The Impact of Social Networks on Parents’ Vaccination Decisions . Instead parents are influenced by their social networks, broadly defined as the people and sources they go to for information, direction, and advice. This study used social network analysis to formally examine parents’ social networks (people networks and source networks) related to their vaccination decision- making. In addition to providing descriptions of typical networks of parents who conform to the recommended vaccination schedule (conformers) and those who do not (nonconformers), this study also quantified the effect of network variables on parents’ vaccination choices. METHODS: This study took place in King County, Washington. Participation was limited to US- born, first- time parents with children aged . Data were collected via an online survey. Logistic regression was used to analyze the resulting data. RESULTS: One hundred twenty- six conformers and 7. Although people networks were reported by 9. P < . 0. 01). Model comparisons of parent, people, and source network characteristics indicated that people network variables were better predictors of parents’ vaccination choices than parents’ own characteristics or the characteristics of their source networks. In fact, the variable most predictive of parents’ vaccination decisions was the percent of parents’ people networks recommending nonconformity. CONCLUSIONS: These results strongly suggest that social networks, and particularly parents’ people networks, play an important role in parents’ vaccination decision- making. Abbreviations: AIC — Akaike Information Criterion. Pratiques Cliniques et Sociales. The 50 Best Robots Ever. ROBONAUT Not all NASA robots drive around poking at rocks. This android will one day work alongside people on space stations. Background: Outdoor fine particulate matter (. BACKGROUND AND OBJECTIVE: Parents decide whether their children are vaccinated, but they rarely reach these decisions on their own. Instead parents are influenced by. Fear of a Muslim Planet:The Islamic roots of hip-hop. MIT Press, DJ Spooky ed., 2008. CI — confidence interval. OR — odds ratio. What’s Known on This Subject: Previous studies have suggested that health care providers, family members, friends, and others play a role in shaping parents’ vaccination decisions. Other research has suggested that the media can influence whether parents decide to vaccinate their children. What This Study Adds: Through the application of social network analysis, this study formally examines and quantifies how parents are influenced by the people and sources around them. Its findings suggest that social networks are important, particularly for parents who do not completely vaccinate. In the United States, the majority of vaccinations are given to children aged < 5 years. Parents thus play a key role in vaccine acceptance. More than any other persons, they determine whether their children will receive the recommended vaccines. When making decisions about vaccination, however, parents rarely reach conclusions completely on their own. Rather, they rely on others, such as health care providers, family members, and friends, for information, direction, and advice. In the United States and other developed countries, most parents also have the option to consult sources such as the Internet, magazine articles, and television programs to obtain additional information and advice. Thus, instead of deciding to accept or reject vaccination independently, parents make vaccination decisions in concert with their social networks, broadly defined here as including the people they interact with as well as the sources of information they consult. Despite awareness that parents are influenced by the people and sources around them,1–8 parents’ social networks relating to their vaccination decision- making have not been well studied. En 1997, l'Australie et l'Iran se sont livr. FIFA.com revient pour vous sur cette soir The formal study of social networks is referred to as social network analysis. Social network analysis is a broad and flexible research methodology that includes examinations of the networks of single individuals within populations. This specific approach is referred to as egocentric network analysis. The purpose of this research was to use egocentric network analysis to examine parents’ networks specifically relating to their vaccination decisions whether they conformed to the nationally recommended vaccination schedule by having their children vaccinated completely and on time (conformers) or whether they did not by delaying vaccination, partially vaccinating, or not vaccinating at all (nonconformers). In addition to providing general descriptions of typical people and source networks for conformers and nonconformers, this study also tested the a priori hypothesis that variables related to parents’ people and source networks would be better predictors of parents’ vaccination decisions than more conventional variables including parents’ demographic characteristics and parents’ own perceptions of vaccination. Methods. Study Population and Sampling. Data for this study were collected via an online survey between March and July 2. Participants were drawn from parents living in King County, Washington, an area known for lower- than- average