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Using classification and regression tree analysis to explore parental influenza vaccine decisions.
Vaccine. 2020 01 29; 38(5):1032-1039.V

Abstract

BACKGROUND AND OBJECTIVES

Influenza poses a public health threat for children and adults. The CDC recommends annual influenza vaccination for children <18 years, yet vaccine uptake remains low for children (57.9%) and adults (37.1%). Given that parental decision-making is key in childhood vaccine uptake, there is a critical need to understand vaccine hesitancy among parents who decide not to vaccinate their children. This study aims to explore predictors of children's influenza vaccine status given parental vaccination status and examine the factors that contribute to concordance or discordance between parental and children's vaccine uptake.

METHODS

Classification and regression tree (CART) analyses were used to identify drivers of parental decisions to vaccinate their children against influenza. Hierarchy and interactions of these variables in predicting children's vaccination status were explored.

RESULTS

From a nationally representative sample of non-Hispanic Black and White parents who completed an online survey (n = 328), the main factors influencing parents' decisions to vaccinate their children were vaccine behavior following physician recommendation, knowledge of influenza recommendations for children, influenza vaccine confidence and disease risk. Among unvaccinated parents, the greatest concordance was observed among parents who usually do not get vaccinated following physician recommendation and had lower knowledge of recommendations for influenza vaccination for children. The greatest discordance was observed among unvaccinated parents who had lower hesitancy about recommended vaccines.

CONCLUSIONS

Understanding drivers of parental decisions to vaccinate themselves and their children can provide insights on health communication and provider approaches to increase influenza vaccine coverage and prevent influenza related mortality.

Authors+Show Affiliations

Department of Family Science, University of Maryland, College Park, MD, United States. Electronic address: lamay@terpmail.umd.edu.Department of Human Development and Quantitative Methods, University of Maryland, College Park, MD, United States.Center for Health and Risk Communication (Emeritus), University of Georgia, Athens, GA, United States.Center for Health Equity, University of Maryland, College Park, MD, United States.Department of Family Science, University of Maryland, College Park, MD, United States; Center for Health Equity, University of Maryland, College Park, MD, United States.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

31806534

Citation

Lama, Yuki, et al. "Using Classification and Regression Tree Analysis to Explore Parental Influenza Vaccine Decisions." Vaccine, vol. 38, no. 5, 2020, pp. 1032-1039.
Lama Y, Hancock GR, Freimuth VS, et al. Using classification and regression tree analysis to explore parental influenza vaccine decisions. Vaccine. 2020;38(5):1032-1039.
Lama, Y., Hancock, G. R., Freimuth, V. S., Jamison, A. M., & Quinn, S. C. (2020). Using classification and regression tree analysis to explore parental influenza vaccine decisions. Vaccine, 38(5), 1032-1039. https://doi.org/10.1016/j.vaccine.2019.11.039
Lama Y, et al. Using Classification and Regression Tree Analysis to Explore Parental Influenza Vaccine Decisions. Vaccine. 2020 01 29;38(5):1032-1039. PubMed PMID: 31806534.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Using classification and regression tree analysis to explore parental influenza vaccine decisions. AU - Lama,Yuki, AU - Hancock,Gregory R, AU - Freimuth,Vicki S, AU - Jamison,Amelia M, AU - Quinn,Sandra Crouse, Y1 - 2019/12/02/ PY - 2019/08/12/received PY - 2019/11/12/revised PY - 2019/11/18/accepted PY - 2019/12/7/pubmed PY - 2021/2/27/medline PY - 2019/12/7/entrez KW - Child health KW - Influenza KW - Influenza vaccination KW - Vaccine decision-making SP - 1032 EP - 1039 JF - Vaccine JO - Vaccine VL - 38 IS - 5 N2 - BACKGROUND AND OBJECTIVES: Influenza poses a public health threat for children and adults. The CDC recommends annual influenza vaccination for children <18 years, yet vaccine uptake remains low for children (57.9%) and adults (37.1%). Given that parental decision-making is key in childhood vaccine uptake, there is a critical need to understand vaccine hesitancy among parents who decide not to vaccinate their children. This study aims to explore predictors of children's influenza vaccine status given parental vaccination status and examine the factors that contribute to concordance or discordance between parental and children's vaccine uptake. METHODS: Classification and regression tree (CART) analyses were used to identify drivers of parental decisions to vaccinate their children against influenza. Hierarchy and interactions of these variables in predicting children's vaccination status were explored. RESULTS: From a nationally representative sample of non-Hispanic Black and White parents who completed an online survey (n = 328), the main factors influencing parents' decisions to vaccinate their children were vaccine behavior following physician recommendation, knowledge of influenza recommendations for children, influenza vaccine confidence and disease risk. Among unvaccinated parents, the greatest concordance was observed among parents who usually do not get vaccinated following physician recommendation and had lower knowledge of recommendations for influenza vaccination for children. The greatest discordance was observed among unvaccinated parents who had lower hesitancy about recommended vaccines. CONCLUSIONS: Understanding drivers of parental decisions to vaccinate themselves and their children can provide insights on health communication and provider approaches to increase influenza vaccine coverage and prevent influenza related mortality. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/31806534/Using_classification_and_regression_tree_analysis_to_explore_parental_influenza_vaccine_decisions_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(19)31568-3 DB - PRIME DP - Unbound Medicine ER -