Parent Behavior Management Training for Child ADHD Enhanced to Address Health Behaviors: Comparison of Telemedicine "Telegroup" Versus In-Person Delivery.

OBJECTIVE: ADHD is associated with suboptimal health behaviors including physical activity (PA). LEAP is a parent BMT group program enhanced to focus on health behaviors, integrated with mHealth technology. Little is known about implementing BMT via telemedicine "telegroups." METHODS: Children ages 5 to 10 with ADHD and their caregiver wore activity trackers and participated in an 8 to 9 week parent BMT and social media group emphasizing PA, sleep, and screen use. A 7-day child accelerometer-wear and parent and teacher measures were completed pre- and post-group. Groups were in-person prior to the COVID-19 pandemic and in telegroup format during the pandemic. RESULTS: Thirty-three families participated in person and 23 participated via virtual telegroup. Group attendance was superior for telegroup with equivalent satisfaction and skill use. Changes in health behavior and clinical outcomes were equivalent. CONCLUSIONS: LEAP is a feasible and novel BMT intervention that can be delivered in an accessible telegroup format with high participation and acceptability.

Development of PIVOT with MI: A motivational Interviewing-Based vaccine communication training for pediatric clinicians.

Delay or refusal of childhood vaccines is common and may be increasing. Pediatricians are parents' most trusted source for vaccine information, yet many struggle with how to communicate with parents who resist recommended vaccines. Evidence-based communication strategies for vaccine conversations are lacking. In this manuscript, we describe the development and perceived usefulness of a curriculum to train clinicians on a specific vaccine communication strategy as part of the PIVOT with MI study, a cluster randomized trial testing the effectiveness of this communication strategy on increasing childhood vaccination uptake among 24 pediatric practices in Colorado and Washington. The communication strategy is based on the existing evidence-based communication strategies of a presumptive format for initiating vaccine conversations and use of motivational interviewing if hesitancy persists. Focus groups and semi-structured interviews with pediatric clinicians helped inform the development of the training curriculum, which consisted of an introductory video module followed by 3 training sessions. Between September 2019 and January 2021, 134 pediatric clinicians (92 pediatricians, 42 advanced practice providers) participated in the training as part of the PIVOT with MI study. Of these, 92 % viewed an introductory video module, 93 % attended or viewed a baseline synchronous training, 82 % attended or viewed a 1st refresher training, and 77 % attended or viewed a 2nd refresher training. A follow-up survey was administered August 2020 through March 2021; among respondents (n = 100), >95 % of participants reported that each component of the training program was very or somewhat useful. These data suggest that the PIVOT with MI training intervention is a useful vaccine communication resource with the potential for high engagement among pediatric clinicians.

Parenting in a Pandemic: Preliminary Support for Delivering Brief Behavioral Parent Training Through Telehealth.

Behavioral problems, such as noncompliance and aggression, are a common referral reason to mental health services for young children. Behavioral parent training (BPT) is the leading intervention for addressing behavioral problems and leads to benefits in a variety of parental factors (e.g., parenting efficacy and parenting stress). While the COVID-19 pandemic dramatically shifted service delivery toward telehealth services, limited work has evaluated the effectiveness of BPT when delivered in a brief, group format through telehealth. The current retrospective chart review study evaluated the engagement to and preliminary effectiveness of a brief version of BPT delivered through telehealth to 64 families of 3- to 7-year-olds referred for behavioral problems. Families attended an average of 4.55 of 6 sessions and most families had two caregivers who engaged in the intervention. Significant reductions in caregivers' report of children's behavioral problems and improvements in parenting self-efficacy resulted. Future research and clinical implications are discussed.

Parental COVID-19-related health information practises, sources, evaluations and needs: A qualitative interview study.

