“Parental Delay or Refusal of Vaccine Doses, Childhood Vaccination Coverage at 24 Months of Age, and the Health Belief Model”, Article Critique Example

Title of the article and Abstract

The research article qualitatively examines the association between parents’ beliefs about vaccines, their decision to delay or refuse vaccines for their children, and vaccination coverage of children at aged 24 months. The title of the research article is short, concise, definitive, written in lower case giving the reader an overview of the article without having to read it. The article’s title gives a clear overview of the research to the reader as well as the purpose of the article by reading it. A good research should begin with an abstract which gives in summary the objective or the aim of the study, methods used and the results findings.

A good abstract therefore should be brief, comprehensive, concise, specific, accurate in which it correctly reflects the purpose of the article. Self-contained, it defines all the abbreviations and acronyms used except units of measurements (Ridley, 2008). Evaluating the article, the author’s begin by giving an abstract of the article in which the author’s give a brief summary on what the article is all about giving the reader a clue of article contents by reading. The abstract in detailed defines the objective of the study which is to examine the association between parents’ beliefs about vaccines, their decision to delay or refuse vaccines for their children, and vaccination coverage of children at aged 24 months, research design method used as well as instruments, data collection methods, results and conclusion (Smith, Humiston, Marcuse, Zhao, Dorella & Howes, 2011).

Introduction

Introduction provides a context for author’s arguments attracts reader’s attention, gives the reader an overview of the thesis (Charles, 2009). Problem of the study is usually stated under introduction hence easier to be identified by the reader. The article’s introduction is concise hence it builds a foundation for the research. The author’s of the article begin the introduction by introducing the reader to the area of study as well as relating the topic of study with previous studies that have been done. At the end of the introduction the author’s clearly states the purpose of the study which is to examine the association between parents’ beliefs about vaccines, their decision to delay or refuse vaccines for their children, and vaccination coverage of children at aged 24 months. Though, the article has an introduction that provides a foundation for the entire research, the introduction provided is precise as well as it clearly lacks the elements which constitute a good introduction (Smith, Humiston, Marcuse, Zhao, Dorella & Howes, 2011).

Relevance of research problem and significance

Reading through the article, the research problem is to examine the association between parents’ beliefs about vaccines, their decision to delay or refuse vaccines for their children, and vaccination coverage of children at aged 24 months. Primarily, the research endeavored to examine in detailed the reasons to why parents refuse or delay to vaccinate their children. Evaluating the research problem in relation to its relevance as far as the research is concerned, the research problem is relevant because it has its main focus on finding out reasons as to why many parents refuse or delay to vaccinate their children.

Children Vaccination is a significant aspect in the field of medicine due to the rising number of children deaths. Many parents deliberately refuse to vaccinate their children as a result of ignorance and traditional beliefs. This issue has raised many concerns in the medical field with efforts being done to ensure proper child vaccination. This research problem is of great significance in the field of medicine because it will provide the main reasons why many parents refuse or delay to vaccinate their children hence providing proper solutions to unanswered questions.

Congruence between research question and methods used

No specific research questions have been mentioned, though the author addresses the overall context of the study in a qualitative manner. In the abstract part and introduction the author’s have stated the research problem which correlates with the methods used for data collection and data analysis. The research problem is based on human behavior as well as qualitative kind of research design. Since the research is based on qualitative kind of research design, the methods used in data collection thus surveys, interviews and open ended questions is congruent with the research objective. 

Literature review

A literature review establishes hypothetical framework for the author’s area of research, define key terms and terminologies, identify related studies, models supporting the topic of research, defines and establishes the area of study. It also demonstrates the ability of the author to identify relevant information and existing knowledge on the topic of study (Elisabeth, 2009). In addition a good literature review summarizes extensively body of knowledge related to the phenomenon of interest in a manner that the author or author’s utilizes various studies done on this topic. Characteristics of good literature review comprises of; Organization in which it should flow from general to specific, Relevance in which it is easy and simple to understand, well written and easy to follow, thorough covering the scope as indicated, accurate and current, scholarly, analytical, critical and covers intensively existing knowledge on the topic of study (Carol & Sharon, 2008)

Any research article therefore should have a good literature review primarily because it provides a background on which the study is based. Additionally, it provides a correlation between the problem of study, previous studies done, the results or findings, methods used giving a strong significance as far as the current study is concerned (Carol & Sharon, 2008). Though, literature review is a central element of good research article, the article in question has no literature review. The article fails to provide a clear linkage between previous studies done under this area of study and the problem of study leaving it upon the reader to make concrete conclusions. Since a literature review in any research provides a clear foundation for the current research, this element is missing in the research article; there is no proper foundation for the problem in question making the research less valid and questionable. 

