what does the literature show about barriers to

8/7/2019 What Does the literature show about barriers to

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W HAT D OES THE LITERATURE

SHOW ABOUT BARRIERS TOIMMUNIZATIONS AMONGDIFFERENT ETHIC GROUPS ?

By Terri Burns


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Introduction

Goals for immunizationBarriers to immunizationResearchConclusion


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Goals for immunizations

Problem: We are notmeeting these goals.


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T he CDC has a goal of immunizations of 90percent, but many communities have fallenshort of this goal. Are there different barriersfor different ethnic groups? Why arentchildren being immunized?

See if you can answer this question.


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A.T hey dont understand the importance.B. Cost.

C. Providers not reminding patients.D. Parent are afraid.E. All the above.

Why do you think children are not being immunized?


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If you said E all the above, you arecorrect!!


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T here are many barriers to immunizations,more than listed. A few more are clinichours are not convenient to working moms.Caregivers, parents have notransportation. Providers will not giveshots if children are sick. All of thebarriers found in the articlesresearched could be easily remedied withthe proper interventions.


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OU CH!!


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Research


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T he first article for analysis is quantitative research article by Salsberry, P.J., Nickel, J. T ., & Mitch, R. (1994). Immunization status of 2-year-olds inmiddle/upper- and lower-income populations: A community survey.

T his study was part of a larger study, purpose and problem stated.T his was a descriptive, non experimental study, survey method used.

No theoretical/conceptual framework noted .Review of the literature and assumptions were stated. Limitations of smallsample size and nonresponse bias were also noted.

Population and variables were identified. Sampling was done through asystematic random sample, limiting bias. A pilot study was also mentioned.Data was organized and analyzed and the results interpreted. No tool for

measuring data was mentioned.Similar perceptions of barriers to immunizations existed between

middle/upper- and lower income groups consisting of white and non whiteparticipants.

.


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T e second artic e or ana ysis was anot er artic e by a sberry, P. J.,Nickel, J. T ., & Mitch, R. (1993), Why aren't preschoolers immunized? A comparison of parents' and providers' perceptions of the barriers toimmunizations.

T his was another descriptive study of a non experimental survey design.Study purpose and problem were identified and no hypothesis was needed.A theoretical model was not found.Population was identified and sampling was done through interval

sampling by a computer. Measurement of variables was done using theLiker-scale, which was not adequately explained.Data was done by questionnaire mailed to participants with an estimated

completion time of 15 minutes.Data was analyzed and interpreted.

.. T his study was interesting because it compared parental perceived barriers andprovider perceived barriers. T he results showed partly that providers blamed theparents and parents blamed the providers. Parents also listed similar barriers fromthe researchers previous study. Limitations were mentioned as to sample size andbias because providers and parents were not linked. Despite limitations, suggestions

for interventions were mentioned that could help improve immunization rates .


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T he last quantitative article reviewed was Mayo, A. M., & Cobler, S. (2004), Fluvaccines and patient decision making: What we need to know.

This was a descriptive, comparative design that used a theoretical decision makingmodel similar to health promotion models.

Sampling was done with a convenience sample of 436 patients. T wo data collectioninstruments were used. Based on research, they generated a new instrument, thatincluded lists of barriers and motivators and that used the Likert format tocategorize the demographic response. T he second instrument was the DecisionalConflict Scale (DCS). Surveys were mailed including a Flu Vaccine Survey and theDCS to all 436 patients.

Data was analyzed with an Excel program and findings interpreted. Limitations of sampling method were stated and recommend that study be replicated withstratified sampling method.

Basic findings were patients that received vaccinations in the past had moremotivators and fewer barriers than those who had not received prior vaccinations.

Also noted was of importance to health care workers, was that myths aboutvaccinations still exist about contracting the flu.


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T he last article reviewed was a qualitative study by Niederhauser, V. P.,& Markowitz, M. (2007), Barriers to immunizations: Multiethnic parentsof under- and unimmunized children speak.

T his was an ethnographic study that used a focus group of conveniencesampling. Problem and purpose were stated.

O pen ended questions were conducted by an interviewer and datacategorized and analyzed by A T LAS software. Reliability was established

with the way data was collected and transcribed verbatim.Five core themes emerged and barriers such as transportation issues,

sick with fever, and lack of understanding importance of immunizations.

Recommendations for further study and communicating results to localhealth care agencies were made.


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Conclusion


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Barriers exist when it comes to vaccinations andimmunizations. All ethnic groups and people of allincome levels were shown to have similar barriers,whether it is lack of information, cost, and health careproviders not giving immunizations to sick children.In light of the fact that similar results came fromdifferent research studies, I believe health careproviders and health care workers should be lookingat this data closely . We have the opportunity tochange these barriers with interventions and a childslife may depend on it.


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References

E vers, D. B. (2000). Insights on immunizations from caregivers of children receiving medicaid-funded services. Journal of the Society of Pediatric Nurses, 5 (4), 157. Retrieved from http://0-search.ebscohost.com.libcat.ferris.edu/login.aspx?direct=true&db=cin20&AN=2001004711&site=ehost-liveMayo, A. M., & Cobler, S. (2004). Flu vaccines and patient decision making: What we need to know. Journal of the AmericanAcademy of Nurse Practitioners, 16 (9), 402-410. Retrieved from http://0-search.ebscohost.com.libcat.ferris.edu/login.aspx?direct=true&db=cin20&AN=2004190626&site=ehost-live

Niederhauser, V. P., & Markowitz, M. (2007). Barriers to immunizations: Multiethnic parents of under- and unimmunized childrenspeak. Journal of the American Academy of Nurse Practitioners, 19 (1), 15-23. Retrieved from http://0-search.ebscohost.com.libcat.ferris.edu/login.aspx?direct=true&db=cin20&AN=2009481211&site=ehost-liveNieswiadomy, R. M. (2008). Foundations of Nursing Research 5 th ed. Pearson E ducation, Inc.,

Upper Saddle River, New Jersey.Salsberry, P. J., Nickel, J. T., & Mitch, R. (1993). Why aren't preschoolers immunized? A comparison of parents' and providers'perceptions of the barriers to immunizations. Journal of Community Health Nursing, 10 (4), 213-224. Retrieved from http://0-search.ebscohost.com.libcat.ferris.edu/login.aspx?direct=true&db=cin20&AN=1994178329&site=ehost-liveSalsberry, P. J., Nickel, J. T., & Mitch, R. (1994). Immunization status of 2-year-olds in middle/upper- and lower-income populations: A

community survey. Public Health Nursing, 11 (1), 17-23. Retrieved from http://0-search.ebscohost.com.libcat.ferris.edu/login.aspx?direct=true&db=cin20&AN=1994181883&site=ehost-live

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