BACKGROUND: Parents of infants and young children may have specific health information needs and preferences, as they are responsible for their children's health. COVID-19 posed many challenges for families, not least in terms of the constantly updated disease-prevention guidelines. However, little is known about parents' experiences with this unprecedented situation, that is, how and where they seek, use and evaluate COVID-19 (child)-specific health information. We aimed to find out more about this to provide insights to health (information) providers when communicating pandemic information to parents. METHODS: We conducted semistructured telephone interviews (August to October 2020) with a purposively selected sample of 20 German-speaking and 10 Arabic-speaking parents of children up to 4 years old. Recruitment occurred through multiple channels, including childcare institutions and social media. Qualitative content analysis of the interview transcripts illustrates the main differences between the two groups. RESULTS: By the time the interviews were conducted (mid-2020), some parents reported to seek information less actively or not at all, compared to the beginning of COVID-19. German speakers frequently used Google to obtain information, whereas Arabic speakers mentioned social media (particularly Facebook) as a central source. However, medical providers were the most trusted source for child health. Though determining the credibility of online information was difficult for some parents, others, mostly German speakers (middle-high education), were aware of some author-related criteria. When deciding on information use, parents often rely on their own judgement and gut instinct. Besides the necessity to disseminate information via multiple outlets to reach all parents, Arabic speakers desired audio-visual and translation tools to facilitate understanding. DISCUSSION AND PUBLIC CONCLUSION: Apart from education, language and knowledge of the health system and of the attributes of credible information may determine its quality and consequent decisions. There seems to be a considerable need to foster knowledge about reliable information sources, a greater understanding of the range of quality criteria and specific support for nonnative speakers, not least to better inform parents' decision-making. PATIENT AND PUBLIC CONTRIBUTION: A parent panel (n = 7) contributed to gathering ideas regarding recruitment, discussing initial results and the choice of topics and questions for a second interview phase.

Protocol for the PLAYshop randomised controlled trial: examining efficacy of a virtually delivered parent-focused physical literacy intervention for early childhood on child-specific and family-specific outcomes.

INTRODUCTION: The PLAYshop programme is a novel, brief, theory-based, parent-focused physical literacy intervention in early childhood designed to address the major public health issue of childhood physical inactivity. The primary objective of this study is to examine the efficacy of the virtually delivered PLAYshop programme in increasing preschool-aged children's physical literacy, including fundamental movement skills and motivation and enjoyment. METHODS AND ANALYSIS: This study aims to recruit 130 families with preschool-aged children (3-5 years) from Alberta and British Columbia, Canada who will be randomised to an intervention or control group. The PLAYshop programme is informed by the Capability, Opportunity, Motivation, Behavior (COM-B) model and includes four intervention strategies: (1) educational training via a 60 min virtual synchronous workshop, (2) educational resources via handouts, (3) material resources via a goody bag of basic active play equipment and (4) follow-up support via access to a digital app with an online toolkit and four biweekly booster lessons (1-week, 3-week, 5-week and 7-week follow-up). To assess the primary outcome of physical literacy, five fundamental movement skills (overhand throw, underhand throw, horizontal jump, hop, one leg balance) will be measured virtually at baseline and 2-month follow-up using the Test of Gross Motor Development (TGMD) and the Movement Assessment Battery for Children-Second Edition (MABC-2) tools. Additionally, children's motivation and enjoyment will also be assessed at baseline and 2-month follow-up by: (1) parental-report using items from the Preschool Physical Literacy Assessment (PrePLAy) and (2) self-report using an adapted Five Degrees of Happiness Likert scale for children. The control group will receive the PLAYshop programme after the 2-month follow-up. ETHICS AND DISSEMINATION: The protocol was approved by the University of Alberta (00093764) and University of Victoria (16-444) Research Ethics Boards. Findings will be disseminated through peer-reviewed publications, conference presentations, social and traditional media and a circulated infographic. TRIAL REGISTRATION NUMBER: NCT05255250.

Best shot: A motivational interviewing approach to address vaccine hesitancy in pediatric outpatient settings.