Discussion of Methodological Dimensions

Research design

The research study was based on qualitative research design because it has its own focus on human behavior which is to examine reasons as to why some parents delay or refuse to vaccinate their children. According to a qualitative research design is a method of design traditionally used in social sciences hence in most cases it aims to gather an in-depth understanding of human behavior and the reasons that govern that behavior (Elisabeth,2009). A qualitative study therefore can be viewed as an inquiry process of understanding a social or human problem build in a complex, holistic picture as well as conducted in a natural setting(Carol & Sharon, 2008). In qualitative study, researchers conduct their research in their own natural settings through the collection of a variety of empirical materials, interviews, questionnaires as data collection methods.

The author’s of the article main objective is to understand the existing phenomena which is the reasons as to why many parents delay or refuse to vaccinate their children, which actually is the case in the qualitative kind of research design. In qualitative kind of research design, the data collection methods used are questionnaires, interviews, surveys among other empirical methods. The data collection methods used in the research article comprised of surveys, interviews and questionnaires which proves to the reader that qualitative kind of research design was used. A part from qualitative research design, the authors based their research on statistical kind of research methodology because all the estimates obtained from the data collected were computed using the survey library of the R statistical software package which allowed the researchers to account for the NIS sampling weights (Smith, Humiston, Marcuse, Zhao, Dorella & Howes, 2011).

Population and sample

In the research article, the population as well as the sample size used has been described explicitly by the author’s. The authors have covered the methods used to select the participants, the participants involved as well as the criterion which was used in a comprehensive and detailed manner. Evaluating the research article, purposive sampling was used in choosing the research participants .Purposive sampling is a research method in which the researchers use specific characteristics and qualities when choosing participants to be involved in the research (Ridley, 2008). The sample population comprised of parents and grandparents with knowledge about vaccination status of the age-eligible children in the household. This sample population comprised of 99.4% of respondents interviewed. The other participants involved in the research study were households with children aged 19-35 months, which comprised a sample population of 64.0%(Smith, Humiston, Marcuse, Zhao, Dorella & Howes, 2011)..

The other participants were children’s vaccination providers who comprised of 69.0%. Though, the authors in detailed have provided the sample population used in the research it fails to provide in depth the total sample size used in the research study. Additionally, the authors in the research methods section do not specify the number of male and female participants who were involved in the study. This makes it difficult for the reader to determine if the sample size was adequate enough thus it will be adequate if the sample size comprised of an equally population of women and men.

Collection of data

The author’s used qualitative case study approach in which data was collected through the use of detailed surveys, open ended interviews questions and questionnaires in which participants were required to respond to questions in relation to the study. The methods used in the research study have been covered comprehensively by the authors under the methods section. From the article data was collected through the National Immunization (NIS) which was conducted in two phases: a telephone survey to identify households that have children aged 19-35 months, parents and grandparents, survey mails to children vaccination providers (Smith, Humiston, Marcuse, Zhao, Dorella & Howes, 2011).

Questionnaires were used to collect data among parents and grandparents the reasons as to why they delay as well as refuse children vaccine doses. The author’s have adequately described the specific instruments used in data collection as well as how these instruments were used in collecting data. The variables were not operationalized using the best possible method which implies that the researchers did not tackle this part as required. Despite these shortcomings, the report indicates that the data collection methods yielded necessary data to research findings hence accurate findings based on the reliability and validity of data were established. Of the 17,313 children aged 19-35months sampled by the NIS in 2009, data was analyzed data on a subsample of Il,2(i6 children who were aged 24—35 months and who had adequate provider data returned from the mail survey(Smith, Humiston, Marcuse, Zhao, Dorella & Howes, 2011).

Under the methods section, the author’s have covered the instruments used in data collection as well as how data was collected adequately well as one would expect with any other qualitative study.

Internal and external validity

In order to ensure reliability as well as validity of the data collected and the research in general , the researchers used likert kind of interview scale in which the author’s categorized parents into four categories thus neither delaying nor refusing, (2) delaying but not refusing, (3) refusing and not delaying, or (4) delaying and refusing(Smith, Humiston, Marcuse, Zhao, Dorella & Howes, 2011). To assess parents’ beliefs about vaccines, the researchers used reliable data sources from the2009 NIS to correlate parents’ report on delay/refusal with the four psychosocial domains that index the Health Belief Model outlines. To accurately measure the domains, parents were read 11 statements to provide a verbatim response whether on a scale of zero to 10, where zero meant strongly disagree and 10 meant strongly agree, they agreed or disagreed with the statements (Smith, Humiston, Marcuse, Zhao, Dorella & Howes, 2011).

To ensure reliability of data collection and analysis statistical methods used by the NIS, were approved by the Centers for Disease Control and Prevention (CDC) Institutional Review Board. Data collected and estimates were computed using the survey library of the R statistical software package which allowed the researchers to account for the NIS sampling weights, sampling design of the NIS, independence of sampling from year to year, and clustering of age-eligible children within households. The sub-sample of children aged 24—35 months was defined as a “domain of study” and analyzed using special statistical methods designed for complex surveys. Estimated percentages were reported along with their 95% confidence intervals (CIs), and differences in estimated percentages were considered to be statistically significant if a t-test used to compare estimates showed p<0.05.To ensure reliability of the results the researchers focused on vaccination coverage at aged 24 months, hence all of the analyses was restricted to children sampled by the NIS who were aged 24-35months (Smith, Humiston, Marcuse, Zhao, Dorella & Howes, 2011). 

