Abstract
Purpose: This study aims to investigate the effect of parents' health literacy on vaccine hesitancy. Additionally, it examines levels of health literacy and vaccine hesitancy among parents in relation to demographic variables. The recent significant increase in vaccine hesitancy and opposition, combined with the limited number of studies focusing on parents, underscores the importance of this research.
Materials and Methods: This quantitative study employed a cross-sectional and descriptive design. Health literacy and vaccine hesitancy scales were used as data collection instruments. The surveys were distributed via online platforms, and data were collected in February 2021. A total of 488 parents residing in Türkiye participated in the study. As the data followed a normal distribution, parametric tests were used for analysis.
Results: Among the participants, 69% were mothers, 30.3% had only one child, and 37.3% were between the ages of 31 and 40. Health literacy was found to be a significant negative predictor of vaccine hesitancy. Similarly, being a father was also a significant negative predictor. Although there was a positive association between educational level and vaccine hesitancy, this relationship was not statistically significant.
Conclusion: Health literacy and paternal status significantly and negatively predicted vaccine hesitancy, while educational level did not show a significant effect. These variables collectively explained 4.5% of the variance in vaccine hesitancy. Although the effect size was modest, higher health literacy and being a father contributed to reduced vaccine hesitancy. In contrast, being a mother and having lower health literacy levels were associated with increased vaccine hesitancy.
Keywords
References
- Kutlu HH, Altındiş M. Anti-vaccination. Flora J Infect Dis Clin Microbiol. 2018;23:247–58.
- Gür E. Vaccine hesitancy-vaccine refusal. Turk Arch Pediatr. 2019;54:1.
- Centers for Disease Control and Prevention (CDC). Ten great public health achievements—United States, 1900–1999. MMWR Morb Mortal Wkly Rep. 1999;48:241–3.
- World Health Organization. Assessment Report of the Global Vaccine Action Plan. Geneva, WHO, 2017.
- World Health Organization. Immunization Coverage. Genev,: WHO, 2019.
- Smith TC. Vaccine rejection and hesitancy: a review and call to action. Open Forum Infect Dis. 2017;4:1-7.
- World Health Organization. Ten Threats to Global Health in 2019. Geneva, WHO, 2019.
- World Health Organization. Health Literacy: The Solid Facts. Copenhage, WHO Regional Office for Europe, 2013.
- Wilson SL, Wiysonge C. Social media and vaccine hesitancy. BMJ Glob Health. 2020;5:e004206.
- Dubé E, Bettinger JA, Fisher WA, Naus M, Mahmud SM, Hilderman T. Vaccine acceptance, hesitancy and refusal in Canada: challenges and potential approaches. Can Commun Dis Rep. 2016;42:246.
- Health Ministry of the Republic of Türkiye. National vaccine workshop report. Ankara; 2016 Mar 24–26. http://www.enfeksiyon.org.tr/2.calistayrapor.pdf (Accessed Mar 2021).
- Schillinger D. Social determinants, health literacy, and disparities: intersections and controversies. Health Lit Res Pract. 2021;5:e234–43.
- Bin Naeem S, Kamel Boulos MN. COVID-19 misinformation online and health literacy: a brief overview. Int J Environ Res Public Health. 2021;18:8091.
- World Health Organization. Health Promotion Glossary. Geneva, WHO, 1988.
- Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155:97–107.
- Erdağ GÇ. Sağlığın temel belirleyicisi olarak sağlık okuryazarlığı. In Sağlık Okuryazarlığı, (Eds F Yıldırım, A Keser): 1-14. Ankara, Ankara Üniversitesi Basımevi, 2015.
- Patel H, Jeve YB, Sherman SM, Moss EL. Knowledge of human papillomavirus and the human papillomavirus vaccine in European adolescents: a systematic review. Sex Transm Infect. 2016;92:474–9.
- Çam C, Ünsal A, Arslantaş D, Kılınç A, Öztürk Emiral G. Evaluation of immunization knowledge sufficiency levels, attitudes and behaviors and health literacy levels of adults. Osmangazi J Med. 2021;43:7–19.
- Wilson FL, Baker LM, Nordstrom CK, Legwand C. Using the teach-back and Orem's Self-care Deficit Nursing theory to increase childhood immunization communication among low-income mothers. Issues Compr Pediatr Nurs. 2008;31:7–22.
