Motivating factors influencing participation in hepatitis B immunization programs in rural populations.

The emphasis on immunization of children aged 0-2 results in a large pocket of need within the school-aged population, particularly in regard to hepatitis B immunization. After implementing a school-based hepatitis B immunization program in a rural, west central Indiana county, a study was conducted to identify the factors that motivated rural families to participate in the program. A retrospective, descriptive design using a convenience sample of 553 elementary and middle-school students was used. Survey results were received from 41 percent (227) of the sample; 95 percent of the returned questionnaires (215) was used for analysis. Approximately 82 percent of the children immunized were between 11 and 19 years old, with the largest cluster (49 percent) in the 11-13 year age group. Benefit to health, convenience of location and time, and no financial cost to the family were the top three reasons for program participation. Recommendations from health care providers and other parents were ranked as least likely to influence participation. More than 70 percent of the respondents indicated that both parents were not immunized against hepatitis B, 11.6 percent had completed the series, while 14 percent were unsure of their immunization status. These findings corroborated previously held assumptions regarding barriers to appropriate immunization status in rural America and reveal implications for future immunization, health promotion and education programs for rural residents.