 MMR doses or 1 MMR dose before the catch-up. Receipt of catch-up invitation predicted uptake only in the 0 dose group (OR = 3.45, 95% CI = 1.18-10.05), whilst perceived social desirability/benefit of MMR uptake predicted uptake only in the 1 dose group (OR = 9.61, 95% CI = 2.57-35.97). Attitudes and demographics explained only 28% of MMR uptake in the 0 dose group compared with 61% in the 1 dose group.

Conclusions: Catch-up MMR invitations may effectively move children from 0 to 1 MMR doses (unimmunised to partially immunised), whilst attitudinal interventions highlighting social benefits of MMR may effectively move children from 1 to 2 MMR doses (partially to fully immunised). Older children may be best targeted through school-based programmes. A formal evaluation element should be incorporated into future catch-up campaigns to inform their continuing improvement.

Show MeSH
Related in: MedlinePlus