- Sørensen K, Van den Broucke S, Pelikan JM, Fullam J, Doyle G, Slonska Z et al. Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health. 2013;13:948.
- Toçi E, Burazeri G, Sorensen K, Jerliu N, Ramadani N, Roshi E et al. Health literacy and socioeconomic characteristics among older people in transitional Kosovo. J Adv Med Biomed Res. 2013;3:1646–58.
- Aras Z, Bayık Temel A. Evaluation of validity and reliability of the Turkish version of health literacy scale. Florence Nightingale J Nurs. 2017;25:85–94.
- Kılınçarslan MG, Sarıgül B, Toraman C, Şahin EM. Development of valid and reliable scale of vaccine hesitancy in Turkish language. Konuralp Med J. 2020;12:420–9.
- Hobani F, Alhalal E. Factors related to parents’ adherence to childhood immunization. BMC Public Health. 2022;22:819.
- Latkin CA, Dayton L, Yi G, Colon B, Kong X. Mask usage, social distancing, racial, and gender correlates of COVID-19 vaccine intentions among adults in the US. PLoS One. 2021;16:e0246970.
- Allington D, McAndrew S, Moxham-Hall V, Duffy B. Coronavirus conspiracy suspicions, general vaccine attitudes, trust and coronavirus information source as predictors of vaccine hesitancy among UK residents during the COVID-19 pandemic. Psychol Med. 2023;53:236–47.
- Aharony N, Goldman R. E-health literacy and the vaccination dilemma: an Israeli perspective. Inf Res. 2017;22:751.
- Çimen Z, Bayık Temel A. Investigation of health literacy, perception of health and related factors in elderly patients with chronic illness. J Ege Univ Nurs Fac. 2017;33:105–25.
- Güven A. Sağlık okuryazarlığını etkileyen faktörler ve sağlık okuryazarlığı ile hasta güvenliği ilişkisi (Master’s Thesis). Ankara, Hacettepe University, 2016.
- Rafferty AP, Luo H, Winterbauer NL, Bell RA, Little NRG, Imai S. Health literacy among adults with multiple chronic health conditions. J Public Health Manag Pract. 2022;28:E610–4.
- Yeşildal M, Kaya ŞD. The relationship between digital literacy and health literacy in adult individuals: the case of Konya. Erciyes Univ J Health Sci. 2021;30:174–81.
- Biasio LR. Vaccine hesitancy and health literacy. Hum Vaccin Immunother. 2017;13:701–2.
- Akbulut Y. Sağlık okuryazarlığının sağlık harcamaları ve sağlık hizmetleri kullanımı açısından değerlendirilmesi. In Sağlık Okuryazarlığı,(Eds F Yıldırım, A Keser): 113-32. Ankara: Ankara University Publishing House; 2015.
- Biasio LR. Vaccine literacy is undervalued. Hum Vaccin Immunother. 2019;15:2552–3.
- World Health Organization. Report of the SAGE Working Group On Vaccine Hesitancy. Geneva, WHO, 2014.
- Shon EJ, Lee L. Effects of vaccine literacy, health beliefs, and flu vaccination on perceived physical health status among under/graduate students. Vaccines (Basel). 2023;11:765.
- Song I, Lee SH. COVID-19 vaccine refusal associated with health literacy: findings from a population-based survey in Korea. BMC Public Health. 2023;23:255.
- Casigliani V, Arzilli G, Menicagli D, Scardina G, Lopalco PL. Vaccine hesitancy and health literacy: we need to change our paradigm. Eur J Public Health. 2020;30:15–6.
Abstract
Amaç: Çalışma ebeveynlerin sağlık okuryazarlığının aşı tereddüdü üzerindeki etkisini araştırmayı amaçlamaktadır. Ayrıca çalışmada ebeveynlerin sağlık okuryazarlığı ve aşı tereddüdü düzeyleri demografik değişkenlere göre incelenmiştir. Son dönemlerde aşı tereddüdü ve karşıtlığı konusunda önemli artışların olması ve bu konuda ebeveynler üzerinde yapılan araştırmaların kısıtlı olması bu araştırmanın önemini artırmaktadır.
