The Healthy, Immunized Communities Study: A pilot intervention to increase parents' intentions to get vaccines for their middle school children

William A Calo; Elizabeth A Hivner; Alicia M Hoke; Chelsea M Bufalini; Erik B Lehman; Jennifer L Kraschnewski

doi:10.1016/j.jvacx.2023.100273

The Healthy, Immunized Communities Study: A pilot intervention to increase parents' intentions to get vaccines for their middle school children

Vaccine X. 2023 Feb 11:13:100273. doi: 10.1016/j.jvacx.2023.100273. eCollection 2023 Apr.

Authors

William A Calo¹, Elizabeth A Hivner², Alicia M Hoke², Chelsea M Bufalini¹, Erik B Lehman¹, Jennifer L Kraschnewski^{1

3}

Affiliations

¹ Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States.
² Department of Pediatrics, Penn State College of Medicine, Hershey, PA, United States.
³ Department of Medicine, Penn State College of Medicine, Hershey, PA, United States.

Abstract

Pennsylvania shortened the provisional period for student vaccine compliance in 2018. We pilot tested a school-based health education intervention, The Healthy, Immunized Communities Study, to improve parents' intentions to get school-required (tetanus, diphtheria, acellular pertussis [Tdap]; and meningococcal conjugate [MCV]) and recommended (human papillomavirus [HPV]) vaccines for their children. In Phase 1, we partnered with the School District of Lancaster (SDL) to conduct four focus groups with stakeholders (local clinicians, school staff, school nurses, and parents) to inform the development of the intervention. In Phase 2, we randomized four middle schools in SDL to either the intervention (six email communications and school-community educational event) or control group. Seventy-eight parents took part in the intervention and 70 joined the control group. Vaccine intentions were compared within and between groups from baseline to 6-month follow-up with generalized estimating equations (GEE) models. Compared to the control, the intervention did not increase parents' vaccine intentions for Tdap (RR = 1.18; 95 % CI:0.98-1.41), MCV (RR = 1.10; 95 % CI:0.89-1.35), or HPV (RR = 0.96; 95 % CI:0.86-1.07). Among intervention participants, only 37 % opened ≥ 3 email communications and 23 % attended the event. Intervention participants reported high satisfaction with email communications (e.g., informative = 71 %) and felt that the school-community event met their educational objectives on key topics (e.g., immune system = 89 %). In conclusion, although we observed no intervention effect, our data suggest that this could be a result of the low uptake of intervention components. Further research is needed to understand how school-based vaccination-focused interventions can be successfully implemented with high fidelity among parents.

Keywords: Meningococcal conjugate vaccine; Middle school; Parents; Student vaccine compliance; Tetanus, diphtheria, acellular pertussis (Tdap) vaccine.