Predictors of childhood immunization completion in a rural population

Despite the availability of effective vaccines, immunization rates among tw o-year old children continue to be low in many areas of the United States i ncluding rural West Virginia. The goal of this study was to identify barrie rs to childhood immunization in rural West Virginia and determine factors t hat were important in the completion of the childhood immunization schedule . A telephone survey was used to collect data from a randomly selected samp le of 316 mothers, of two-year olds, from 18 rural counties of West Virgini a. Results indicated that two-thirds or 65% of the children in the study sa mple had completed their recommended immunizations by two years of age. Imm unization barriers identified in this study include: living in health profe ssional shortage areas, lack of health insurance, negative beliefs and atti tudes regarding childhood immunizations, problems accessing the immunizatio n clinic, and a perception of inadequate support from the immunization clin ic. Results of the structural equation modeling, using LISREL-8, indicated that 20% of the variation in immunization completion (R-2 = 0.197) was expl ained by attitude towards immunization and perceived support received from the immunization clinic. Furthermore, 42% of the variation in attitude towa rds immunization (R-2 = 0.419) was explained by immunization-related belief s, and 28% of the variation in immunization-related beliefs (the R-2 = 0.27 7) was explained by general problems faced during immunization and perceive d clinic support. The study concluded that positive immunization-related be liefs and attitudes, support from the immunization clinic, and ease of the immunization seeking process are important factors in the timely completion of the childhood immunization schedule. (C) 1999 Elsevier Science Ltd. All rights reserved.