Gereç ve Yöntem: Nicel çalışma kesitsel ve tanımlayıcıdır. Çalışmada veri toplama aracı olarak sağlık okuryazarlığı ölçeği ve aşı tereddüdü ölçeği kullanılmıştır. Ölçekler çevrimiçi platformlar aracılığıyla dağıtılmıştır. Araştırma verileri Şubat 2021'de toplanmıştır. Çalışmaya Türkiye'de yaşayan toplam 488 ebeveyn dâhil edilmiştir. Normal dağılım sağlandığı için verilerin analizinde parametrik testlerden yararlanılmıştır.
Bulgular: Katılımcıların %69'u annelerden, %30,3'ü tek çocuklu ebeveynlerden, %37,3'ü 31-40 yaş aralığındaki ebeveynlerden oluşmaktadır. Sağlık okuryazarlığı aşı tereddüdünü negatif ve anlamlı bir şekilde açıklamaktadır. Babalık aşı tereddüdünü negatif ve anlamlı bir şekilde açıklamaktadır. Katılımcıların eğitim düzeyi ile aşı tereddüdü arasındaki ilişki pozitif olmasına rağmen, bu ilişki anlamlı değildir.
Sonuç: Sağlık okuryazarlığı ve ebeveynlik bağımsız değişkenleri aşı tereddüdünü negatif ve anlamlı bir şekilde açıklarken, eğitim düzeyinin aşı tereddüdünü anlamlı düzeyde açıklamamaktadır. Bu değişkenler aşı tereddüdünün %4,5'ini açıklamıştır. Etki büyüklüğü çok yüksek olmasa da yüksek sağlık okuryazarlığı ve babalığın aşı tereddütünü azaltmada etkili olduğu görülmüştür. Başka bir deyişle anne olmanın ve ebeveynlerin sağlık okuryazarlığının azalmasının aşı tereddüdünü artırdığı söylenebilir.
Keywords
References
- Kutlu HH, Altındiş M. Anti-vaccination. Flora J Infect Dis Clin Microbiol. 2018;23:247–58.
- Gür E. Vaccine hesitancy-vaccine refusal. Turk Arch Pediatr. 2019;54:1.
- Centers for Disease Control and Prevention (CDC). Ten great public health achievements—United States, 1900–1999. MMWR Morb Mortal Wkly Rep. 1999;48:241–3.
- World Health Organization. Assessment Report of the Global Vaccine Action Plan. Geneva, WHO, 2017.
- World Health Organization. Immunization Coverage. Genev,: WHO, 2019.
- Smith TC. Vaccine rejection and hesitancy: a review and call to action. Open Forum Infect Dis. 2017;4:1-7.
- World Health Organization. Ten Threats to Global Health in 2019. Geneva, WHO, 2019.
- World Health Organization. Health Literacy: The Solid Facts. Copenhage, WHO Regional Office for Europe, 2013.
- Wilson SL, Wiysonge C. Social media and vaccine hesitancy. BMJ Glob Health. 2020;5:e004206.
- Dubé E, Bettinger JA, Fisher WA, Naus M, Mahmud SM, Hilderman T. Vaccine acceptance, hesitancy and refusal in Canada: challenges and potential approaches. Can Commun Dis Rep. 2016;42:246.
- Health Ministry of the Republic of Türkiye. National vaccine workshop report. Ankara; 2016 Mar 24–26. http://www.enfeksiyon.org.tr/2.calistayrapor.pdf (Accessed Mar 2021).
- Schillinger D. Social determinants, health literacy, and disparities: intersections and controversies. Health Lit Res Pract. 2021;5:e234–43.
- Bin Naeem S, Kamel Boulos MN. COVID-19 misinformation online and health literacy: a brief overview. Int J Environ Res Public Health. 2021;18:8091.
- World Health Organization. Health Promotion Glossary. Geneva, WHO, 1988.
- Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155:97–107.
- Erdağ GÇ. Sağlığın temel belirleyicisi olarak sağlık okuryazarlığı. In Sağlık Okuryazarlığı, (Eds F Yıldırım, A Keser): 1-14. Ankara, Ankara Üniversitesi Basımevi, 2015.
- Patel H, Jeve YB, Sherman SM, Moss EL. Knowledge of human papillomavirus and the human papillomavirus vaccine in European adolescents: a systematic review. Sex Transm Infect. 2016;92:474–9.
