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James A. Taylor, MD; Robert D. Newman, MD, MPH; for the Puget Sound Pediatric Research Network

Arch Pediatr Adolesc Med. 2000;154:302-306.

Objectives  To evaluate parental health beliefs regarding the varicella vaccine and to identify potential areas for interventions designed to increase immunization against varicella.

Setting  Data were collected in the offices of pediatricians who are members of the Puget Sound Pediatric Research Network, a regional practice-based research group in the Seattle, Wash, area.

Methods  At the time of an office visit, parents were asked to complete a survey on the varicella vaccine. Respondents indicated level of agreement with 10 health belief statements regarding the immunization using a 6-point Likert scale from "completely agree" to "completely disagree"; responses were subsequently transformed to an ordinal scale from 1 to 6, with 6 corresponding to highly positive beliefs. A composite health belief score for each respondent was computed by averaging responses to all statements. Parents also were asked to indicate the level of influence of their child's pediatrician on their decision to use the varicella vaccine.

Results  A total of 598 surveys were completed. Generally, parents agreed that the vaccine was worthwhile even if the only benefit was preventing a rare complication. Conversely, the majority of parents disagreed that varicella vaccine was worthwhile if the only benefit was preventing lost time from work, and that the immunization was worthwhile even if immunity was not lifelong. Parents who indicated that their child's pediatrician's opinion significantly influenced their decision to use the vaccine had higher composite health belief scores than those who indicated less influence (median scores, 4.3 and 4.0, respectively; P<.001).

Conclusions  In this sample, parents had more positive health beliefs about the ability of varicella vaccine to prevent rare complications than to save time lost from work. These data also suggest that pediatricians can have an important role in increasing positive health beliefs about the vaccine. These findings may help future interventions to increase the immunization rate against varicella.

From the Division of General Pediatrics, Department of Pediatrics, University of Washington School of Medicine (Drs Taylor and Newman), International Health Program, Department of Health Services, University of Washington School of Public Health and Community Medicine (Dr Newman), and Health Alliance International (Dr Newman), Seattle, Wash.

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