Page 107 - Preventing pertussis in early infancy - Visser

General discussion General discussion
Validating the measure of general vaccination beliefs in parents and HCWs led to small differences in the definition of these beliefs in the two target groups. This is further described in the paragraph on general vaccination beliefs and marked in Figure 7.1 by the beliefs labelled with an asterisk.
The specific placement of each determinant in the framework (i.e. as determinant of attitude, intention, or vaccination behaviour) could be an issue for discussion. In the design of the framework, we based the choice of the specific placements mostly on available knowledge from the RAA (Fishbein et al. 2010), in combination with the available knowledge on correlations from literature at that time (Goins et al. 2007, Wicker et al. 2008, Cheng et al. 2010, Top et al. 2010, Miller et al. 2011, Baron-Epel et al. 2012, Wiley et al. 2013). In most other studies, it is either unclear how assumptions on the interrelation of measured determinants are made, or how sometimes other decisions are taken regarding the specific place of a determinant and how it influences intentional or actual vaccination behaviour. For instance, the study of Harmsen et al (Harmsen 2014) places moral norm also as a determinant of the intention to accept a childhood vaccination, whereas we assumed it was a determinant of one’s attitude. Although the placement of a determinant might slightly influence how relevant it turns out to be, it is mostly of importance for theoretical discussions. The potential impact on practice – i.e. when using the framework to influence behaviour – seems small as long as all determinants are taken into account in the design of a vaccination programme. However, it could have some influence on the priority that is ascribed to a determinant in intervention development.
Figure 7.1 Theoretical model of the acceptance of pertussis vaccination in parents and HCWs, based on integration of our qualitative and quantitative studies.
The blue boxes in the figure have been assessed in our questionnaire studies.* These determinants are constructs that were part of the general vaccination beliefs in parents, and were separately reported in HCWs. See the paragraph on general vaccination beliefs for more information.
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