BACKGROUND: Vaccine hesitancy in parents and childhood vaccine refusal is increasing. A standard of care to address this problem has not been identified. PURPOSE: To identify if the use of motivational interviewing by pediatric providers during routine well child visits, when compared to standard of care, would increase vaccine rates in children 0-12 months of age. Factors associated with vaccine hesitancy were also investigated. METHODS: A quasi-experimental study was completed on a convenience sample of pediatric providers (N = 6) and caregivers of children 0-12 months of age (N = 66). Four providers were trained to use motivational interviewing. During the well child visit the Parent Attitudes About Childhood Vaccines survey was completed, and the motivational interviewing intervention was implemented. Clinic's data were compared with other clinic data of non-trained providers. FINDINGS: Vaccine refusal/delays rate was 11.4% among caregivers. Vaccine refusal rate decreased after the intervention (9.00% pre-intervention and 6.40% post-intervention). An ordinal regression identified caregivers with higher vaccine hesitancy scores and more children were more likely to delay or refuse vaccines, while caregivers ≥30 years or with high income were less likely to delay/refuse vaccines. A difference in difference analysis identified that an additional 2.6% of children received vaccines when seen by trained providers compared to non-trained (ß = -0.330, OR = 0.719, p = 0.470). DISCUSSION: Findings indicate a condensed motivational interviewing education session may be clinically significant in decreasing vaccine hesitancy among this population. APPLICATIONS TO PRACTICE: A more robust study to confirm these findings is recommended prior to practice implementation.

Parents' and guardians' acceptability of COVID-19 vaccination for children in Ghana: An online survey.

Few studies have examined the intentions of parents and guardians to vaccinate their children younger than 18 years against COVID-19 in Ghana. Parents are the decision makers for children younger than 18 years; therefore, we examined parents' and guardians' intentions to accept the COVID-19 vaccines for their children. An online survey was conducted among 415 parents and guardians in Ghana. The Statistical Package for Social Sciences version 25 was used to analyse the data. We found that 73.3% of parents/guardians would allow their children to be vaccinated against COVID-19. The binary logistic regression analysis shows that parents/guardians with Senior High School education, those who believed COVID-19 could not be cured, and those who agreed and those who neither agreed nor disagreed with the statement "once the vaccine is available and approved, it would be safe" were less likely to accept COVID-19 vaccine for their children. Also, parents/guardians who neither agreed nor disagreed that "the best way to avoid the complications of COVID-19 is by being vaccinated", those who agreed that "I am of the notion that physiological/natural community is better compared to vaccine-induced immunity" and "I believe the vaccine programming may be likened to the new world order" were less likely to accept COVID-19 vaccine for their children. There is a need for public health practitioners to intensify education on the benefits and side effects of COVID-19 vaccines, as well as provide regular and up-to-date information about vaccines' safety to parents and guardians.

Educational videos to address vaccine hesitancy in childhood immunization.

BACKGROUND: As one of the essential programs that have been developed for decades, childhood immunizations are mandatory to protect children from vaccine-preventable diseases. Despite its availability and accessibility, immunization coverage has not reached the intended goals. Vaccine hesitancy and COVID-19 pandemic may threaten immunization coverage in children. This study aimed to evaluate the tailored educational videos to reduce vaccine hesitancy and analyze the changes in childhood routine immunization status. METHODS: This was an interventional quasi-experimental study in three subdistricts of North Jakarta, Indonesia. Participants were allocated into educational videos exposures (intervention group, n = 116) or to the digital version of the maternal and child health handbook (control group, n = 104). We administered a pre- and post-intervention vaccine hesitancy survey using the Parent Attitudes about Childhood Vaccines (PACV) questionnaire with cut-off scores of 50. RESULTS: A total of 220 parents were recruited in this study from June 18, 2021, to December 10, 2021. The pre-intervention PACV survey showed that 19 (8.6%) parents were vaccine-hesitant from both groups: 12 (10.3%) and 7 (6.7%) of parents among intervention and control groups. After the interventions, there were 8 (6.9%) and 8 (7.7%) vaccine-hesitant parents in the intervention and control groups, respectively. We found a significant difference in the post-intervention PACV median score between the intervention and control groups (17 vs 23; p = 0.035). Around 25% of parents have not completed their children's immunization status: 22.4% and 28.8% in the intervention and control groups, respectively. There was a significant difference between the proportion of PACV hesitancy on the immunization status within intervention and control groups (p = 0.001). CONCLUSION: There was a reduction in vaccine hesitancy after interventions. Educational videos intervention distributed through WhatsApp group was associated with lower vaccine hesitancy and can be used as health education tools among Indonesian parents in the community.

