Page 62 - Preventing pertussis in early infancy - Visser

Chapter 4
Quantitative study parents
(deliberate choice) and attitude. Furthermore, Lehmann (Lehmann et al. 2015) recently described the influence of naturalistic beliefs on influenza vaccination acceptance among Dutch healthcare workers. The disease beliefs Harmsen (Harmsen 2014) describes in her study on the acceptance of the National Immunization Programme include the same elements. Finally, trust in government and vaccines is a more often debated issue in vaccination acceptance literature nowadays and the influence of trust on the attitude towards vaccination is also confirmed in studies on pertussis cocooning acceptance as well as in other vaccination settings (Black et al. 2010, Larson et al. 2011, Yaqub et al. 2014, MacDougall et al. 2015). Moral norm reflects the moral responsibility parents feel towards pertussis cocooning vaccination. A study of Hayles (Hayles et al. 2016) described this determinant to be of importance in pertussis cocooning acceptance. Vaccination acceptance research in other settings has also found this determinant (sometimes called personal normative beliefs) to be of value (Godin et al. 2010, Dube et al. 2012, Juraskova et al. 2012, Harmsen 2014). The unique contribution of moral norm in the explanation of attitude in this study proves the value of the determinant in implementing pertussis cocooning.
Implications
We believe that the explanatory framework of the intention to accept pertussis cocooning vaccination presented in this study is useful in the design of a vaccination programme for pertussis cocooning to optimise vaccination uptake. First, because the framework is carefully and methodically composed: it is based on an extensive qualitative study and on literature research, and is in line with leading theoretical notions on the cognitive and affective factors determining health behaviour, among which the RAA. The RAA, or one of its predecessors TPB and TRA, has been used most often in vaccination acceptation research in different disease domains. These theories appear to be able to explain a vast percentage of the variance in intention to accept a vaccine, with other constructs sometimes added (Myers et al. 2011, Dube et al. 2012, Juraskova et al. 2012, Underwood et al. 2015, Yang 2015). Furthermore, our data show that the constructed theoretical model is robust. Univariate analysis showed all psychosocial determinants – except for autonomy – and all determinants of attitude to be significantly related to the outcome variable. These determinants provide a specific starting point in the design of effective vaccination programmes. The final multivariate models on both the determinants of intention and the determinants of attitude also showed good fit (72% and 65% respectively).
Limitations
Some limitations need to be addressed. First, we handed out brief information on pertussis, pertussis vaccination, and the rationale for pertussis cocooning to the research participants. Reading on a topic can always influence readers. However, in this study it was important to approximate the situation in which parents are actually offered a pertussis cocooning vaccination. Therefore, we chose to offer information in a way specifically
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