Sandra Bean | Oregon State University (original) (raw)

Papers by Sandra Bean

Health Promotion Practice, Jun 8, 2018

We sought to examine parent vaccine information sources and to understand vaccine beliefs and con... more We sought to examine parent vaccine information sources and to understand vaccine beliefs and concerns of a representative sample of Oregon parents from an area where low vaccination levels occur. We hoped to understand how these beliefs affect pediatric vaccine uptake and to inform efforts to shift vaccinehesitant habits toward a norm of full vaccination. Oregon still permits nonmedical exemptions. We passively recruited parents of children ages 0 to 13 years, then divided them into focus groups by stancewhether vaccine-accepting or-hesitant. Because of recruitment challenges, we supplemented focus group data from 33 participants with six individual parent interviews. In focus groups and interviews, we probed for vaccine information sources perceived as credible as well as perceptions about vaccines and their utility, benefit, and safety, using constructs of the health belief model. The information sources included medical providers, family, and peers or social networks. We found that vaccine beliefs are not dichotomous but fall along a continuum from full acceptance to full opposition. Most parents who participated inclined toward flexible vaccination scheduling. Another new finding was that most participants, regardless of vaccine stance, acknowledged the tension between social responsibility and individual choice regarding vaccination; vaccineaccepters supported social responsibility and vaccinehesitant participants stressed individual choice. In addition, parents across the spectrum expressed skepticism about the reliability of social media.

Sage Open Medicine, 2018

Parental pediatric vaccine decisions are influenced by parents' health provider networks. Complem... more Parental pediatric vaccine decisions are influenced by parents' health provider networks. Complementary and alternative medical providers may be key influences in the networks of those parents who do not vaccinate their children. Methods: From March to July 2013, we conducted semi-structured interviews of Oregon complementary and alternative medical providers (N = 36) in five disciplines likely to treat parents or children, or both, and whose practitioners are known to express opinions about vaccines and vaccination. We interviewed them concerning their immunology beliefs, vaccine positions, and what these providers recommend to their patients concerning vaccines. We conducted face-to-face interviews and analyzed the interview data using thematic analysis methodology. Results: This article identifies the range and type of immunological beliefs of complementary and alternative medical providers concerning pediatric vaccine recommendations. From repeated readings of the data, we identified three areas of alternative immunological beliefs among complementary and alternative medical providers (i.e. "natural is best," "innate intelligence," and "the fragile immune system"). In addition, complementary and alternative medical providers who embraced mainstream medicine were likely to be vaccine accepters and to mention vaccines as a positive health measure to their patients-these themes were "vaccines prevent illness" and "herd immunity." Conclusion: Complementary and alternative medical providers influence their patients' vaccination decisions, particularly urging caution or complete vaccine avoidance, and may be a major influence in states like Oregon with high non-medical exemption rates. Complementary and alternative medical providers come to their anti-vaccine positions largely through post-graduation continuing education courses and seminars. In Oregon, such courses are unregulated and not vetted.

Qualitative Health Research, Aug 5, 2013

Health care providers exert a significant influence on parental pediatric vaccination decisions. ... more Health care providers exert a significant influence on parental pediatric vaccination decisions. We conducted hour-long interviews with traditional and alternative health care providers in which we explored a range of associations between vaccination perceptions and practice. A key finding was that the Health Belief Model constructs of perceived susceptibility to and severity of either an illness or an adverse vaccine event partially explained health care provider (HCP) beliefs about the risks or benefits of vaccination, especially among alternative care providers. Low or high perceived susceptibility to a vaccine-preventable disease (VPD) or of the severity of a given VPD affects whether an HCP will promote or oppose pediatric vaccination recommendations. Beyond these perceptions, health and vaccination beliefs are affected by the contextual factors of personal experience, group norms, immunology beliefs, and beliefs about industry and government. Building powerful affective heuristics might be critical to balancing the forces that defeat good public health practices.

Health promotion practice, 2018

We sought to examine parent vaccine information sources and to understand vaccine beliefs and con... more We sought to examine parent vaccine information sources and to understand vaccine beliefs and concerns of a representative sample of Oregon parents from an area where low vaccination levels occur. We hoped to understand how these beliefs affect pediatric vaccine uptake and to inform efforts to shift vaccine-hesitant habits toward a norm of full vaccination. Oregon still permits nonmedical exemptions. We passively recruited parents of children ages 0 to 13 years, then divided them into focus groups by stance-whether vaccine-accepting or -hesitant. Because of recruitment challenges, we supplemented focus group data from 33 participants with six individual parent interviews. In focus groups and interviews, we probed for vaccine information sources perceived as credible as well as perceptions about vaccines and their utility, benefit, and safety, using constructs of the health belief model. The information sources included medical providers, family, and peers or social networks. We foun...

