Skip to main content
Top
Published in: BMC Pediatrics 1/2014

Open Access 01-12-2014 | Research article

Are parents' knowledge and practice regarding immunization related to pediatrics’ immunization compliance? a mixed method study

Authors: Omer Qutaiba B Al-lela, Mohd Baidi Bahari, Harith Khalid Al-Qazaz, Muhannad RM Salih, Shazia Q Jamshed, Ramadan M Elkalmi

Published in: BMC Pediatrics | Issue 1/2014

Login to get access

Abstract

Background

Immunization rate is one of the best public health outcome and service indicators of the last 100 years. Parental decisions regarding immunization are very important to improve immunization rate. The aim of this study was to evaluate the correlation between parental knowledge-practices (KP) and children's immunization completeness.

Methods

A mixed method has been utilized in this study: a retrospective cohort study was used to evaluate immunization completeness; a prospective cross-sectional study was used to evaluate immunization KP of parents. 528 children born between 1 January 2003 and 31 June 2008 were randomly selected from five public health clinics in Mosul, Iraq. Immunization history of each child was collected retrospectively from their immunization record/card.

Results

About half of studied children (n = 286, 56.3%) were immunized with all vaccination doses; these children were considered as having had complete immunization. 66.1% of the parents was found to have adequate KP scores. A significant association of immunization completeness with total KP groups (p < 0.05) was found.

