Comparing the effect of parental education via both lecture and film upon vaccination uptake for children under one year of age: A cluster randomized clinical trial

Azam Songol, Leila Amiri-Farahani, Shima Haghani, Sally Pezaro, Soghra Omrani Saravi

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    Background and Aim
    Vaccination is the most cost-effective action in preventing infectious diseases. Despite Iran's success in high vaccination coverage, in some areas there is a delay in vaccination. The aim of this study was to determine and compare the effect of education on immunization via lecture and film upon parental delay in vaccination uptake for children under 12 months of age.

    A multicentre cluster-randomized clinical trial with comprehensive urban health centres (CUHCs) in Shooshtar city, Khuzestan province, Iran as the unit of randomization was conducted. Overall, 8 CUHCs were randomized to receive education either via film (n = 165) or lecture (n = 164). In order to assign CUHCs to two groups, a simple random sampling method of coin tossing was used. Parents with children under 12 months and with a history of delayed vaccination were included in the study. Consecutive sampling was performed until the number needed for the cluster was reached. Interventions were delivered in small groups of 5–8 participants. Demographical data and clinical histories were collected from parents directly via a personal characteristic’s questionnaire. Clinical data was extracted from vaccination records, the child's vaccine card and the vaccine information registration system. Statistical analyses of intervention effects were performed as per-protocol analysis.

    In terms of individual characteristics and vaccine information significant differences between the two groups were only observed in relation to the parent of the participant, the child's gender, the number of children in the family, and timely injection of the vaccine in the previous child (p < 0.05). The chance of delay in vaccination after the intervention, without and considering the effect of intervening variables was 78 % and 74 % higher in the lecture group than in the film group, respectively (OR = 1.786, CI = 1.152–2.774 vs AOR = 1.743, CI = 1.011–3.007). Overall, 37.6 % of children in the film-based education group and 51.8 % of children in the lecture-based education group received their next vaccine with a delay of more than 7 days.

    Education delivered via film can reduce the delay in vaccination more effectively. These findings, along with those of other studies conducted around the world suggest that multimedia education should be considered more widely in the field of education in children's vaccination.
    Original languageEnglish
    Pages (from-to)1067-1073
    Number of pages7
    Issue number5
    Early online date2 Jan 2023
    Publication statusPublished - 27 Jan 2023

    Bibliographical note

    © 2022. Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International


    This research was supported by the research grant no. IR.IUMS.REC.1399.646 from Iran University of Medical Sciences.


    • Immunization
    • Vaccination
    • Childhood
    • Infant
    • Delayed Vaccination
    • Vaccination Hesitancy


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