Schooling amidst a pandemic in the United States: Parents' perceptions about reopening schools and anticipated challenges during COVID-19.

INTRODUCTION: During the COVID-19 pandemic, numerous states in the United States instituted measures to close schools or shift them to virtual platforms. Understanding parents' preferences for sending their children back to school, and their experiences with distance learning is critical for informing school reopening guidelines. This study characterizes parents' plans to return their children to school, and examines the challenges associated with school closures during the 2020-2021 academic year. METHODS: A national-level cross-sectional online survey was conducted in September 2020. Focusing on a subset of 510 respondents, who were parents of school-aged children, we examined variations in parents' plans for their children to return to school by their demographic and family characteristics, and challenges they anticipated during the school-year using multivariable logistic regressions. RESULTS: Fifty percent of respondents (n = 249) said that they would send their children back to school, 18% (n = 92) stated it would depend on what the district plans for school reopening, and 32% (n = 160) would not send their children back to school. No demographic characteristics were significantly associated with parents plans to not return their children to school. Overall, parents reported high-level of access to digital technology to support their child's learning needs (84%). However, those who reported challenges with distance learning due to a lack of childcare were less likely to not return their children to school (aOR = 0.33, 95% CI: 0.17, 0.64). Parents who reported requiring supervision after school had higher odds of having plans to not return their children to school (aOR = 1.97, 95% CI: 1.03, 3.79). Parents viewed COVID-19 vaccines and face-masks important for resuming in-person classes. DISCUSSION: About one-third of parents objected to their children returning to school despite facing challenges with distance learning. Besides access to vaccines and face-masks, our findings highlight the need to better equip parents to support remote learning, and childcare.

Methods of Current Practice: Qualitative Analysis of Intervention Strategies Utilized by Vaccine Waiver Educators in Michigan.

By enacting administrative rule 325.176 (12), Michigan added a vaccine education component as a precondition to granting vaccine waivers to vaccine-hesitant parents wishing to file a nonmedical vaccine exemption for their school-aged child. The purpose of the study was to identify best practices for reaching vaccine-hesitant parents during face-to-face vaccine education sessions conducted by vaccine waiver educators in Michigan. This study utilized qualitative descriptive content analysis of semi-structured phone interviews with vaccine waiver educators from local health departments (LHDs) in Michigan. Participants were vaccine waiver educators who were employed by a local health department in Michigan and had conducted at least 30 vaccine waiver education sessions. Strategies, resources, and techniques identified by educators as beneficial included using and providing information from a variety of sources, compiling their own educational materials, creating a positive experience, holding personalized sessions, and streamlining exemption and vaccination sessions. However, unexpected themes that emerged from the interviews revealed that vaccine waiver educators need additional training in discussing vaccine ingredients with parents, handling religious vaccine exemption requests, and assessing the role of schools. Implementing successful vaccine education interventions targeting vaccine-hesitancy is crucial to public health. Charging LHDs with overseeing vaccine education via a face-to-face discussion is a novel intervention strategy, the effective implementation of which may inform vaccine education intervention nationwide and may even be translated into international contexts and prove useful to current COVID-19 vaccination efforts.

ezPreemie study protocol: a randomised controlled factorial trial testing web-based parent training and coaching with parents of children born very preterm.