Conclusions

Future efforts are required to improve immunization rate and parents' knowledge and practice. The study results reinforce recommendations for the periodic assessment of immunization rate and the use of educational programmes to improve the immunization rate, knowledge and practice.
Literature
1.
go back to reference Gellin B, Maibach E, Marcuse E: Do parents understand immunizations? A national telephone survey. Pediatrics. 2000, 106 (5): 1097-1102. 10.1542/peds.106.5.1097.CrossRefPubMed Gellin B, Maibach E, Marcuse E: Do parents understand immunizations? A national telephone survey. Pediatrics. 2000, 106 (5): 1097-1102. 10.1542/peds.106.5.1097.CrossRefPubMed
2.
go back to reference Ritvo P, et al: A Canadian national survey of attitudes and knowledge regarding preventive vaccines. J Immune Based Ther Vaccin. 2003, 1 (1): 3-10.1186/1476-8518-1-3.CrossRef Ritvo P, et al: A Canadian national survey of attitudes and knowledge regarding preventive vaccines. J Immune Based Ther Vaccin. 2003, 1 (1): 3-10.1186/1476-8518-1-3.CrossRef
3.
go back to reference Sporton R, Francis S: Choosing not to immunize: are parents making informed decisions?. Fam Pract. 2001, 18 (2): 181-188. 10.1093/fampra/18.2.181.CrossRefPubMed Sporton R, Francis S: Choosing not to immunize: are parents making informed decisions?. Fam Pract. 2001, 18 (2): 181-188. 10.1093/fampra/18.2.181.CrossRefPubMed
4.
go back to reference Richards A, Sheridan J: Reasons for delayed compliance with the childhood vaccination schedule and some failings of computerised vaccination registers. Aust NZ j public health. 1999, 23 (3): 315-317. 10.1111/j.1467-842X.1999.tb01263.x.CrossRef Richards A, Sheridan J: Reasons for delayed compliance with the childhood vaccination schedule and some failings of computerised vaccination registers. Aust NZ j public health. 1999, 23 (3): 315-317. 10.1111/j.1467-842X.1999.tb01263.x.CrossRef
5.
go back to reference Salsberry P, Nickel J, Mitch R: Why aren't preschoolers immunized? A comparison of parents' and providers' perceptions of the barriers to immunizations. J Commun Health Nurs. 1993, 10 (4): 213-224. 10.1207/s15327655jchn1004_2.CrossRef Salsberry P, Nickel J, Mitch R: Why aren't preschoolers immunized? A comparison of parents' and providers' perceptions of the barriers to immunizations. J Commun Health Nurs. 1993, 10 (4): 213-224. 10.1207/s15327655jchn1004_2.CrossRef
6.
go back to reference Schmalz K, Larwa L: Problems encountered by parents and guardians of elementary school-age children in obtaining immunizations. J Sch Nurs Off Publ National Assoc Sch Nurs. 1997, 13 (1): 10-16. Schmalz K, Larwa L: Problems encountered by parents and guardians of elementary school-age children in obtaining immunizations. J Sch Nurs Off Publ National Assoc Sch Nurs. 1997, 13 (1): 10-16.
7.
go back to reference Bernsen RM, et al: Knowledge, attitude and practice towards immunizations among mothers in a traditional city in the United Arab Emirates. J Med Sci. 2011, 4 (3): 114-121. Bernsen RM, et al: Knowledge, attitude and practice towards immunizations among mothers in a traditional city in the United Arab Emirates. J Med Sci. 2011, 4 (3): 114-121.
8.
go back to reference Cohen N, et al: Physician knowledge of catch-up regimens and contraindications for childhood immunizations. Pediatrics. 2003, 111 (5): 925-933. 10.1542/peds.111.5.925.CrossRefPubMed Cohen N, et al: Physician knowledge of catch-up regimens and contraindications for childhood immunizations. Pediatrics. 2003, 111 (5): 925-933. 10.1542/peds.111.5.925.CrossRefPubMed
9.
go back to reference Siegel R, Schubert C: Physician beliefs and knowledge about vaccinations. Clin pediatr. 1996, 35 (2): 79-83. 10.1177/000992289603500205.CrossRef Siegel R, Schubert C: Physician beliefs and knowledge about vaccinations. Clin pediatr. 1996, 35 (2): 79-83. 10.1177/000992289603500205.CrossRef
10.
go back to reference Wood D, et al: Knowledge of the childhood immunization schedule and of contraindications to vaccinate by private and public providers in Los Angeles. Pediatr Infect Dis J. 1996, 15 (2): 140-145. 10.1097/00006454-199602000-00010.CrossRefPubMed Wood D, et al: Knowledge of the childhood immunization schedule and of contraindications to vaccinate by private and public providers in Los Angeles. Pediatr Infect Dis J. 1996, 15 (2): 140-145. 10.1097/00006454-199602000-00010.CrossRefPubMed
11.
go back to reference Davis T, et al: Childhood vaccine risk/benefit communication in private practice office settings: a national survey. Pediatrics. 2001, 107 (2): e17-10.1542/peds.107.2.e17.CrossRefPubMed Davis T, et al: Childhood vaccine risk/benefit communication in private practice office settings: a national survey. Pediatrics. 2001, 107 (2): e17-10.1542/peds.107.2.e17.CrossRefPubMed
12.
go back to reference McWha L, et al: Measuring up: results from the national immunization coverage survey, 2002. Can Commun Dis Report. 2004, 30 (5): 37-50. McWha L, et al: Measuring up: results from the national immunization coverage survey, 2002. Can Commun Dis Report. 2004, 30 (5): 37-50.
13.
go back to reference Pruitt R, Kline P, Kovaz R: Perceived barriers to childhood immunization among rural populations. J Commun Health Nurs. 1995, 12 (2): 65-72. 10.1207/s15327655jchn1202_1.CrossRef Pruitt R, Kline P, Kovaz R: Perceived barriers to childhood immunization among rural populations. J Commun Health Nurs. 1995, 12 (2): 65-72. 10.1207/s15327655jchn1202_1.CrossRef
14.
go back to reference Hall J, Roter D, Katz N: Meta-analysis of correlates of provider behavior in medical encounters. Med Care. 1988, 26 (7): 657-675. 10.1097/00005650-198807000-00002.CrossRefPubMed Hall J, Roter D, Katz N: Meta-analysis of correlates of provider behavior in medical encounters. Med Care. 1988, 26 (7): 657-675. 10.1097/00005650-198807000-00002.CrossRefPubMed
15.
go back to reference Ong L, et al: Doctor-patient communication: a review of the literature. Soc Sci Med. 1995, 40 (7): 903-918. 10.1016/0277-9536(94)00155-M.CrossRefPubMed Ong L, et al: Doctor-patient communication: a review of the literature. Soc Sci Med. 1995, 40 (7): 903-918. 10.1016/0277-9536(94)00155-M.CrossRefPubMed
16.
go back to reference Stewart M: Effective physician-patient communication and health outcomes: a review. Can Med Assoc J. 1995, 152 (9): 1423-1433. Stewart M: Effective physician-patient communication and health outcomes: a review. Can Med Assoc J. 1995, 152 (9): 1423-1433.
17.
go back to reference AlLela O, et al: Influence of health providers on pediatrics' immunization rate. J Trop Pediatr. 2012, 58 (6): 441-445. 10.1093/tropej/fms014.CrossRef AlLela O, et al: Influence of health providers on pediatrics' immunization rate. J Trop Pediatr. 2012, 58 (6): 441-445. 10.1093/tropej/fms014.CrossRef
18.
go back to reference Al-lela OQB, et al: Development of a questionnaire on knowledge, attitude and practice about immunization among Iraqi parents. J Public Health. 2011, 19: 1-7.CrossRef Al-lela OQB, et al: Development of a questionnaire on knowledge, attitude and practice about immunization among Iraqi parents. J Public Health. 2011, 19: 1-7.CrossRef
20.
go back to reference Nath B, et al: KAP study on immunization of children in a city of North India–a 30 cluster survey. Online J Health Allied Sci. 2008, 7 (1): 1-6. Nath B, et al: KAP study on immunization of children in a city of North India–a 30 cluster survey. Online J Health Allied Sci. 2008, 7 (1): 1-6.
21.
go back to reference Phouphenghack K, Kamsrichan W, Vorakitpokatorn S: Knowledge and perception of mothers about immunization of children under 3 years of age in the Saythany District, Vientiane. Lao PDR J Public Health. 2007, 5 (3): 107-115. Phouphenghack K, Kamsrichan W, Vorakitpokatorn S: Knowledge and perception of mothers about immunization of children under 3 years of age in the Saythany District, Vientiane. Lao PDR J Public Health. 2007, 5 (3): 107-115.
22.
go back to reference Qidwai W, Ali S, Ayub S: Knowledge, attitude and practice regarding immunization among family practice patients. J Dow Univ Health Sci. 2007, 1 (1): 15-19. Qidwai W, Ali S, Ayub S: Knowledge, attitude and practice regarding immunization among family practice patients. J Dow Univ Health Sci. 2007, 1 (1): 15-19.
23.
go back to reference Roodpeyma S, et al: Mothers and vaccination: Knowledge, attitudes, and practice in Iran. J Pediatr Infect Dis. 2007, 2 (1): 29-34. Roodpeyma S, et al: Mothers and vaccination: Knowledge, attitudes, and practice in Iran. J Pediatr Infect Dis. 2007, 2 (1): 29-34.
24.
go back to reference Shah B, Sharma M, Vani S: Knowledge, attitude and practice of immunization in an urban educated population. Ind J Pediatr. 1991, 58 (5): 691-695. 10.1007/BF02820193.CrossRef Shah B, Sharma M, Vani S: Knowledge, attitude and practice of immunization in an urban educated population. Ind J Pediatr. 1991, 58 (5): 691-695. 10.1007/BF02820193.CrossRef
25.
