What affects pediatric healthcare providers to encourage receipt of routine childhood vaccinations? Results from the Northern District of Israel, 2016

Background: Pediatric healthcare providers (HCPs) are a major resource which helps parents make decisions about their children's vaccinations. It is important to assess their behavior to encourage the receipt of routine vaccines. Objectives: (1) To evaluate the knowledge level of and attitudes towards routine childhood vaccinations among pediatric HCPs; (2) To assess their behavior to encourage the receipt of routine vaccinations and associated predictors; (3) To examine their willingness to receive immunization training and to improve their skills to cope with vaccine-hesitant parents. Study design and settings: This is a cross-sectional study among pediatric physicians and nurses working at primary clinics (curative service) and mother-child health clinics (preventive service) in Jewish localities in the Northern District of Israel. Methods: A structured, anonymous, self-administered questionnaire was used. Results: The study included 271 HCPs (response rate = 72.2%). An insufficient knowledge level about vaccines was demonstrated among participants (mean score: 5.2 ± 0.91 and 4.71 ± 1.21 points out of 6 in the preventive and curative services, respectively; p = 0.000). The overall attitude towards vaccinations was positive (mean score: 45.40 ± 5.98 and 42.95 ± 6.84 points out of 56 in the preventive and curative services, respectively; p = 0.002). The two predictors that were associated with the behavior of HCPs to encourage childhood vaccinations were workplace (preventive vs. curative service) and the number of parents encountered by the HCP who opposed or feared vaccines. No association was found between the behavior and the knowledge level and the attitudes. Of the HCPs, 79.3% were interested in immunization training and 66.1% in participating in workshops to improve their communication skills to cope with vaccine-hesitant parents. Conclusions: There is a need to increase the commitment of HCPs to encourage parents to vaccinate their children with routine vaccines, to improve their knowledge about vaccines, and to provide them with communication tools to deal with vaccine-hesitant parents.