Qualitative Health Research, 2013

Vaccine, 2011

Context: Anti-vaccination websites appeal to persons searching the Internet for vaccine informati... more Context: Anti-vaccination websites appeal to persons searching the Internet for vaccine information that reinforces their predilection to avoid vaccination for themselves or their children. Few published studies have systematically examined these sites. Objectives: The aim of this study was to employ content analysis as a useful tool for examining and comparing anti-vaccination websites for recurring and changing emphases in content, design, and credibility themes since earlier anti-vaccination website content analyses were conducted. Methods: Between February and May 2010, using a commonly available search engine followed by a deep web search, 25 websites that contained anti-vaccination content were reviewed and analyzed for 24 content, 14 design, and 13 credibility attributes. Results: Although several content claims remained similar to earlier analyses, two new themes emerged:

Health Promotion Practice, Jun 8, 2018

We sought to examine parent vaccine information sources and to understand vaccine beliefs and con... more We sought to examine parent vaccine information sources and to understand vaccine beliefs and concerns of a representative sample of Oregon parents from an area where low vaccination levels occur. We hoped to understand how these beliefs affect pediatric vaccine uptake and to inform efforts to shift vaccinehesitant habits toward a norm of full vaccination. Oregon still permits nonmedical exemptions. We passively recruited parents of children ages 0 to 13 years, then divided them into focus groups by stancewhether vaccine-accepting or-hesitant. Because of recruitment challenges, we supplemented focus group data from 33 participants with six individual parent interviews. In focus groups and interviews, we probed for vaccine information sources perceived as credible as well as perceptions about vaccines and their utility, benefit, and safety, using constructs of the health belief model. The information sources included medical providers, family, and peers or social networks. We found that vaccine beliefs are not dichotomous but fall along a continuum from full acceptance to full opposition. Most parents who participated inclined toward flexible vaccination scheduling. Another new finding was that most participants, regardless of vaccine stance, acknowledged the tension between social responsibility and individual choice regarding vaccination; vaccineaccepters supported social responsibility and vaccinehesitant participants stressed individual choice. In addition, parents across the spectrum expressed skepticism about the reliability of social media.

Sage Open Medicine, 2018

Parental pediatric vaccine decisions are influenced by parents' health provider networks. Complem... more Parental pediatric vaccine decisions are influenced by parents' health provider networks. Complementary and alternative medical providers may be key influences in the networks of those parents who do not vaccinate their children. Methods: From March to July 2013, we conducted semi-structured interviews of Oregon complementary and alternative medical providers (N = 36) in five disciplines likely to treat parents or children, or both, and whose practitioners are known to express opinions about vaccines and vaccination. We interviewed them concerning their immunology beliefs, vaccine positions, and what these providers recommend to their patients concerning vaccines. We conducted face-to-face interviews and analyzed the interview data using thematic analysis methodology. Results: This article identifies the range and type of immunological beliefs of complementary and alternative medical providers concerning pediatric vaccine recommendations. From repeated readings of the data, we identified three areas of alternative immunological beliefs among complementary and alternative medical providers (i.e. "natural is best," "innate intelligence," and "the fragile immune system"). In addition, complementary and alternative medical providers who embraced mainstream medicine were likely to be vaccine accepters and to mention vaccines as a positive health measure to their patients-these themes were "vaccines prevent illness" and "herd immunity." Conclusion: Complementary and alternative medical providers influence their patients' vaccination decisions, particularly urging caution or complete vaccine avoidance, and may be a major influence in states like Oregon with high non-medical exemption rates. Complementary and alternative medical providers come to their anti-vaccine positions largely through post-graduation continuing education courses and seminars. In Oregon, such courses are unregulated and not vetted.

Qualitative Health Research, Aug 5, 2013

Health care providers exert a significant influence on parental pediatric vaccination decisions. ... more Health care providers exert a significant influence on parental pediatric vaccination decisions. We conducted hour-long interviews with traditional and alternative health care providers in which we explored a range of associations between vaccination perceptions and practice. A key finding was that the Health Belief Model constructs of perceived susceptibility to and severity of either an illness or an adverse vaccine event partially explained health care provider (HCP) beliefs about the risks or benefits of vaccination, especially among alternative care providers. Low or high perceived susceptibility to a vaccine-preventable disease (VPD) or of the severity of a given VPD affects whether an HCP will promote or oppose pediatric vaccination recommendations. Beyond these perceptions, health and vaccination beliefs are affected by the contextual factors of personal experience, group norms, immunology beliefs, and beliefs about industry and government. Building powerful affective heuristics might be critical to balancing the forces that defeat good public health practices.

Health promotion practice, 2018

We sought to examine parent vaccine information sources and to understand vaccine beliefs and con... more We sought to examine parent vaccine information sources and to understand vaccine beliefs and concerns of a representative sample of Oregon parents from an area where low vaccination levels occur. We hoped to understand how these beliefs affect pediatric vaccine uptake and to inform efforts to shift vaccine-hesitant habits toward a norm of full vaccination. Oregon still permits nonmedical exemptions. We passively recruited parents of children ages 0 to 13 years, then divided them into focus groups by stance-whether vaccine-accepting or -hesitant. Because of recruitment challenges, we supplemented focus group data from 33 participants with six individual parent interviews. In focus groups and interviews, we probed for vaccine information sources perceived as credible as well as perceptions about vaccines and their utility, benefit, and safety, using constructs of the health belief model. The information sources included medical providers, family, and peers or social networks. We foun...

Qualitative Health Research, 2013

Vaccine, 2011

Context: Anti-vaccination websites appeal to persons searching the Internet for vaccine informati... more Context: Anti-vaccination websites appeal to persons searching the Internet for vaccine information that reinforces their predilection to avoid vaccination for themselves or their children. Few published studies have systematically examined these sites. Objectives: The aim of this study was to employ content analysis as a useful tool for examining and comparing anti-vaccination websites for recurring and changing emphases in content, design, and credibility themes since earlier anti-vaccination website content analyses were conducted. Methods: Between February and May 2010, using a commonly available search engine followed by a deep web search, 25 websites that contained anti-vaccination content were reviewed and analyzed for 24 content, 14 design, and 13 credibility attributes. Results: Although several content claims remained similar to earlier analyses, two new themes emerged: