Date of Graduation

1996

Document Type

Dissertation/Thesis

Abstract

Despite the availability of effective vaccines, immunization rates among two-year old children continue to be low in many areas of the United States including West Virginia. The overall goal of this study was to identify barriers to childhood immunization in rural West Virginia, determine factors that are important in the timely completion of the childhood immunization schedule, develop and validate immunization persuasion messages, and determine which message strategy, fear, motherhood-arousal or rational is most effective in attracting mothers' attention to their child's past-due immunization status. The study was conducted in two phases. In phase I, a telephone survey was used to collect data from a randomly selected sample of 316 mothers, of two-year olds, from 18 rural counties of West Virginia. Results indicate that two-thirds or 65% of the children in the study sample had completed their recommended immunizations by two years of age. Immunization barriers identified in this study, include: living in health professional shortage areas, lack of health insurance, low socioeconomic status, negative beliefs and attitudes regarding childhood immunizations, problems accessing the immunization clinic, and a perception of inadequate support from the immunization clinic. Results of the structural equation modeling, using LISREL-8, indicated that 20% of the variation in immunization completion (R{dollar}\\sp2{dollar} = 0.197) was explained by attitude towards immunization and perceived clinic support. Furthermore, 42% of the variation in attitude towards immunization (R{dollar}\\sp2{dollar} = 0.419) was explained by immunization related beliefs, and 28% of the variation in immunization related beliefs (the R{dollar}\\sp2{dollar} = 0.277) was explained by general problems faced during immunization and perceived clinic support. In phase II, three immunization persuasion messages were developed, validated, and tested for their effectiveness. All three messages were found to be valid in terms of their hypothesized persuasive effects. However, the fear message was most effective in attracting mothers' attention to their child's past-due immunization status. The study concludes that positive immunization-related beliefs and attitudes, support from the immunization clinic, and ease of the immunization seeking process are important factors in the timely of completion of the childhood immunization schedule.

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