Research Proposal Powerpoint RE: 13
Assessing Current Approaches to Childhood Immunizations
Department of Psychology, Grand Canyon University
Research Proposal Powerpoint RE: 13
Assessing Current Approaches to Childhood Immunizations
Department of Psychology, Grand Canyon University
PSY-550: Research Methods
Dr. Shari Schwartz
May 19, 2021
Immunization is the process in which an individual is protected against disease, and it is done via vaccination. On the other hand, vaccination is the action of a vaccine being introduced into the body to produce immunity to a particular disease. A vaccine is a product that arouses the immune system of an individual, thus the production of immunity to a particular disease. The immunity thus protects the individual from that disease. Immunity is the protection from a disease that is infectious. Child immunization is the primary public health approach in the reduction of child mortality and morbidity. Assessment of the current approaches that are linked to the immunization of a child is essential. Globally, primary immunization is estimated to prevent approximately 2.5 million childhood deaths annually from tetanus, diphtheria, measles, and pertussis (Dube et al., 2013). Immunization succession is always accompanied by rejection of public health practices, and reasons for these have never been straightforward. Some of the motivations are religious, scientific, or even political. To reduce the incidence and prevalence of vaccine-preventable diseases, vaccination programs depend on a high uptake level. Vaccination offers protection for vaccinated individuals. When there are high vaccination coverage rates, the indirect protection rate is stimulated for the overall community (Dube et al., 2013).
Despite this massive use, immunization coverage in countries still developing has been reported to be still low. If mothers were educated on the importance of these vaccine services to their children, all the children would receive immunization as per the Expanded Program on the Immunization schedule, hence preventing mortality and morbidity. According to Thapar et al., in 2014, approximately an 18.7million children could not get the third dose of the Diphtheria-Pertussis-Tetanus (DPT3) vaccine. The total percentage of children who are one year and below and have to receive their dosses of DPT3 vaccine is seen as a proxy indicator regarding full immunization. The DPT3 estimates assess the health system performance and measure the immunization program effectiveness regarding service delivery. These strategies are thus used in the implementation of strategies for the elimination and eradication of diseases. According to Thapar et al., the global coverage for DPT1 and DPT3 was 90% and 86%, respectively, while that of measles first dose at 86%.
The above estimates thus do not replicate the seen differences in vaccine coverage. The coverage of DPT1 and DPT3 varied from 84% and 76% in Africa and 97% and 94% in the European countries. In India, the routine has been lower than in the rest of the countries. Following the 2013 outbreak in Israel, many parents were reluctant to take their children to vaccinate Oral Polio Vaccine afterward, and thus, poliomyelitis seemed to be reoccurring due to this. To attain maximum immunization coverage, the global vaccine action plan (GVAP) asked countries to try and accomplish 90percent immunization coverage by 2020 for all vaccines. Out of 194 country members of the world health organization, only 129 achieved the coverage goal of GVAP national vaccination. Immunization coverage in all the world countries has been stable since 2010, with 85 to 86 percent. Despite the high rate of childhood vaccination coverage, some estimates hide groups of under-vaccinated children due to parents’ hesitance. In recent years, a lot has been investigated, and the word vaccine hesitance has been formed, but evidence that has been found in regards to factors that link to vaccine hesitance has not been thoroughly investigated. This research will help adopt a more panoramic lens so that these factors can be brought into focus and know-how they look globally.
