COMMUNITY HEALTH STUDIES VOLUME Xll, NUMBER zyxwvuts 1, 1988 zyxwvuts PARENTAL PERCEPTIONS OF MEASLES zyxwvut Debra Blaze-Temple, Colin W. Binns, Duncan P. Boldy Division of Health Sciences, Curtin University of Technology, Perth zyxwv 6OOO. Abstract Australia has recently decided to undertake an eradication programme for indigenous measles. A zyxwvu 90 to zyxwvuts 95 per cent coverage rate will be needed to prevent epidemics in urban areas. The reasons for non-compliance must be understood if this goal is to be reached by voluntary participation. This study used household interviews to assess the measles immunisation status of zyxwvuts 506 children age 0 to 10 years and the attitudes/ knowledge of 312 parents in selected areas of Perth. No statistical associations were found between measles immunisation compliance and child's age, parental ethnicity, child order, family size, parental kvel of education or parental ignorance level. However, lower family income, high parental apathy level and high parental fear level were found to be associated with measles immunisation noncompliance. Introduction Australia recently joined with several other nations attempting to eradicate indigenous measles through immunisation. Other countries involved in eradication campaigns include Czechoslovakia, Finland, Sweden, the United States of America and Canada.' Western Australia will attempt to achieve the herd immunity levels required to eliminate epidemics of this disease (90 to 95% immunised) by voluntary rather than compulsory participation. Most measles immunisation sunteys have been designed to determine compliance level (also known as coverage) rather than reasons for non- compliance. According to Buchanan and Spencer, 'There is a need to study urgently, and in depth, the causes of immunisation non-compliance so as to formulate appropriate remedieC.2 The present study was designed to assess measles immunisation coverage and reasons for non-ompliance as well as the characteristics and perceptions of non- compliers. Noncompliance with childhood immunisations in general has been linked with ethnicity by several researchers,'-6 but has been shown to be independent of ethnicity by other^.^" Low income was associated with noncompliance in two studies:' but not in an~ther.~ Educational level of the mother appeared BLAZE-TEMPLE, BlNNS & BOLDY 55 to be positively correlated with compliance in a study by the Australian Bureau of Statistics,' but not correlated in another study.7 The relationships in the Australian Bureau of Statistics research appear to be significant but were not statistically analysed. In a recent survey by Mak et al.,7 non-compliance for measles immunisation was significantly related to birth order (first born children were more likely to be immunised than second or successive children) and employment of the mother during the child's first two years of life. Only two Australian studies asked why parents did not obtain a particular scheduled immunisation for their children.)' In the Mak et al. study, the three main reasons parents gave for not immunising 217 children were: the child had measles already (31%). they feared the sideeffects of the vaccine (I 3%) they forgot or lacked time (I 2%).' In the ABS study, children not immuniscd for measles totalled 2.350, and the main reason given for not immunising (32%) was that the 'child had measles already".' There is a lack of detailed information however, on parental knowledge and attitudes concerning measles and measles immunisation. Methods A 96 item interview schedule was constructed to measure respondent attitudes and knowledge concerning measles (the disease) and measks immunisation. The instrument was tested for consensual validity by using a four-member expert panel (experts in community health research and immunisation). Their averaged overall score for the instrument was 4, from a 5 point scale, 5 = excelknt, I= barely meeting minimum standards Some modifications were made to the schedule based on their comments. The schedule was then pre-tested on 20 respondents after which further modifmtions were made to wording to increase clarity. The . schedule was not tested for reliability. Because of indications in the literature that certain ethnic groups, and non-Australians in general, exhibit greater immunisation non- compliance, 19 federal census colkction districts were chosen (198 1 census) based on a high density of COMMUNITY HEALTH STUDIES