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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
general
Structural equation modeling to detect correlates of childhood vaccination: A moderated mediation analysis
PLoS ONE, Volume 15, No. 10 October, Article e0240749, Year 2020
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Description
Objectives This study used a health belief theory derived framework and structural equation model to examine moderators, mediators, and direct and indirect predictors of childhood vaccination. Methods A secondary analysis was conducted using data collected from a cross-sectional survey of a random sample of 1599 parents living in urban and rural areas of Mysore district, India. Applying two-stage probability proportionate-to-size sampling, adolescent girls attending 7th through 10th grades in 23 schools were selected to take home a questionnaire to be answered by their parents to primarily assess HPV vaccine intentions. Parents were also asked whether their children had received one dose of Bacillus Calmette–Guérin; three doses of Diphtheria, Pertussis, Tetanus; three doses of oral Polio vaccine; and one dose of Measles vaccine. In addition, parents were asked about their attitudes towards childhood vaccination. Results Out of the 1599 parents, 52.2% reported that their children had received all the routine vaccines (fully vaccinated); 42.7% reported their children had missed at least one routine vaccine, and 5.2% reported that their children had missed all routine vaccinations. Perceptions about the benefits/facilitators to childhood vaccination significantly predicted the full vaccination rate (standardized regression coefficient (β) = 0.29) directly and mediated the effect of parental education (β = 0.11) and employment (β = -0.06) on the rate of full vaccination. Parental education was significantly associated indirectly with higher rates of full vaccination (β = 0.11). Parental employment was significantly associated indirectly with decreasing rates of full vaccination (β = -0.05). Area of residence moderated the role of religion (β = 0.24) and the ‘number of children’ in a family (β = 0.33) on parental perceptions about barriers to childhood vaccination. The model to data fit was acceptable (Root Mean Square Error of Approximation = 0.02, 95% CI 0.018 to 0.023; Comparative Fit Index = 0.92; Tucker–Lewis Index = 0.91). Conclusions Full vaccination rate was relatively low among children in Mysore, especially among parents who were unsure about the benefits of routine vaccination and those with low educational levels. Interventions increasing awareness of the benefits of childhood vaccination that target rural parents with lower levels of education may help increase the rate of full childhood vaccination in India. Copyright: © 2020 Degarege et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC7561155/bin/pone.0240749.s001.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC7561155/bin/pone.0240749.s002.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC7561155/bin/pone.0240749.s003.docx
Authors & Co-Authors
Degarege, Abraham
United States, Omaha
University of Nebraska Medical Center
Krupp, Karl F.
United States, Tucson
The University of Arizona
India, Mysore
Public Health Research Institute of India
Srinivas, Vijaya
India, Mysore
Public Health Research Institute of India
Ibrahimou, Boubakari
United States, Miami
Florida International University
Madhivanan, Purnima
United States, Tucson
The University of Arizona
India, Mysore
Public Health Research Institute of India
Statistics
Citations: 3
Authors: 5
Affiliations: 4
Identifiers
Doi:
10.1371/journal.pone.0240749
ISSN:
19326203
Research Areas
Cancer
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Participants Gender
Female