Many factors are inducing the uptake of vaccines among the parents of the children. They include the pain, ethnic concerns of the vaccine, fever, and adverse effects of the vaccines that come about after a child has been immunized, and most of them lead to vaccine hesitancy in most countries. The spread of vaccine fear and ant vaccine has become common, mostly on online platforms and people. In terms of vaccine policy, vaccine attitudes and behaviors are differentiated from one another even though they might be slightly related. Attitudes towards vaccination may be different from actual behaviors as a mother who pursues vaccination for both her children, and she may be displaying pro-vaccine behavior, but at the same time, they may be hesitant to receive the same vaccines. In such a case, the mother’s behavior may be that it is just a school requirement that she is to follow; otherwise, she would not opt to receive the vaccine if it were not that way. Simultaneously, the attitudes that drive her to vaccine hesitancy may be due to science, influence in personalities she trusts, matters of religion, and skepticism. The primary focus of this proposal is the group of parents who hold vaccine-hesitant attitudes and exhibit non-vaccinating behaviors for their children. Parents who refuse their children to be vaccinated always defend their positions based on their beliefs (Girmay and Dadi 2019). Parents have their reasons for vaccinations; others believe that vaccines will ruin instead of helping their child, while others believe that natural immunity is better than an artificial one. According to Gesser-Edelsburg et al., the risk of the public perception is based on a dependent context analysis. According to Gesser-Edelsburg et al., the parents who give full immunization of other vaccines but fail with oral polio vaccine occurred due to lack of faith in the health system, reasons particularly to the polio outbreak concerns related to the safety of the vaccine. Most mothers believed that their children were to be protected when given the oral polio vaccine, but it was for society’s well-being in an absolute sense.
A sample of mentally stable parents who are 18 to 45 years will be invited to answer questions linked to immunization-related intention, beliefs, and even behaviors. These participants will be selected via the multistage sampling technique. Using multistage sampling, the population will be divided into groups then later into subgroups so that the appropriate ones are found. Several steps will be used to divide the groups to find the target population. The first step will include a random selection of seven clusters from the population. A selection of three households with children less than five years will be performed randomly. The community health information system (CHIS) registration log will be used as a sampling frame to select households with children less than five years. During the collection of data for the study, if participants will not be found a home, the researchers will have to go back there the next day (Etikan and Bala 2017).
This study will make use of both primary and secondary data. The primary data will be collected from personal structured interviews, which will be given to the mothers. After the participants have answered, the questions grading will be done against the predetermined scoring system. Telephone surveys will also collect data from the target population as trained interviewers will contact probable respondents to gather information. Demographic and health survey programs will be used as the secondary data collection data whereby children who have received immunization fully and partially will be traced.
Simple random stratified sampling will be appropriate as it will ensure particular characteristics that will be represented proportionately in the sample. A simple random method is a technique that is to be used to choose the population that is to test the hypotheses concerning the entire population. This study will adopt a simple random procedure of mothers from each of the targeted populations. In general, non-probability sampling selects any member of the population indiscriminately. The population will first be defined then a sample size will be chosen. The lottery method, including the use of a computer program, will be considered to select the target population randomly. Data will then be collected from the chosen samples without bias (Wang et al., 2018).
A community-based cross-sectional study will be used to conduct the study. This design will help the researcher collect and analyze data that is important in addressing the research question. A comprehensive analysis would provide an overview of variables, without their existence being determined (Thomas, 2020).
The mean and standard deviation of the age of all the mothers who will participate in the study will be calculated in terms of years to find the majority who are confined to beliefs and other factors, thus reluctant to take their children for complete immunization. The mean age of the children who have not received complete vaccination due to the mother’s hesitance and those who have received full immunization as per EPI will also be determined. The mother’s level of education will also be accessed to see whether they are aware of the vaccines their children should get and the number of doses, thus choosing to ignore or whether they have no idea at all. The mother’s religion will also be assed that is whether Muslim, Christian, or Hindu. The mother’s monthly income will also be assessed to see whether they lack funds for taking them to an immunization facility. The mother’s antenatal clinic books will be assessed to determine whether they attended all the visits as required and if so, they received the tetanus vaccine and whether they gave birth in a health facility. This will determine whether the health care providers gave the mothers enough convincing information about the importance of being immunized. All of this information will help the researcher assess whether the participants have enough knowledge of their child’s immunization.
