Assessment of the impact of a digital intervention on public attitudes to vaccination

Since 1980, vaccination coverage has been lower than the recommended level set by the World Health Organisation for all vaccines included in the National Immunisation Schedule. The focus of this thesis is vaccine resistance. We focus , in particular, on the measles-mumps-rubella (MMR) vaccine, due to a history of resistance to this in the United Kingdom. Much previous work has focused on adult perceptions of vaccination, and interventions aimed at adults have shown limited effect on attitudes towards vaccination. Moreover, few studies have investigated vaccination attitudes held by teenagers and young adults, who form an important target group when we consider future intentions to vaccinate their own children. Digital interventions have previously been successful in affecting teenagers’ attitudes towards important health issues. The aim of this research, therefore, was to determine the impact of a variety of interventions on teenagers’ attitudes towards vaccination. We developed and evaluated an educational digital-based resource for infectious disease epidemiology. This began with the development of an attitudinal survey, using a range of qualitative methods (including interviews) in order to establish the range of views held by local young people and focus groups in Greater Manchester, UK. The findings from the interviews were used as the basis for the design of an attitudinal intervention, which used both "traditional" (presentation-based) and "digital" modes of delivery. The intervention was trialled with GCSE Biology students (n=63), using three groups (presentation, digital and control). This study showed no significant difference in post-trial change in attitudinal scores across the three groups immediately after the intervention (p=0.115), or after a six-month period (p=0.116). In addition, no difference in resource engagement between the two intervention groups was observed. Although the first result may appear somewhat surprising, it is entirely consistent with previous related studies involving adults. The main novel contributions of this research are: (1) a detailed assessment of current attitudes of teenagers towards vaccination, (2) a fully-evaluated and novel form of software-based attitudinal intervention, and (3) a detailed analysis of the impact of this form of intervention on attitudes towards vaccination in young people. Our fundamental conclusion will, we hope, inform the development of future healthcare interventions concerning young people and vaccination