University students immunized and not immunized for measles: a comparison of beliefs, attitudes, and perceived barriers and benefits

This descriptive comparative study was designed to compare students who were immunized or not immunized during the January 1997 Simon Fraser University (SFU) measles outbreak. The study was prompted by the public health concern regarding 20% of the campus population that was thought to be susceptible to measles, but was not immunized during the outbreak. The theoretical framework guiding this study was the Health Belief Model. The comparison between the immunized and non-immunized student samples was made in terms of age, perceived susceptibility to measles, measles severity, benefits and barriers to immunization, cues to action, health motivation, confidence, knowledge of measles, prior contact with measles, perceived threat, and student area of study at the university. The study also described what nonimmunized students indicated it would have taken for them to be immunized. In October 1997, a self-administered questionnaire was mailed to a random sample of 400 SFU students who were immunized and 400 SFU students who were not. One of the components of this questionnaire developed for the study was the "Immunization Health Belief Model Scale," based on "The Breast Self Examination-Related Health Belief Model Scales" developed by Champion (1993). The following variables were significantly related to being immunized: student age, perceived susceptibility, severity, barriers, cues to action, and threat. Students enrolled in types of study relating to human health were significantly more likely to be immunized. Content analysis of the non-immunized students' descriptions of what it would have taken for them to be immunized reflected themes which substantiated the influence of the variables of perceived susceptibility, barriers, cues to action, and threat. Logistic regression analysis achieved an overall correct prediction rate of 84.7% by including the contribution of the four variables of susceptibility, barriers, cues to action, and health motivation. The study findings were consistent with ones which had been reviewed in the literature and supported the Health Belief Model. The Immunization Health Belief Model Scale was a valuable tool for ascertaining attitudes and beliefs relating to immunization decision-making. Nurses are in pivotal positions to influence immunization-seeking behaviours. Nursing interventions targetted to significant attitudes and beliefs will increase immunization coverage levels and result in improved disease prevention.Applied Science, Faculty ofNursing, School ofGraduat