go back to reference Sedney MA: Comments on median split procedures for scoring androgyny measures. Sex Roles. 1981, 7.2: 217-222.CrossRef Sedney MA: Comments on median split procedures for scoring androgyny measures. Sex Roles. 1981, 7.2: 217-222.CrossRef
26.
go back to reference Stanley B, et al: Association of aggressive behavior with altered serotonergic function in patients who are not suicidal. Am J Psychiatr. 2000, 157 (4): 609-614. 10.1176/appi.ajp.157.4.609.CrossRefPubMed Stanley B, et al: Association of aggressive behavior with altered serotonergic function in patients who are not suicidal. Am J Psychiatr. 2000, 157 (4): 609-614. 10.1176/appi.ajp.157.4.609.CrossRefPubMed
27.
go back to reference Thompson R, Teare J, Elliott S: Impulsivity: from theoretical constructs to applied interventions. J Spec Educ. 1983, 17 (2): 157-169. 10.1177/002246698301700207.CrossRef Thompson R, Teare J, Elliott S: Impulsivity: from theoretical constructs to applied interventions. J Spec Educ. 1983, 17 (2): 157-169. 10.1177/002246698301700207.CrossRef
29.
go back to reference Duclos P: Vaccination coverage of 2-year-old children and immunization practices–Canada, 1994. Vaccine. 1997, 15 (1): 20-24. 10.1016/S0264-410X(96)00122-3.CrossRefPubMed Duclos P: Vaccination coverage of 2-year-old children and immunization practices–Canada, 1994. Vaccine. 1997, 15 (1): 20-24. 10.1016/S0264-410X(96)00122-3.CrossRefPubMed
30.
go back to reference Lopreiato J, Ottolini M: Assessment of immunization compliance among children in the Department of Defense health care system. Pediatrics. 1996, 97 (3): 308-311.PubMed Lopreiato J, Ottolini M: Assessment of immunization compliance among children in the Department of Defense health care system. Pediatrics. 1996, 97 (3): 308-311.PubMed
31.
go back to reference Ba’amer A: Coverage of and barriers to routine child vaccination in Mukalla district, Hadramout governorate, Yemen. East Mediterr Health j. 2007, 16 (2): 223-227. Ba’amer A: Coverage of and barriers to routine child vaccination in Mukalla district, Hadramout governorate, Yemen. East Mediterr Health j. 2007, 16 (2): 223-227.
32.
go back to reference Hamlin J, et al: Inappropriately timed immunizations: types, causes, and their relationship to record keeping. Am J Public Health. 1996, 86 (12): 1812-1814. 10.2105/AJPH.86.12.1812.CrossRefPubMedPubMedCentral Hamlin J, et al: Inappropriately timed immunizations: types, causes, and their relationship to record keeping. Am J Public Health. 1996, 86 (12): 1812-1814. 10.2105/AJPH.86.12.1812.CrossRefPubMedPubMedCentral
33.
go back to reference Hariweni T, et al: Knowledge, attitude, and practice of underfive children stimulation of working and nonworking mothers. Paediatr Indones. 2004, 44 (3–4): 101-105. Hariweni T, et al: Knowledge, attitude, and practice of underfive children stimulation of working and nonworking mothers. Paediatr Indones. 2004, 44 (3–4): 101-105.
34.
go back to reference Strobino D, et al: Parental attitudes do not explain underimmunization. Pediatrics. 1996, 98 (6): 1076-1083.PubMed Strobino D, et al: Parental attitudes do not explain underimmunization. Pediatrics. 1996, 98 (6): 1076-1083.PubMed
35.
go back to reference Angelillo I, et al: Mothers and vaccination: knowledge, attitudes, and behaviour in Italy. Bull World Health Organ. 1999, 77 (3): 224-229.PubMedPubMedCentral Angelillo I, et al: Mothers and vaccination: knowledge, attitudes, and behaviour in Italy. Bull World Health Organ. 1999, 77 (3): 224-229.PubMedPubMedCentral
36.
go back to reference Al-Lela O, et al: Iraqi parents’ views of barriers to childhood immunization. EMHJ. 2013, 19 (3): 295-297. Al-Lela O, et al: Iraqi parents’ views of barriers to childhood immunization. EMHJ. 2013, 19 (3): 295-297.
37.
go back to reference Mansuri FA, Baig LA: Assessment of immunization service in perspective of both the recipients and the providers: a reflection from focus group discussions. J Ayub Med Coll Abbottabad. 2003, 15 (1): 14-18.PubMed Mansuri FA, Baig LA: Assessment of immunization service in perspective of both the recipients and the providers: a reflection from focus group discussions. J Ayub Med Coll Abbottabad. 2003, 15 (1): 14-18.PubMed
39.
go back to reference Gentile A, et al: Delayed vaccine schedule and missed opportunities for vaccination in children up to 24 months: a multicenter study. Arch Argent Pediatria. 2011, 109 (3): 219-225. Gentile A, et al: Delayed vaccine schedule and missed opportunities for vaccination in children up to 24 months: a multicenter study. Arch Argent Pediatria. 2011, 109 (3): 219-225.