INTRODUCTION: Children born very preterm (VPT; gestational age <32 weeks) are twice as likely to demonstrate behaviour problems such as aggression, non-compliance, temper tantrums and irritability compared with their term-born peers. While behavioural parent training (BPT), also referred to as behaviour therapy is a gold standard for prevention and treatment of childhood problem behaviours, there are limited accessible and effective BPT interventions for families with children born VPT. The purpose of this paper is to describe a multicentre, randomised controlled protocol for a factorial design trial evaluating the independent and combined effects of the ezParent BPT intervention plus brief, weekly coaching calls on parent and child outcomes for families with toddlers born VPT. METHODS AND ANALYSIS: The study employs a 2×2 factorial randomised design. Parents (n=220) of children aged 20-30 months corrected age who were born VPT (<32 weeks) will be recruited from two large metropolitan Neonatal Intensive Care Units follow-up clinics and randomised to one of four conditions: (1) ezParent (2) ezParent +coach, (3) Active control or (4) Active Control +coach. Data on parenting and child behaviour outcomes will be obtained from all participants at baseline and 3, 6 and 12 months postbaseline. All analyses will use an intention-to-treat approach, independent of their actual dose of each intervention. ETHICS AND DISSEMINATION: The study protocol has been approved by The Ohio State University Institutional Review Board (IRB) using a single IRB. Study results will be disseminated through presentations at regional and national conferences, publications in peer-reviewed journals, and sharing research reports with participating families and recruiting sites. TRIAL REGISTRATION NUMBER: NCT05217615.

Attitude and Acceptance of COVID-19 Vaccine in Parents and Adolescents: A Nationwide Survey.

PURPOSE: Coronavirus disease 2019 (COVID-19) vaccines are currently authorized for emergency use in adolescents aged 12-17 years; however, there is concern and uncertainty regarding the safety and necessity of COVID-19 vaccination. A survey was carried out to assess the attitudes and acceptance towards vaccination in adolescents. METHODS: A nationwide web-based survey was conducted among adolescents aged 12-17 years and their parents between June 29 and July 8, 2021 on a platform provided by the Ministry of Education. RESULTS: A total of 341,326 parents and 272,914 adolescents participated in this study. Intention for vaccination was 69.1% for adolescents, and 72.2% of parents reported they would recommend vaccination for their child. Among adolescents, perception of safety (odds ratio [OR] 4.09, 95% confidence interval [CI] 3.95-4.22), effectiveness (OR 2.24, 95% CI 2.17-2.32), and risk-benefit (OR 1.75, 95% CI 1.72-1.78) had the highest impact on intention for vaccination. Also, perceived risk (OR 1.14, 95% CI 1.12-1.17), severity (OR 1.12, 95% CI 1.10-1.13) for COVID-19 infection, self-health perception (OR 1.12, 95%, CI 1.10-1.14) and recent vaccination of childhood vaccines (OR 1.25, 95% CI 1.19-1.32) were related to intention for COVID-19 vaccination. On the other hand, self-perceived knowledge (OR 0.96, 95% 0.95-0.98) was related to vaccine hesitancy. Gender or school district did not influence intention for COVID-19 vaccination in adolescents. DISCUSSION: Decisions on COVID-19 vaccination for adolescents should be a shared process between adolescents, parents, and physicians based on updated information on safety and effectiveness.

COVID-19 vaccine hesitancy between teachers and students in a college, a cross-sectional study in China.

