@article{fdi:010074861,
  title = {{S}ocial differentiation of vaccine hesitancy among {F}rench parents and the mediating role of trust and commitment to health : a nationwide cross-sectional study},
  author = {{B}ocquier, {A}. and {F}ressard, {L}. and {C}ortaredona, {S}{\'e}bastien and {Z}aytseva, {A}. and {W}ard, {J}. and {G}autier, {A}. and {P}eretti-{W}atel, {P}. and {V}erger, {P}. and {L}ydie, {N}. and {R}ahib, {D}. and {L}imousi, {F}. and {R}ichard, {J}. {B}. and {B}rouard, {C}. and {L}arsen, {C}. and {B}arom{\`e}tre {S}ant{\'e} 2016 {G}roup},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {T}he relations between vaccine hesitancy ({VH}) and individual socioeconomic status ({SES}) vary with context and remain poorly understood. {W}e examined associations between parental {SES} and {VH} levels and their potential mediation by two attitudinal factors: commitment to making "good" health-related decisions and trust in mainstream medicine. {M}ethods: {D}ata come from the 2016 {B}arometre sante, a random cross-sectional telephone survey of the {F}rench general population. {W}e analyzed a sample comprising 3927 parents of children aged 1-15 years, dividing them into 4 categories according to their {VH} level. {W}e performed bivariate and then multiple multinomial logistic regression analyses to study associations between parental educational level, income, and {VH}. {W}e then reassessed the logistic model with a causal steps approach, adding the commitment and trust scores. {R}esults: {V}accine refusers accounted for 26% of parents (95% {CI} = 25%, 28%), delayers 7% (95% {CI} = 6%, 8%), and acceptors with doubts 13% (95% {CI} = 12%, 14%). {I}n bivariate analyses, educational level was associated with {VH} but income was not, while commitment and trust scores varied significantly with both {VH} and educational level (p < 0.001). {I}n multivariate analyses, highly educated parents were more prone to be delayers ({AOR} (>= {B}ac + 4 versus < {B}ac) = 1.73, 95% {CI} = 1.12, 2.69) or refusers ({AOR} (>= {B}ac + 4 versus < {B}ac) = 1.56, 95% {CI} = 1.19, 2.04) than nonhesitant. {T}hese associations did not remain significant after inclusion of the commitment and trust scores in the model. {C}onclusions: {V}accine refusal and delay are frequent among {F}rench parents, especially the more educated. {O}ur results suggest that levels of commitment and trust play a key role in shaping {VH}. {S}uitable educational interventions are needed to restore trust in authorities and vaccines. {H}elping healthcare professionals to communicate better with vaccine-hesitant parents is also essential.},
  keywords = {{S}ocioeconomic factors ; {A}ttitude to health ; {V}accination refusal ; {P}arents ; {C}ross-sectional studies ; {FRANCE}},
  booktitle = {},
  journal = {{V}accine},
  volume = {36},
  numero = {50},
  pages = {7666--7673},
  ISSN = {0264-410{X}},
  year = {2018},
  URL = {https://www.documentation.ird.fr/hor/fdi:010074861},
}