Factors influencing the immunization status of children in a rural setting.

INTRODUCTION: The purposes of this study were to (a) assess parental perceptions of their decision making regarding children's vaccinations and (b) describe parents' evaluation of immunization services provided by rural clinics/offices.
METHODS: A qualitative design was used in this study, which was conducted in rural Missouri. Twelve mothers of children younger than age 3 years with fewer than the recommended number of immunizations were interviewed using a semi-structured format. The interview results were analyzed using the constant comparative method.
RESULTS: The following parental perceptions were identified as factors related to immunizations in this rural setting: knowledge of communicable diseases and vaccines, misperceptions about communicable diseases and vaccines, past experiences, competing tasks, transportation, health care personnel, need for reminders, health system, and cost. DISCUSSION: Two findings unique to this study were the importance of relationships with health care providers and the challenge of competing tasks. These findings, combined with the other factors identified, reinforced the importance of rural health care providers' maintaining a strong relationship with clients, providing accurate and timely information, and ensuring a readily accessible health care system.