Studies have identified teacher effects on students' attitudes. This study explored the differences in and associations between teachers' and students' COVID-19 vaccine hesitancy, and the factors that affect it. A population-based self-administered online survey was conducted to evaluate the COVID-19 vaccine hesitancy of teachers and students in a college in Taizhou, China. A total of 835 valid questionnaires were obtained. All data were analyzed using IBM SPSS statistics 26.0 software. The proportions of COVID-19 vaccine hesitancy for teachers and students were 31.7%, and 23.8%, respectively. In the binary logistic regression analysis, teachers who perceived the safety of the COVID-19 vaccine as low (OR = 6.794 , 95%CI: 1.701-27.143), did not pay continuous attention to the vaccine news (OR = 3.498, 95%CI: 1.150-10.640), and suffered chronic diseases (OR = 2.659, 95%CI: 1.135-6.227) were more likely to hesitate to get vaccinated against COVID-19. The group of students who perceived the COVID-19 vaccine safety as being low (OR = 1.805, 95%CI: 1.094-2.979) were more hesitant to get the COVID-19 vaccine. While both teachers and students were hesitant about the COVID-19 vaccine, teachers were found to be more so. Perceptions regarding the safety of COVID-19 vaccines, attention to and awareness of vaccine news, and chronic medical conditions were the main factors that influenced the hesitation regarding COVID-19 vaccines. Therefore, students' vaccine hesitancy may depend largely on the perceptions of the vaccine's safety rather than teachers' vaccine hesitancy.

Child and adolescent COVID-19 vaccination status and reasons for non-vaccination by parental vaccination status.

OBJECTIVES: COVID-19 vaccines are recommended for children ages ≥5 years. To develop effective interventions to increase uptake, this study explores reasons for parental hesitancy of child and adolescent COVID-19 vaccination. STUDY DESIGN: The Household Pulse Survey (HPS) is a nationally representative cross-sectional online household survey of adults aged ≥18 years that began data collection in April 2020 to help understand household experiences during the COVID-19 pandemic. METHODS: Using data from December 29, 2021, to January 10, 2022 (n = 11,478), we assessed child and adolescent COVID-19 vaccination coverage and parental intent to vaccinate their children and adolescents. Factors associated with child and adolescent vaccination coverage were examined using multivariable regression models. Reasons for not having had their child or adolescent vaccinated, stratified by parental vaccination status, were compared using tests of differences in proportions. RESULTS: Less than one-half (42.3%) of children and three-quarters (74.8%) of adolescents are vaccinated. Vaccination coverage was lower among households with lower education, as well as among children who had not had a preventive check-up in the past year. Parents of unvaccinated children were more likely to report that they do not trust COVID-19 vaccines, do not trust the government, and do not believe children need a COVID-19 vaccine compared to parents of vaccinated children. CONCLUSION: Efforts to increase uptake of vaccines by children and adolescents should target those with lower education, reassure parents of the vaccine safety and efficacy for themselves and their children/adolescents, and support yearly preventive care visits for their children.

Parent/guardian intentions to vaccinate children against COVID-19 in the United States.

Vaccination is critical for protecting adults and children from COVID-19 infection, hospitalization, and death. Analyzing subsamples of parent/guardians of children age 0-11 (n = 343) and 12-17 (n = 322) from a larger national survey of US adults (n = 2,022), we aimed to assess intentions to vaccinate children and how intentions might vary across parent/guardian sociodemographic characteristics, healthcare coverage, vaccination status, political affiliation, prior COVID-19 infection, exposure to COVID-19 death(s) of family or friends, perceived norms of vaccination, and COVID-19 vaccine hesitancy. We also report the prevalence of vaccinated children for parents whose oldest child was eligible for vaccination at the time of the survey. More than one third of parents whose oldest child was not yet eligible for vaccination (11 or younger) planned to get them vaccinated right away when a vaccine became available to them. Among parents whose child was eligible to be vaccinated (age 12-17 years), approximately a third reported their child had already been vaccinated and approximately a third planned to do so right away. Intentions to vaccinate children age 0 to 11 were significantly associated with age, gender, race/ethnicity, education, COVID-19 vaccination, political affiliation, social norms, and COVID-19 vaccine hesitancy. Intentions to vaccinate children age 12 to 17 were significantly associated with age, education, healthcare coverage, COVID-19 vaccination, political affiliation, social norms, and COVID-19 vaccine hesitancy. We discuss implications for public health officials and for future research.

Growing Healthy Together: A Randomized Clinical Trial Using Parent Mentors for Early Childhood Obesity in Low-Income, Latino Families.