The correlation will be used to see if there is a relationship between the mother’s age and vaccine hesitance. The relationship between the mother’s religion, level of education, and beliefs will be correlated with vaccination hesitance. The Pearson’s coefficient will be used to demonstrate the correlation between the two variables. A correlation coefficient of +1 will show a perfect correlation, while a zero correlation will show no relationship exists. IBM SPSS and strata program will be used to make this analysis which will show whether correlation will exist or not. A t table will then be used to compare the calculated t value with that of the critical t value to identify the statistical significance.
The immunization program’s success relies on high vaccine uptake rates and vaccination coverage. Maintenance of high vaccination coverage has resulted in effective control of diseases that can be prevented through vaccination. This study will access the current approaches to childhood immunization and the factors associated with partial immunization of children below five years. If the results obtained will be significant, they will provide a clue in the future if the same thing happens to someone else. If the same thing happens in a different place globally, the public will use the results to take proper preventive measures to protect themselves.
The research will follow the APA ethical guidelines, including informed consent, debriefing statement, deception, and obtaining IRB permission. Verbal informed consent will be attained from every participant before the process of data collection begins. The participants will be given a complete description of the hypotheses to be tested, the procedures to follow them, and other relevant information regarding the study. Ethical clearance will be acquired from the Institutional Review Board (IRB), and a permission letter to carry out the research will be obtained from the University. Participants will fully be educated about the main goals and objectives of the study, and they will be assured that all the data they provide will remain confidential.
Limitations are the design characteristics that will influence or affect the interpretation of the findings of the research. Despite getting evidence that might be important, limitations such as follow-up on the effects of the health system factors that might influence immunization uptake might be hard to access, including the number of available, logistics, and the health care personnel. Mothers not remembering all the events that happened since the child was born is another limitation that might occur, especially when they do not have the immunization cards used. The amount of time needed to conduct the study is another limitation experienced in a cross-sectional study. Much time is needed to gather all the information.
Future studies regarding the health conditions caused when a child does not receive full immunization will arise after this study. If the study finds out that most of these mothers are reluctant to take their children for full immunization, various studies might be carried out in the future. Those studies will identify the digital technology used to track those mothers who do not take their children to the hospital.
Acceptance of the research proposal
Talks with representatives in the study area
Research tools development
Training of interviewees
Information to community and authorities
Dubé, E., Laberge, C., Guay, M., Bramadat, P., Roy, R., & Bettinger, J. A. (2013). Vaccine hesitancy: an overview. Human vaccines & immunotherapeutics, 9(8), 1763-1773.
Dubé, E., Vivion, M., Sauvageau, C., Gagneur, A., Gagnon, R., & Guay, M. (2016). “Nature does things well; why should we interfere?” Vaccine hesitancy among mothers. Qualitative Health Research, 26(3), 411-425.
Etikan, I., & Bala, K. (2017). Sampling and sampling methods. Biometrics & Biostatistics International Journal, 5(6), 00149.
Gesser-Edelsburg, A., Shir-Raz, Y., & Green, M. S. (2016). Why do parents who usually vaccinate their children hesitate or refuse? General good vs. individual risk. Journal of Risk Research, 19(4), 405-424.
Girmay, A., & Dadi, A. F. (2019). Full immunization coverage and associated factors among children aged 12-23 months in hard-to-reach areas of Ethiopia. International Journal of pediatrics, 2019.
Thapar, R., Kumar, N., Surendran, P., Shahdiya, A., Mahendran, V., Ramesh, R, & Kumar, A. (2021). Vaccine hesitancy among mothers of under-five children in Coastal South India: a facility-based cross-sectional study. F1000Research, 10(186), 186.
Thomas, L. (2020, May 8). What is a cross-sectional study? Retrieved from https://www.scribbr.com/methodology/cross-sectional-study/
Wang, N., Gao, X., & Li, J. (2018). Random sampling for fast face sketch synthesis. Pattern Recognition, 76, 215-227.