Reliability and validity of a survey to identify vaccine hesitancy among parents in Changxing county, Zhejiang province

Background: To evaluate the validity and reliability of a survey to identify vaccine hesitancy among parents. Methods: Cross-sectional survey of parents of 19-35 month old children was conducted in Changxing County, Zhejiang Province, through a questionnaire developed for the survey of the vaccine hesitancy. Construct validity was assessed by linking parental responses to their child's immunization record. The association between mean% of days of under-immunization and the parental socio-demographics and the individual item response was explored via the univariate and multivariate analyses. Factor analysis was applied to confirm survey sub-domains and Cronbach's alpha to determine the internal consistency reliability of sub-domain scales. Results: We approached 336 households while 285 of them agreed to participate in this study. Education level and the parental 'score of vaccination hesitancy' were significantly associated with the mean% of days of under-immunization. Cronbach's coefficients for the 3 sub-domain scales created by re-grouping the questionnaire's items were 0.71, 0.83, and 0.72, respectively. Conclusions: The survey represented a valid and reliable instrument to identify VHPs and it could help to screen parents to receive an intervention aimed at increasing acceptance of vaccinations.