Children spend increasing amounts of time online prompting parents and carers, educators, school systems, and governments to raise concerns about their online safety. In a world first, Australia’s eSafety Commissioner (eSafety) was charged with developing a national framework for online safety education. The Framework was developed in a two-stage sequential mixed-methods study involving collaboration between researchers, eSafety, experts and stakeholders. Stage 1, a rapid review of eight evidence sources provided the foundation for a multi-component Framework addressing key elements and effective practices for online safety education. Stage 2, tested and refined the Framework via individual interviews with online safety experts, and focus groups with stakeholders representing school-sector organisations and children’s advocacy groups. The final Framework comprises 5 elements and 22 effective practices. The Framework will support schools in teaching online safety, assessing the quality of programs and approaches, and guiding best practice.
Kerryann Walsh, Elizabeth Pink, Natasha J Ayling et al.
This study investigated parent-reported barriers and enablers to establishing sun safety practices with young children (0-4 years; N = 423) living in Australia. An online survey examined parent/child adherence to recommended sun safety practices and barriers and enablers to establishing sun safety practices. Adherence to different sun safety practices varied across age groups. Lack of child cooperation was the most commonly-endorsed barrier while child compliance was the most commonly-endorsed facilitator. Young children's lack of cooperation with sun safety practices represents a major obstacle for parents. In conclusion, the development and testing of family-based intervention approaches to reduce child resistance and promote cooperation is warranted.
Kavindri Kulasinghe, Amy E. Mitchell, Alina Morawska
Children receiving nirsevimab were texted a link to an online survey to monitor adverse events following immunization. Total of 4340 parents received the link, which 1195 (27.5%) responded. Forty-seven (11.4%) of 410 children who received nirsevimab alone and 230 (29.3%) of 785 children who received nirsevimab coadministered reported any reaction. No adverse events required in-patient care or had ongoing sequelae.
Dale Carcione, Phoebe Spencer, Grace Pettigrew et al.
Children are vulnerable road users. While many Australian parents are social media users and augmented reality effects are a huge trend in social media, there has been little research attention on the use of social media augmented reality for educating children in road safety. In this research, seven gamified social media augmented reality learning experiences were created about six road safety subjects to engage parents and educate children aged 5-9 years in the Australian Capital Territory region, Australia. The current research aimed to investigate the results of Facebook’s augmented reality educational interventions (advertisement campaigns) and analyse the perspectives of the parents who tried the learning experiences with their children. The results of Meta’s ads manager and Spark AR Hub analytics were used to evaluate the success of Facebook augmented reality advertisements. A questionnaire was developed to gather the perspectives of parents. Ten parents completed the questionnaire and were then interviewed to discuss their responses in more depth. Augmented reality Facebook advertisements reached 200,351 people and received 719,296 impressions and 3,218 clicks. All interviewees recommended the use of augmented reality gamified learning experiences to educate children about road safety. This study provides insights into how to use social media augmented reality to engage parents and educate children.
BACKGROUND: Maternal vaccinations for influenza and pertussis are recommended in New Zealand to protect mothers and their infant from infection. However, maternal immunisation coverage in New Zealand is suboptimal. Furthermore, there is unacceptable inequitable maternal immunisation rates across the country with Māori and Pacific women having significantly lower maternal immunisation rates than those of other New Zealanders. METHODS: This research set out to explore what pregnant/recently pregnant Māori and Pacific women knew about immunisation during pregnancy and what factors influenced their decision to be vaccinated. A semi-structured interview guide was developed with questions focusing on knowledge of pertussis and influenza vaccination during pregnancy and decision-making. Māori and Pacific women aged over 16 years were purposively sampled and interviewed in Dunedin and Gisborne, New Zealand between May and August 2021. Interviews were analysed following a directed qualitative content approach. Data were arranged into coding nodes based on the study aims (deductive analysis) informed by previous literature and within these participant experiences were inductively coded into themes and subthemes. RESULTS: Not all women were aware of maternal vaccine recommendations or they diseases they protected against. Many underestimated how dangerous influenza and pertussis could be and some were more concerned about potential harms of the vaccine. Furthermore, understanding potential harms of infection and protection provided by vaccination did not necessarily mean women would choose to be vaccinated. Those who decided to vaccinate felt well-informed, had vaccination recommended by their healthcare provider, and did so to protect their and their infant's health. Those who decided against vaccination were concerned about safety of the vaccines, lacked the information they needed, were not offered the vaccine, or did not consider vaccination a priority. CONCLUSIONS: There is a lack of understanding about vaccine benefits and risks of vaccine-preventable diseases which can result in the reinforcement of negative influences such as the fear of side effects. Furthermore, if vaccine benefits are not understood, inaccessibility of vaccines and the precedence of other life priorities may prevent uptake. Being well-informed and supported to make positive decisions to vaccinate in pregnancy is likely to improve vaccine coverage in Māori and Pacific Island New Zealanders.
