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首页> 外文期刊>Vaccine >Risk factors associated with parents claiming personal-belief exemptions to school immunization requirements: community and other influences on more skeptical parents in Oregon, 2006.
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Risk factors associated with parents claiming personal-belief exemptions to school immunization requirements: community and other influences on more skeptical parents in Oregon, 2006.

机译：与父母声称免除学校免疫要求的个人信仰相关的风险因素：俄勒冈州，2006年，社区和其他对持怀疑态度的父母的影响。

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Background and objectives: With vaccine-preventable diseases at record lows, few studies investigate rising parent-claimed exemptions to school immunization requirements. After finding exemption clusters in Oregon, we hypothesized that exemption risk factors may vary among communities. We surveyed parents to identify risk factors for exemptions and evaluated risk factor differences among communities with differing exemption rates. Design: Retrospective cohort study, multi-staged, population-proportionate sampling. Setting and participants; Parents of 2004-05 Oregon elementary school children ( N=2900). Main outcome measure: Parent-reported exemption status. Results: The response rate was 55%. Compared to vaccinators, exemptors were significantly more likely to have: strong vaccine concerns (weighted adjusted odds ratio (aOR)=15.3, 95% CI 6.4-36.7); "vaccine-hesitant" concerns (aOR=2.3; 95% CI 1.0-5.0); >1 childbirth(s) at a non-hospital, alternative setting (aOR=3.6; 95% CI 1.6-8.0); distrust of local doctors (aOR=2.7; 95% CI 1.0-7.5); reported chiropractic healthcare for their youngest school-age child (aOR=3.9; 95% CI 1.8-8.5); and reported knowledge of someone with a vaccine-hurt child (aOR=1.8; 95% CI 0.9-3.4). Exemptors were less likely to have "pro-vaccine" beliefs (aOR=0.2; 95% CI 0.0-0.6) and less likely to report relying on print materials (aOR=0.4; 95% CI 0.2-0.8). The strengths of association differed significantly for those with strong vaccine concerns and those reporting knowledge of someone with a vaccine-hurt child, depending on residence in exemption-rate areas, e.g., exemptors in medium-rate areas were more likely to have strong vaccine concerns (aOR=13.5; 95% CI 5.4-34.0) than those in high-rate areas (aOR=9.7; 95% CI 3.7-25.4). Conclusions: Vaccine beliefs were important risk factors. That differing community-level exemption use modified the effects of several individual-level factors suggests that communities also influence parent decisions. Therefore, understanding community contexts and norms may be important when designing interventions.
机译：背景和目标：由于疫苗可预防的疾病处于创纪录的低位，很少有研究调查父母声称对学校免疫要求的豁免不断增加。在俄勒冈州发现豁免集群后，我们假设豁免风险因素可能在各个社区之间有所不同。我们对父母进行了调查，以确定豁免的风险因素，并评估了豁免率不同的社区之间的风险因素差异。设计：回顾性队列研究，多阶段，人口比例抽样。设置和参与者; 2004-05俄勒冈小学生的父母（N = 2900）。主要结果度量：父母报告的豁免状态。结果：回应率为55％。与疫苗接种者相比，豁免者更可能具有以下方面：对疫苗的强烈关注（加权调整后的优势比（aOR）= 15.3，95％CI 6.4-36.7）; “疫苗-粘接剂”问题（aOR = 2.3; 95％CI 1.0-5.0）;在非医院的替代环境中> 1个分娩（aOR = 3.6; 95％CI 1.6-8.0）;不信任当地医生（aOR = 2.7; 95％CI 1.0-7.5）;报告了他们最小的学龄儿童的整脊保健（aOR = 3.9; 95％CI 1.8-8.5）;并报告了某人有疫苗伤儿童的知识（aOR = 1.8; 95％CI 0.9-3.4）。豁免者不太可能具有“亲疫苗”信念（aOR = 0.2; 95％CI 0.0-0.6），也不太可能报告依赖印刷材料（aOR = 0.4; 95％CI 0.2-0.8）。对于那些强烈关注疫苗问题的人和那些报告了解有疫苗伤害儿童知识的人，结社的实力差异很大，这取决于在免税率地区的居住情况，例如，在中等费率地区的免税者更可能强烈关注疫苗（aOR = 13.5; 95％CI 5.4-34.0）高于高发地区（aOR = 9.7; 95％CI 3.7-25.4）。结论：疫苗信仰是重要的危险因素。社区级别豁免的不同使用改变了几个个人级别因素的影响，表明社区也影响父母的决定。因此，在设计干预措施时，了​​解社区环境和规范可能很重要。

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