Uncertainty and Negative Emotions in Parental Decision-making on Childhood Vaccinations: Extending the Theory of Planned Behavior to the Context of Conflicting Health Information.

Delaying childhood vaccinations has become a public health threat. Numerous studies have shown that the proliferation of conflicting information about the health effects of childhood vaccinations leads parents to believe misinformation about the outcomes of these vaccinations. To build upon the limited understanding of how conflicting information affects decision-making of health protective behaviors, this study extends and applies the theory of planned behavior (TPB) in the context of childhood vaccinations. This study integrates perceived uncertainty as an antecedent of the TPB model, and incudes the negative emotions resulting from the uncertainty as a parallel predictor for the model to examine parents' acceptance of and engagement in childhood vaccinations. Drawing from a survey of with parents in the United States (N = 405), we found that both perceived uncertainty and subjective norms are strong predictors of parents' attitudes and perceived control regarding childhood vaccinations. Additionally, our study also proved that affective factors and the other three cognitive components in TPB are equally important on the formation of parents' intentions of childhood vaccinations. Theoretical and practical implications are discussed in this study.