40.
go back to reference Tanon V, Borrero C, Pedrogo Y: Knowledge and misconceptions about immunizations among medical students, pediatric, and family medicine resident. Bol Asoc Med Puerto Rico. 2010, 102 (1): 5-8. Tanon V, Borrero C, Pedrogo Y: Knowledge and misconceptions about immunizations among medical students, pediatric, and family medicine resident. Bol Asoc Med Puerto Rico. 2010, 102 (1): 5-8.
41.
go back to reference Shaw JS, et al: Impact of an encounter-based prompting system on resident vaccine administration performance and immunization knowledge. Pediatrics. 2000, 105 (Supplement): 978-983.PubMed Shaw JS, et al: Impact of an encounter-based prompting system on resident vaccine administration performance and immunization knowledge. Pediatrics. 2000, 105 (Supplement): 978-983.PubMed
42.
go back to reference Smith P, et al: Association between health care providers' influence on parents who have concerns about vaccine safety and vaccination coverage. Pediatrics. 2006, 118 (5): e1287-e1292. 10.1542/peds.2006-0923.CrossRefPubMed Smith P, et al: Association between health care providers' influence on parents who have concerns about vaccine safety and vaccination coverage. Pediatrics. 2006, 118 (5): e1287-e1292. 10.1542/peds.2006-0923.CrossRefPubMed
43.
go back to reference Rajesh K, et al: Knowledge about tetanus immunization among doctors in Delhi. Ind J Med Sci. 2005, 59 (1): 3-8. 10.4103/0019-5359.13811.CrossRef Rajesh K, et al: Knowledge about tetanus immunization among doctors in Delhi. Ind J Med Sci. 2005, 59 (1): 3-8. 10.4103/0019-5359.13811.CrossRef
44.
go back to reference Speers T, Lewis J: Journalists and jabs: media coverage of the MMR vaccine. Commun Med. 2004, 1 (2): 171-181. 10.1515/come.2004.1.2.171.CrossRefPubMed Speers T, Lewis J: Journalists and jabs: media coverage of the MMR vaccine. Commun Med. 2004, 1 (2): 171-181. 10.1515/come.2004.1.2.171.CrossRefPubMed
45.
go back to reference Quaiyum MA, et al: Impact of national immunization days on polio-related knowledge and practice of urban women in Bangladesh. Health Policy Plan. 1997, 12 (4): 363-371. 10.1093/heapol/12.4.363.CrossRefPubMed Quaiyum MA, et al: Impact of national immunization days on polio-related knowledge and practice of urban women in Bangladesh. Health Policy Plan. 1997, 12 (4): 363-371. 10.1093/heapol/12.4.363.CrossRefPubMed
46.
go back to reference Singh M, Badole C, Singh M: Immunization coverage and the knowledge and practice of mothers regarding immunization in rural area. Ind J public health. 1994, 38 (3): 103-107. Singh M, Badole C, Singh M: Immunization coverage and the knowledge and practice of mothers regarding immunization in rural area. Ind J public health. 1994, 38 (3): 103-107.
47.
go back to reference Bhasin SK, Agarwal OP, Kanan AT: Knowledge and practice of mothers regarding pulse polio immunization in National Capital Territory of Delhi. J commun dis. 1997, 29 (4): 363-366.PubMed Bhasin SK, Agarwal OP, Kanan AT: Knowledge and practice of mothers regarding pulse polio immunization in National Capital Territory of Delhi. J commun dis. 1997, 29 (4): 363-366.PubMed
48.
go back to reference Sharkness CM, et al: Do we practice what we teach about childhood immunizations in New Jersey?. Family Medicine-Kansas City. 1998, 30: 727-732. Sharkness CM, et al: Do we practice what we teach about childhood immunizations in New Jersey?. Family Medicine-Kansas City. 1998, 30: 727-732.
49.
go back to reference Taylor JA, et al: The influence of provider behavior, parental characteristics, and a public policy initiative on the immunization status of children followed by private pediatricians: a study from Pediatric Research in Office Settings. Pediatrics. 1997, 99 (2): 209-215.PubMed Taylor JA, et al: The influence of provider behavior, parental characteristics, and a public policy initiative on the immunization status of children followed by private pediatricians: a study from Pediatric Research in Office Settings. Pediatrics. 1997, 99 (2): 209-215.PubMed
Metadata
Title
Are parents' knowledge and practice regarding immunization related to pediatrics’ immunization compliance? a mixed method study
Authors
Omer Qutaiba B Al-lela
Mohd Baidi Bahari
Harith Khalid Al-Qazaz
Muhannad RM Salih
Shazia Q Jamshed
Ramadan M Elkalmi
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2014
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/1471-2431-14-20

Other articles of this Issue 1/2014

BMC Pediatrics 1/2014 Go to the issue