Hobani Fatimah O, Alharthi Abeer K, Alharbi Manal F
Executive Nursing Administration Department, Jazan Health Cluster, Jazan, Saudi Arabia.
Department of Mental, Psychiatric, and Community Health Nursing, College of Nursing, King Saud University, Riyadh, Saudi Arabia.
BMC Public Health. 2025 Jul 25;25(1):2548. doi: 10.1186/s12889-025-23657-5.
Vaccines are a global health success story, saving millions of lives each year. However, barriers to acceptance, such as misinformation, safety concerns, and trust issues, persist among parents. This study aimed to explore factors influencing Saudi parents' decisions to vaccinate their children, focusing on attitudes, subjective norms, perceived behavioral control, and behavioral intentions.
A cross-sectional study was conducted in Jazan, Saudi Arabia, across 170 primary healthcare centers (PHCCs) in seven administrative sectors. A random sampling approach selected 10 PHCCs per sector. Saudi parents with children aged 0-6 years attending PHCCs were approached to complete an online questionnaire. Data were collected from December 2023 to February 2024 with a total sample size of n=1310. The inter-relationship in the Theory of Planned Behavior was examined based on the data collected. Structural Equation Modeling (SEM) was used to evaluate the direct relationship between the predictor variables: attitude, subjective norm, and parent perceived behavioral control, on a mediating variable: behavioral intention. Mediation analysis was further carried out to investigate the indirect relationship between the predictor variables and the parents' vaccination decision-making.
The largest proportion of participants was from the Central Sector (27.9%), and the majority were female (68.5%). Most participants were aged 31-40 years (49.8%), married (92.6%), had a university-level education (65.9%), and 66.6% of participants were employed. Approximately 96.3% of children had received vaccinations, and 95.4% were vaccinated. The SEM revealed significant influence of parental attitudes on behavioral intention (B = 0.18, p<0.05); significant influence of subjective norms on behavioral intention (B = 0.08,p<0.05), and negative significant influence of perceived behavioral control on behavioral intentions (B = -0.208, p<0.05). Behavioral intention partially mediated the relationships between the predictor variables and parents' vaccination decision-making. The model fit indices: P value 0.00, Root Mean Square Error of Approximation (RMSEA)= 0.058, Comparative Fit Index (CFI)= 0.866, Tucker Lewis index (TLI)= 0.911, demonstrate the model's overall fit to the data, which indicates a good model fit.
These findings highlight the influence of parental beliefs and social factors on vaccination decisions and emphasize the need for targeted interventions. Insights from this study can inform culturally and contextually relevant strategies to address vaccination hesitancy and strengthen trust in childhood vaccination programs in Saudi Arabia.
疫苗是全球卫生领域的一项成功成果，每年挽救数百万人的生命。然而，父母中仍然存在诸如错误信息、安全担忧和信任问题等接受疫苗的障碍。本研究旨在探讨影响沙特父母为子女接种疫苗决策的因素，重点关注态度、主观规范、感知行为控制和行为意图。
在沙特阿拉伯的吉赞进行了一项横断面研究，涵盖七个行政区的170个初级医疗保健中心（PHCC）。采用随机抽样方法，每个行政区选取10个PHCC。邀请在PHCC就诊的0至6岁儿童的沙特父母完成一份在线问卷。数据收集时间为2023年12月至2024年2月，总样本量为n = 1310。根据收集到的数据，检验计划行为理论中的相互关系。使用结构方程模型（SEM）评估预测变量（态度、主观规范和父母感知行为控制）与中介变量（行为意图）之间的直接关系。进一步进行中介分析，以研究预测变量与父母疫苗接种决策之间的间接关系。
最大比例的参与者来自中央行政区（27.9%），大多数为女性（68.5%）。大多数参与者年龄在31至40岁之间（49.8%），已婚（92.6%），拥有大学学历（65.9%），66.6%的参与者有工作。约96.3%的儿童已接种疫苗，95.4%的儿童完成了疫苗接种。SEM显示父母态度对行为意图有显著影响（B = 0.18，p<0.05）；主观规范对行为意图有显著影响（B = 0.08，p<0.05），感知行为控制对行为意图有显著负向影响（B = -0.208，p<0.05）。行为意图部分中介了预测变量与父母疫苗接种决策之间的关系。模型拟合指数：P值为0.00，近似均方根误差（RMSEA）= 0.058，比较拟合指数（CFI）= 0.866，塔克·刘易斯指数（TLI）= 0.911，表明模型与数据总体拟合良好，即模型拟合度良好。
这些发现突出了父母信念和社会因素对疫苗接种决策的影响，并强调了有针对性干预措施的必要性。本研究的见解可为制定与文化和背景相关的策略提供参考，以解决疫苗接种犹豫问题，并增强沙特阿拉伯对儿童疫苗接种计划的信任。
