Development, Theoretical Framework, and Evaluation of a Parent and Teacher–Delivered Intervention on Adolescent Vaccination

• Authors: Lisa M. Gargano, Emory University; Natasha L. Herbert, Emory University; Julia Painter, Emory University; Jessica Sales, Emory University; Tara M. Vogt, Centers for Disease Control and Prevention; Christopher Morfaw, Georgia Department of Public Health; LaDawna M. Jones, Emory University; Dennis Murray, Augusta University; Ralph Diclemente, Emory University; James Hughes, Emory University
• Journal Title: Health Promotion Practice
• Volume: Volume 15, Number 4
• Publisher: SAGE Publications (UK and US) | 2014-01-17, Pages 556-567
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1177/1524839913518222
• Subjects: Health Sciences, Public Health
• Keywords: child/adolescent health; curriculum; immunization; school health; theory; Adolescent; Age Factors; Child; Faculty; Georgia; Health Knowledge, Attitudes, Practice; Humans; Parents; School Health Services; Self Efficacy; Sex Factors; Socioeconomic Factors; Vaccination

Abstract

The Advisory Committee on Immunization Practices recommended immunization schedule for adolescents includes three vaccines (tetanus, diphtheria, and acellular pertussis [Tdap]; human papillomavirus [HPV] vaccine; and meningococcal conjugate vaccine [MCV4]) and an annual influenza vaccination. Given the increasing number of recommended vaccines for adolescents and health and economic costs associated with nonvaccination, it is imperative that effective strategies for increasing vaccination rates among adolescents are developed. This article describes the development, theoretical framework, and initial first-year evaluation of an intervention designed to promote vaccine acceptance among a middle and high school–based sample of adolescents and their parents in eastern Georgia. Adolescents, parents, and teachers were active participants in the development of the intervention. The intervention, which consisted of a brochure for parents and a teacher-delivered curriculum for adolescents, was guided by constructs from the health belief model and theory of reasoned action. Evaluation results indicated that our intervention development methods were successful in creating a brochure that met cultural relevance and the literacy needs of parents. We also demonstrated an increase in student knowledge of and positive attitudes toward vaccines. To our knowledge, this study is the first to extensively engage middle and high school students, parents, and teachers in the design and implementation of key theory-based educational components of a school-based, teacher-delivered adolescent vaccination intervention.