Background: Parent mentors are a potential community-based mechanism for delivering behavioral interventions. For communities at a higher risk of obesity and challenges with access to care, such as migrant and seasonal farm workers, this may be an effective intervention for obesity. This study examined the effect of parent mentors on weight outcomes. Methods: This randomized clinical trial assigned parents of 2- to 5 year-old children enrolled in Head Start 1:1:1 to control, a parent mentor teaching We Can!, or a parent mentor teaching an intervention derived from positive deviance methods. The parent mentor arms were designed to have weekly interactions and monthly community meetings over 6 months. The primary outcome was change in adiposity, as measured by body mass indices. Results: We randomized 188 parents, and 155 completed the 6-month visit. Most parents, 107 (58%), had less than a high school education, and 170 (90%) reported Latino ethnicity. In the intention-to-treat analysis, no difference between the groups was observed for change in percent distance from the median or BMI z-score. The median number of interactions was 14 (IQR 10-20) over 6 months for those who did engage, though 24 of 118 (20%) had no interaction. Those with no interactions in We Can! had a mean increase in change from median of 6.7 [standard deviation (SD) = 8.2]; those with higher participation experienced a 0.4 (SD = 9.2) change, p = 0.04. Conclusions: Parent mentors were not effective in changing the adiposity indices in this study overall, with some evidence of efficacy after accounting for participation. Clinicaltrials.gov registration number: NCT03330743.

Intention to vaccinate young children against COVID-19: A large-scale survey of Hong Kong parents.

COVID-19 vaccines (Sinovac and Pfizer/BioNTech) have recently been approved for Hong Kong children. Understanding parental intentions to vaccinate children against COVID-19 is important to the development of an effective COVID-19 vaccine campaign. From a large-scale, geographically representative dataset in Hong Kong (N = 11,141), we examined parents' intentions to vaccinate their children against COVID-19 under three conditions: (1) no policy restrictions, (2) vaccination rate considered for school resumption, and (3) more choices of vaccine. Results showed that levels of vaccine hesitancy in Hong Kong parents are high. Hong Kong parents' intention to vaccinate their children was highest when there were more vaccines to choose from, followed by when vaccination rate was considered to resume school, and when there was no policy restrictions. Finally, Hong Kong parents with higher education backgrounds and family income were less willing to vaccinate their children. Together, these findings indicate that effective vaccines campaign should consider the characteristics and preferences of parents who have little intention to vaccinate within a specific social context.

Parental vaccine hesitancy and concerns regarding the COVID-19 virus.

PURPOSE: This study assessed parental vaccine hesitancy in a metropolitan area of the United States. The study aimed to determine what characteristics and contributing factors influenced parental vaccine hesitancy and concerns regarding COVID-19. DESIGN AND METHODS: An online survey was used to recruit 93 parents to answer demographic and vaccine hesitancy information. Vaccine hesitancy was measured using the Parent Attitudes about Childhood Vaccines survey. The study was conducted between June 2020 and September 2020 during the COVID-19 pandemic. RESULTS: The rate of vaccine hesitancy was 15%. One hundred percent of vaccine hesitant parents were mothers, at least 30 years of age, married, and had completed at least some college. When characteristics of vaccine hesitant parents were compared to non-hesitant parents, the hesitant parents reported having more children, with 93% reporting two or more children compared to only 74% of non-hesitant parents (p = 0.046). Fifty percent of hesitant parents reported no concerns regarding COVID-19 compared to only 20% of non-hesitant parents (p = 0.006), and significantly less hesitant parents reported willingness to have their children receive a safe, effective COVID-19 vaccine if it were available compared to non-hesitant parents (p < 0.001). CONCLUSIONS: Our findings indicate that older mothers with two or more children are more likely to be vaccine hesitant and this hesitancy extends to the current COVID-19 pandemic. PRACTICE IMPLICATIONS: Healthcare providers can use the results of this study to identify parents at risk for vaccine hesitancy and initiate individualized education to promote on-time childhood vaccination.