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Medical Research Council Social and Public Health Sciences
Unit
University of Glasgow, 4 Lilybank Gardens
Glasgow G12 8RZ
PhD STUDENTSHIP
Parental decision making in MMR vaccination:
perceptions of risks, benefits, and barriers
Background
Recent publicity about possible long term sequelae following MMR
vaccination has generated much media interest. Despite support for
MMR from a number of independent expert committees, and
assurances about the safety of the immunisation programme and
the risks of non-immunisation, many parents have genuine worries
and this may be contributing to falling vaccination rates in the UK.
Although average vaccination rates across Scotland are high
(approximately 93%) uptake in some Health Board areas has now
fallen below 90%, which is below the target of 92%.
Current concerns about MMR date to 1998, when the medical
journal The Lancet published a study of 12 children who developed
autism within 12 days of receiving the MMR vaccine. This and
subsequent studies (including those presenting negative evidence)
were widely reported in the media, and led to assurances from the
medical establishment that the vaccine is safe, and a £3m NHS
publicity campaign to promote the vaccine. However, such
assurances are often mistrusted by parents on the grounds that
there is a “government cover-up”, not dissimilar to the BSE crisis. In
addition myths currently abound concerning both MMR and the
single vaccine which is often seen by parents as a safe alternative.
In this climate it seems unlikely that simple assurances to parents
about the risks and benefits of vaccination will be persuasive, and a
greater understanding of parents’ decision making is probably
required.
Current research literature focuses on the absolute risks and
benefits of vaccination (e.g., Bedford and Elliman, 2000), and on
the adverse role of the media (Begg et al., 1998) but there is little on
parental decision making around vaccination. Some non-UK
research on other forms of vaccination (e.g., pertussis vaccination)
has identified psychological and other factors influencing such
decisions (e.g., Meszaros et al., 1996) and a range of social factors
have also been investigated (Forrest et al., 2000; Zimmerman et al.,
1996). There is also a much larger literature examining parental
decision making with respect to other preventive interventions.
However the generalisability of the non-UK research on MMR
decision making is unclear, and attempts to increase coverage need
to incorporate a more sophisticated understanding of parent’s
decision making around MMR vaccination. This research project
aims to investigate this understanding and represents an opportunity
to carry out an in-depth investigation of an important health issue.
Aims
The main aim of the study is to investigate the factors that influence
parent’s decision making regarding childhood MMR vaccination, in
order to inform the wider debate (for example, by identifying
barriers to vaccination).
Plan
The details of the project will be developed in conjunction with the
student, but the project could include a comparison of parents
whose child was immunised with parents of non-immunised children,
in terms of: perceptions of risk and benefits, perceptions of
information from health professionals and other information sources
(including the media); social and other factors influencing
vaccination; and preferences for different types of outcomes.
Methods
A range of methods will be considered, depending on the specific
research question. However, the methods are likely to include the
following:
Questionnairesurvey of parents to elicit information on
expectations and experiences of vaccination
Semi-structuredinterviews with a sample of parents to explore
barriers and beliefs relating to vaccination
Groupinterviews (focus groups) to generate data on public
perceptions of the media and health professionals as sources of
information on MMR
Analysisof documentary materials relating to MMR (such as
media coverage, and Department of Health publicity material)
References
Bedford & Elliman, Concerns about immunisation BMJ 2000
320:240-243
Begg et al., Media dents confidence in MMR vaccine BMJ 1998
316:561
Forrest et al., 2000; Factors influencing vaccination uptake.
Communicable Diseases Intelligence 2000 24:51-3.
Meszaros et al., Journal of Clinical Epidemiology 1996 49:697-703
Zimmerman et al., Archives of Pediatrics and Adolescent Medicine
1996 150:1054-1061
Supervision
The student will be supervised by Dr. Mark Petticrew, who is an
Associate Director of the Social and Public Health Sciences Unit. In
addition, following the usual practice in the Unit, an advisory
committee of four to six members will be set up to provide support to
the student and to periodically review the progress of the
studentship. It may also be possible to develop direct links with
other MMR projects in Scotland.
The successful candidate will register for a PhD in the Social
Science Faculty at the University of Glasgow. This Faculty will
provide support for the student through its postgraduate induction
programme and by providing contact with other Social Science
postgraduates.
The Unit
The research student will be based in the MRC Social and Public
Health Sciences Unit (Director Professor Sally Macintyre; unit
website { HYPERLINK http://www.msoc-mrc.gla.ac.uk/) }http://www.msoc-mrc.gla.ac.uk/). The unit was created on 1
October 1998 at the University of Glasgow as the result of a merger
between the Medical Research Council’s Medical Sociology Unit
and the Public Health Research Unit, funded by the Chief Scientist
Office of the Scottish Office Department of Health. The aim of the
Unit is to promote human health via the study of social and
environmental influences on health, specifically:
to study how people’s social positions, and their social and
physical environments, influence their physical and mental
health and capacity to lead healthy lives;
to design and evaluate interventions aiming to improve public
health and reduce social inequalities in health; and
to influence policy and practice by communicating the results
and implications of research to a wide range of audiences.
The Unit provides excellent support for junior researchers and
students and has one of the UK’s longest established and largest
groups of social scientists studying the impact of social factors on
health and illness. Researchers employ a range of quantitative and
qualitative methods. The Unit is well resourced, with its own library
and librarian, a network of PCs, a wide range of software, e-mail
and internet access. The Unit currently has 8 full-time PhD
students, 7 funded by MRC and 1 funded by the CSO.
Eligibility
The MRC has qualifying and eligibility requirements for all
studentships. In terms of residence the student must have a
‘relevant connection’ with the United Kingdom at the date of
application. A relevant connection is established where:
the candidate has been ordinarily resident in the UK throughout
the three year period preceding the date of application for a
studentship; and,
the candidate has not been so resident during any part of that
three year period, wholly or mainly for the purpose of receiving
full-time education and,
the candidate is not subject under the immigration laws to any
restriction on the period for which the candidate may stay.
A temporary absence abroad during the three years, for the reason
of employment of the candidate, the candidate’s spouse or parents,
or the full-time education of the candidate or spouse, will not be
classed as having interrupted the period of residence.
There are exceptions to the rule of a relevant connection on the
grounds of refugee status, European Union nationality, and
nationality in European Economic Areas. Please enquire for further
details of these rules. Candidates who are resident in the UK on a
student visa, work permit or dependent visa have restrictions on the
time they may stay in the UK and cannot demonstrate a relevant
connection or settled status. They will not therefore be eligible on
residence grounds.
Qualifications
The student would be expected to have a 1st or 2:1 Honours degree
in a relevant social science (e.g. Sociology, Psychology).
Stipend
The level of the stipend from 1 October 2000 is £10,000 per year for
the 3-year research studentship. The MRC has a system of
allowances for young dependants, students with disabilities, and
various aspects of fieldwork and training. Please enquire for further
details.
Application
Informal enquiries about the studentship should be directed to Mark
Petticrew on 0141 357 3949 or e-mail: [log in to unmask]
Applications should be in the form of:
a covering letter explaining why you are interested in the
studentship
a full CV, including the names of two academic referees and
their email addresses (if possible) and telephone numbers
a completed application form (enclosed)
These should be sent to Barbara Jamieson, MRC Social and Public
Health Sciences Unit, 4 Lilybank Gardens, Glasgow G12 8RZ, by
Monday, 23rd July 2001.
Interviews will be held on 14th August, 2001.
-------------Barbara---------------------------------
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