Abstract | OBJECTIVE: To determine the causes of low childhood immunization rates based on physicians' knowledge, attitudes, and self-reported practices concerning childhood immunization. DESIGN: A standardized telephone survey conducted by trained interviewers. SETTING: Primary care physicians across the United States. PARTICIPANTS: A stratified random sample of office-based family physicians, pediatricians, and general practitioners younger than 65 years was selected from the American Medical Association master file list that includes nonmembers. Physicians seeing 5 or more patients per week younger than 6 years and having 50% or more primary care patients were eligible for study. Of 1769 eligible physicians who spoke directly with the interviewers, 70% (N = 1241) completed the questionnaire. INTERVENTIONS: The interview was designed to determine physicians' likelihood of recommending vaccination in common clinical scenarios and to probe reasons behind these decisions. RESULTS: Only 4% of physicians who thought the risk for side effects was increased by upper respiratory tract infection (URI) were likely to vaccinate a child with URI vs 55% of physicians who thought there would be no increased risk (P < .001). Eighty-three percent of those who thought the efficacy of measles, mumps, and rubella vaccine would not be affected by a URI recommended vaccination vs only 8% of physicians who thought efficacy would decrease (P < .001). Some respondents (11%) would not administer 3 injectable vaccines simultaneously based on beliefs about side effects, parental objections, and vaccine efficacy. Physicians' likelihood of vaccination also varied by type of visit: 47% were less likely to vaccinate a child with a URI in an acute care as opposed to a well-child setting. CONCLUSION: Physicians' beliefs and practice policies materially influence their likelihood of recommending vaccinations.
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Authors | R K Zimmerman, J J Schlesselman, A L Baird, T A Mieczkowski |
Journal | Archives of pediatrics & adolescent medicine
(Arch Pediatr Adolesc Med)
Vol. 151
Issue 7
Pg. 657-64
(Jul 1997)
ISSN: 1072-4710 [Print] United States |
PMID | 9232038
(Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)
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Topics |
- Attitude of Health Personnel
- Child
- Family Practice
- Health Care Surveys
- Humans
- Immunization
(statistics & numerical data)
- Pediatrics
- Practice Patterns, Physicians'
(statistics & numerical data)
- Surveys and Questionnaires
- Telephone
- Time Factors
- United States
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