Immunization status and sociodemographic characteristics: The mediating role of beliefs, attitudes, and perceived control

Objectives. This study examined how immunization-related beliefs, attitudes , and perceived control mediate up-to-date immunization among various socio demographic groups. Methods. Statewide estimates of immunization rates among children up to the age of 2 years were obtained via a multistage cluster sample. In-person in terviews were conducted with 4832 parents. Information about immunization w as obtained from official records or from health care providers. Results. Differences in immunization among sociodemographic groups were med iated by beliefs about objective barriers to immunization, protection, medi cal contraindication, safety concerns, distrust, and natural immunity. Prot ection beliefs contributed to positive attitudes toward immunization; belie fs in natural immunity and safety concerns contributed to negative attitude s. Beliefs about objective barriers, distrust, safety concerns, and medical contraindications influenced perceived control over immunization. Positive attitudes and a strong sense of control contributed to higher immunization rates. Conclusions. These findings provide a basis for efficient educational campa igns by specifying which beliefs should be bolstered (because they facilita te proper immunization) and which should be targeted for change (because th ey hinder proper immunization) in various sociodemographic groups.