vaccination rates. Participation was limited to US- born, first- time parents with children aged . To ensure that data on parents’ social networks were independent, participation was also limited to 1 parent per household. Careful convenience sampling was used to recruit parents who met these eligibility criteria. Methods successfully used to recruit parents included fliers hung at local community centers, baby stores, and coffee shops; e- mails sent to online parenting groups and community listservs; and handouts provided to local health care providers and day care centers. Power calculations, assuming . To ensure a sample with a sufficient proportion of nonconformers, locations/resources where nonconformers were likely to be found were purposefully oversampled. Recruitment materials instructed interested parents to contact the author via phone or e- mail to receive access to the online survey. After having their eligibility verified, parents were provided with additional instructions as well as a login ID and password for the survey. For parents who did not have computer or Internet access, the recruitment materials indicated that the author was able to provide them with the temporary use of a laptop computer with Internet access. Despite this availability, no parent requested the use of the laptop during this study. After completing the survey, parents received a $2. Survey. The online survey included 3 modules. The first asked parents about their social networks related to their vaccination decision- making. In this module, parents listed the people they obtained information, advice, and/or direction from, as well as the sources they consulted for information and/or advice. In addition, parents reported supplemental information on the 5 people and 5 sources they ranked as being the most influential in their lists of people and sources, including (for the people) the gender, race/ethnicity, and vaccination advice of each person and (for the sources) the type of source; how each source was found; and the vaccination advice provided. The second module asked parents about their vaccination decision- making. Information provided by parents included their current vaccination decision and their perception of vaccines and vaccine- preventable diseases. The third module asked parents to provide basic demographic information about themselves, their households, and their children. Although some of the questions in the vaccination decision- making module were adapted from existing surveys, including the National Immunization Survey, other questions in this module as well as all of the questions in the social network module emerged from in- depth qualitative research. Survey questions were pretested with 2. For additional information on the methodology of this study, see Supplemental Information. The survey questions, along with all of the study procedures described in this article, were approved by the institutional review board at the University of Washington. Informed consent was obtained from all participants. Data Analysis. To determine how parent, people network, and source network variables compared in predicting parents’ vaccination decisions and to avoid potential multicolinearity, it was necessary to consider these variables independently, that is, to run separate models for the respondent, people network, and source network variables. Thus, 3 models were compared in this analysis. Logistic regression, using parents’ vaccination decisions (as conforming/not conforming) as the dependent variable, was used to analyze each model. Model comparisons were made by using Akaike Information Criterion (AIC) values. AIC measures goodness of fit; a lower AIC score indicates a better model fit. Results. One hundred ninety- six eligible parents completed the survey, 1. The demographic characteristics of conforming and nonconforming parents were similar (Table 1). The only significant differences were in parents’ perception of vaccination, calculated by taking the average score of 1. Likert questions (Table 2), and parents’ intent to have their children completely vaccinated by the time they begin kindergarten. Nonconformers were more likely to have an unfavorable opinion of vaccination (2. P < . 0. 01) and were less likely to intend to have their children vaccinated by the time they enter school (5. P < . 0. 01). TABLE 1. Parents’ Demographic Characteristics. TABLE 2. Likert Questionsa Used to Assess Parents’ Perceptions of Vaccination. Network Descriptions. People networks were equally common among both groups of parents; 9. Table 3). While conformers’ and nonconformers’ network members were similar in terms of race/ethnicity, nonconformers had a significantly greater number of network members (mean of 6. P = . 0. 5) and a significantly higher percentage of women included in their networks (7. P = . 0. 5). The greatest difference between the groups, however, was in the percent of network members recommending nonconformity. In typical people networks, 7. Recommendations for nonconformity in this study included complete but delayed vaccination; partial, on- time vaccination; partial vaccination on a delayed schedule; and complete nonvaccination. Coupe du Monde de la FIFA, France 1.
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