The results of the study

The data is presented and analyzed extensively by the author’s through the use of tables and statistical figures in relation to the research questions. The findings are congruent with topic of study thus to examine the association between parents’ beliefs about vaccines, their decision to delay or refuse vaccines for their children, and vaccination coverage of children at aged 24 months. The authors have presented the results adequately using descriptive statistics, standard deviation, mean and frequency distribution

Discussion of Ethical Dimensions

Though, appropriate procedures were used to safeguard the rights of the study through the approval of appropriate institutional review board primarily to ensure protection of the subjects. This was not enough since the privacy of their information from public consent was not assured. 

Discussion of Interpretive Dimensions

Discussion section

The author’s in the discussion section have adequately summarized the research findings. In the discussion section the author’s suggest that there is a gradient within the psychosocial domains of the Health Belief Model that signifies that increased parental hesitancy is associated with parents’ decision to delay or refuse vaccinations for their child, and that this decision is associated with lower vaccination coverage(Smith, Humiston, Marcuse, Zhao, Dorella & Howes, 2011). In the discussion the results of the research indicates that parents who delay and refuse vaccines are less likely to believe that their child is at risk of getting a VPD.

Additionally, the result discussed by the author’s in the discussion section indicates that gradient in parental hesitancy across the Health Belief Model scale is associated with higher-level socioeconomic. It was concluded that children whose parents refused all vaccines were significantly more likely to have a mother who was a college graduate and to live in a suburban household with a higher annual family income (Smith, Humiston, Marcuse, Zhao, Dorella & Howes, 2011).The discussion section has been comprehensively covered by authors in relation to the research problem findings like any other qualitative research study.

Conclusion section

Like the discussion section, the author’s have comprehensively covered this section. In this section the author’s in summary have provided an in depth analysis of the research results to the reader in relation to the problem of study which was to examine the association between parents’ beliefs about vaccines, their decision to delay or refuse vaccines for their children, and vaccination coverage of children at aged 24 months. Reading through the article’s conclusion it is evident that parents who refuse or delay vaccines not only leave their children susceptible to VPDs, but also make their communities vulnerable to outbreaks of VPDs (Smith, Humiston, Marcuse, Zhao, Dorella & Howes, 2011).Additionally, the results showed that parents delay or refuse to vaccinate their children depending on the extent of their concerns about vaccines and some of the reasons are unrelated to vaccine hesitancy. In summary, the researchers found out that children are at risk of having lower vaccination coverage if their parents have a poor working relationship with their child’s vaccination provider or mistrust the medical profession in general.

Implications section

Research implication section suggests the implications of the research study as well as its significance in the given area of study. Though, this an important section in any research study, this section is missing in the research article.

The strengths of the study

The author introduces the aims of the study in the abstract which captures the reader’s interest as well as gives the reader an insight of what the article is all about. The introduction part was covered thoroughly as data collection methods, instruments, analysis and presentation. The results and discussion have been adequately covered in the research article by the authors. Data presentation has been presented and analyzed well using various statistical procedures and instruments in relation to the problem study (Ridley, 2008). The limitations involved in the research study have been well covered as well as the ethical consideration taken as far as the study was concerned in relation to participant’s information privacy.

Weaknesses and limitations of the study

In the introduction section, the author’s explicitly state the objective of the study but it misses to state the research questions or any hypothesis which is important in any research article. Literature review which is an important element in any research study is missing in the research article. Since the literature review provides existing body of knowledge as far as the current topic of study is concerned, the research article does not incorporate a literature review making the research less valid and reliable(Ridley, 2008). The sample size used in the research is not adequately explained though the research mentions in brief the sample population used in the research. Finally, the research article has no implications as well as recommendation included though the discussion and conclusion sections have been adequately covered.

References

Carol, A., R & Sharon, O., B (2008) .Nursing research: a quantitative and qualitative approach. Publisher: Jones and Bartlett,

Charles, M (2009) Writing an Effective Abstract-How to Write a Research Paper. Publisher: Cactus Communication

Elisabeth, B (2009).How to write the Best Research Paper Ever! Publisher: Author House

Smith, P., Humiston, S., G., Marcuse, E.,K.,Zhao, Z., Dorella, C., G & Howes, C. (2011). Parental Delay or Refusal of Vaccine Doses, Childhood Vaccination Coverage at 24 Months of Age, and the Health Belief Model. Public health reports / 2011 supplement 2 / volume 126

Ridley, D (2008).The Literature Review: A Step-by-Step Guide for Students. Publisher: Sage Publications