A longitudinal study using parental cognitions based on the theory of planned behavior to predict childhood influenza vaccination

J Infect Public Health. 2020 Jul;13(7):970-979. doi: 10.1016/j.jiph.2020.04.009. Epub 2020 May 14.

Abstract

Background: The World Health Organization recommends young children aged 6-59 months receive influenza vaccination (IV) annually. This study investigated the IV incidence in a 12-month follow-up period among 24-59 month-old children and identified its predictors based on the theory of planned behavior (TPB).

Methods: A population-based random telephone survey was conducted at baseline (March-June 2011) among Chinese parents of 24-59 month-old children in Hong Kong, China, and a follow-up survey was conducted 12 months afterwards (N=440).

Results: The IV prevalence was 63.2% at follow-up (3% increased from baseline). The IV incidence during the follow-up period for all sampled, ever-vaccinated, and never-vaccinated children was 35.6, 58.5, and 7.7 per 100 person-years, respectively. Stratified analyses of logistic regression were performed for the ever-vaccinated and never-vaccinated children. After adjusting for significant socio-demographic variable(s), parental positive attitude, norm, and behavioral intention were significant predictors of IV at follow-up among ever-vaccinated children, while intention was the only significant predictor among never-vaccinated children.

Conclusions: Most of the IVs received during the follow-up period were re-vaccinations rather than first-time vaccinations. Efforts should target never-vaccinated children's parents, who reported low incidence and intention. TPB also worked less well among never-vaccinated children, and thus research for other predictors of never-vaccinated children's first-time vaccination are warranted. Promotion programs should consider segmentation by children's prior vaccination status.

Keywords: Influenza; Prior experience; Theory of planned behavior; Vaccination; Young children.

MeSH terms

  • Adult
  • Attitude to Health
  • Child, Preschool
  • Cognition
  • Female
  • Follow-Up Studies
  • Hong Kong
  • Humans
  • Incidence
  • Influenza Vaccines / therapeutic use*
  • Influenza, Human / prevention & control*
  • Intention
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Parents / psychology*
  • Surveys and Questionnaires
  • Vaccination / psychology
  • Vaccination / statistics & numerical data*

Substances

  • Influenza Vaccines