- Çam C, Ünsal A, Arslantaş D, Kılınç A, Öztürk Emiral G. Evaluation of immunization knowledge sufficiency levels, attitudes and behaviors and health literacy levels of adults. Osmangazi J Med. 2021;43:7–19.
- Wilson FL, Baker LM, Nordstrom CK, Legwand C. Using the teach-back and Orem's Self-care Deficit Nursing theory to increase childhood immunization communication among low-income mothers. Issues Compr Pediatr Nurs. 2008;31:7–22.
- Sørensen K, Van den Broucke S, Pelikan JM, Fullam J, Doyle G, Slonska Z et al. Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health. 2013;13:948.
- Toçi E, Burazeri G, Sorensen K, Jerliu N, Ramadani N, Roshi E et al. Health literacy and socioeconomic characteristics among older people in transitional Kosovo. J Adv Med Biomed Res. 2013;3:1646–58.
- Aras Z, Bayık Temel A. Evaluation of validity and reliability of the Turkish version of health literacy scale. Florence Nightingale J Nurs. 2017;25:85–94.
- Kılınçarslan MG, Sarıgül B, Toraman C, Şahin EM. Development of valid and reliable scale of vaccine hesitancy in Turkish language. Konuralp Med J. 2020;12:420–9.
- Hobani F, Alhalal E. Factors related to parents’ adherence to childhood immunization. BMC Public Health. 2022;22:819.
- Latkin CA, Dayton L, Yi G, Colon B, Kong X. Mask usage, social distancing, racial, and gender correlates of COVID-19 vaccine intentions among adults in the US. PLoS One. 2021;16:e0246970.
- Allington D, McAndrew S, Moxham-Hall V, Duffy B. Coronavirus conspiracy suspicions, general vaccine attitudes, trust and coronavirus information source as predictors of vaccine hesitancy among UK residents during the COVID-19 pandemic. Psychol Med. 2023;53:236–47.
- Aharony N, Goldman R. E-health literacy and the vaccination dilemma: an Israeli perspective. Inf Res. 2017;22:751.
- Çimen Z, Bayık Temel A. Investigation of health literacy, perception of health and related factors in elderly patients with chronic illness. J Ege Univ Nurs Fac. 2017;33:105–25.
- Güven A. Sağlık okuryazarlığını etkileyen faktörler ve sağlık okuryazarlığı ile hasta güvenliği ilişkisi (Master’s Thesis). Ankara, Hacettepe University, 2016.
- Rafferty AP, Luo H, Winterbauer NL, Bell RA, Little NRG, Imai S. Health literacy among adults with multiple chronic health conditions. J Public Health Manag Pract. 2022;28:E610–4.
- Yeşildal M, Kaya ŞD. The relationship between digital literacy and health literacy in adult individuals: the case of Konya. Erciyes Univ J Health Sci. 2021;30:174–81.
- Biasio LR. Vaccine hesitancy and health literacy. Hum Vaccin Immunother. 2017;13:701–2.
- Akbulut Y. Sağlık okuryazarlığının sağlık harcamaları ve sağlık hizmetleri kullanımı açısından değerlendirilmesi. In Sağlık Okuryazarlığı,(Eds F Yıldırım, A Keser): 113-32. Ankara: Ankara University Publishing House; 2015.
- Biasio LR. Vaccine literacy is undervalued. Hum Vaccin Immunother. 2019;15:2552–3.
- World Health Organization. Report of the SAGE Working Group On Vaccine Hesitancy. Geneva, WHO, 2014.
- Shon EJ, Lee L. Effects of vaccine literacy, health beliefs, and flu vaccination on perceived physical health status among under/graduate students. Vaccines (Basel). 2023;11:765.
- Song I, Lee SH. COVID-19 vaccine refusal associated with health literacy: findings from a population-based survey in Korea. BMC Public Health. 2023;23:255.
- Casigliani V, Arzilli G, Menicagli D, Scardina G, Lopalco PL. Vaccine hesitancy and health literacy: we need to change our paradigm. Eur J Public Health. 2020;30:15–6.
Details
| Primary Language | English |
|---|---|
| Subjects | Infectious Diseases, Psychiatry |
| Journal Section | Research |
| Authors | |
| Publication Date | June 30, 2025 |
| Submission Date | April 14, 2025 |
| Acceptance Date | May 23, 2025 |
| Published in Issue | Year 2025 |
