Page 53 - Preventing pertussis in early infancy - Visser

Chapter 4
Quantitative study parents
Introduction
Despite long-standing vaccination programmes with high coverage, a resurgence of pertussis has been reported in the past decades (Burns et al. 2014, Miller 2014), causing an increased risk of pertussis infection among young infants, who are too young to be fully protected by vaccination. For them, pertussis potentially runs a detrimental clinical course putting them at great risk of severe complications (e.g. apnea, convulsions, death) (Greenberg et al. 2005, Winter et al. 2012, Heininger et al. 2014).
In addition to the regular child immunisation programmes, several strategies have been designed in high-income countries to protect vulnerable infants from pertussis, such as maternal vaccination during pregnancy and cocooning (McIntyre et al. 2009, de Greeff et al. 2010, Libster et al. 2012). In pertussis cocooning, pertussis vaccination is offered to individuals surrounding an infant aiming to prevent transmission to the baby. Parents are an important target group in this strategy (Wiley et al. 2013). Several models based on transmission rates suggest that this strategy has the potential to decrease the disease burden of pertussis in newborns (Coudeville et al. 2009, de Greeff et al. 2012, Peters et al. 2012).So far, introduction of pertussis cocooning has led to a problematic uptake in various countries. (Baratin et al. 2014, Bodeker et al. 2014, Williams 2014). Understanding the potential barriers and enablers for parental acceptance is crucial, since interventions carefully considering these determinants within a coherent theoretical base assure optimal acceptance (Grimshaw et al. 2004, Grol 2013, Baker et al. 2015, Kok et al. 2016). Therefore, the aim of this study is to assess the intention of parents to accept a pertussis cocooning vaccination, and to explore its determinants.
Methods
Study design and population
We performed a cross-sectional questionnaire study among parents of newborns less than 2 months of age in the Netherlands. This specific group would also be the target group of a future parental pertussis cocooning vaccination programme.
Questionnaire development
A 98-item Dutch questionnaire was developed based on the results of a literature review and our previous qualitative study (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, Visser et al. 2016). In this study we conducted 13 focus group meetings and 6 individual interviews to explore the determinants of pertussis cocooning vaccination acceptance in both parents and various groups of healthcare workers. Upon evaluation of the results of this previous study in relation to the psychosocial literature on this topic, we noted similarities with the Reasoned Action Approach (RAA) (Fishbein et al. 2010, Visser et al. 2016). The RAA argues that behaviour (e.g. vaccine acceptance) is determined by the intention to perform this
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