Amber Young, Nadia A. Charania, Natalie Gauld et al.
Australia has a universal infant pneumococcal conjugate vaccination program and until recently a universal pneumococcal polysaccharide vaccine program for non-Indigenous adults aged ≥65 years and Indigenous adults aged ≥50 years. We documented the impacts of infant and adult vaccination programs on the epidemiology of invasive pneumococcal disease (IPD) in Indigenous and non-Indigenous adults. IPD notifications from the National Notifiable Disease Surveillance System were analysed from 2002 to 2017, grouped by age, vaccine serotype group and Indigenous status. Since the universal funding of infant and elderly pneumococcal vaccination programs in January 2005, total IPD decreased by 19% in non-Indigenous adults aged ≥65 years but doubled in Indigenous adults aged ≥50 years. Vaccine uptake was suboptimal in both groups but lower in Indigenous adults. IPD due to the serotypes contained in the pneumococcal conjugate vaccines (PCV) except for serotype 3 declined markedly over the study period but were replaced by non-PCV serotypes. Serotype 3 is currently the most common in older adults. In the populations eligible for the adult 23-valent pneumococcal polysaccharide vaccine (23vPPV) program, IPD rates due to its exclusive serotypes increased to a lower extent than non-vaccine types. In 2017, non-vaccine serotypes accounted for most IPD in the older population eligible for the 23vPPV program, while it's eleven exclusive serotypes accounted for the majority of IPD in younger adults. Infant and adult pneumococcal vaccination programs in Australia have shaped the serotype-specific epidemiology of IPD in older adults. IPD remains a significant health burden for the Indigenous population. Herd immunity impact is clear for PCV serotypes excluding serotype 3 and serotype replacement is evident for non-PCV serotypes. The adult 23vPPV immunisation program appears to have partially curbed replacement with IPD due to its eleven exclusive serotypes, highlighting a potential benefit of increasing adult 23vPPV coverage in Australia.
BACKGROUND: Hepatitis B virus (HBV) immunisation is the first vaccine of infant life and one of the most commonly refused immunisations on the Australian Immunisation Schedule. AIMS: To quantify the frequency of declined HBV immunisation birth-doses, investigate reasons for refusal, and determine information sources used by parents. MATERIALS AND METHODS: A cross-sectional study using a questionnaire was conducted on postnatal women who declined their newborn's HBV birth-dose immunisation during December 2016-July 2017 at an Australian tertiary referral hospital. Mothers who were non-English-speaking, unwell or medically unstable, or otherwise unavailable were excluded. RESULTS: One hundred and thirty-seven of the 1574 (8.7%) eligible reviewed infants had HBV immunisation birth-doses documented as declined; 113 mothers consented to complete the questionnaire. The most common reasons for declining the dose were: 'baby too young' (55.8%); preference for two, four and six-month HBV immunisations only (56.6%); perceived low risk of contracting HBV (45.1%); and a fear of 'overloading' their baby's immune system (42.5%). General practitioners or nurses/midwives (43.3%) and the internet/media (33.6%) were the predominant information sources consulted, and 58.4% felt satisfied with the information they received antenatally. Eighty-eight of 113 mothers (77.9%) would still consider future immunisations for their infant. CONCLUSIONS: The majority of postnatal women decline HBV birth-dose immunisation for their newborns citing age-related safety concerns and vaccine misconceptions. Informal information sources such as the internet and media are often consulted. Addressing the need for antenatal and health professional education toward the birth-dose may be instrumental in improving uptake.
Christine E. Gilmartin, Andrew J. Daley, Laura Leung
Patients at increased risk of vaccine preventable diseases require additional vaccines that are not licensed for Nurse Immunisers to administer without a prescription. An Immunisation Nurse Practitioner (NP) at the Royal Children’s Hospital (RCH) Melbourne was introduced to address deficiencies in the current management of these patients. NP endorsement requires successful completion of a Masters level study program, plus the equivalent of three years (5,000) hours full-time experience in advanced clinical nursing. The Immunisation NP was endorsed in May 2017 and since then, the Immunisation service at RCH has recorded a 140% increase in uptake of Meningococcal B vaccine as well as improved delivery of immunisations to special-risk patients. In addition, there was improved access to specialist immunisation advice as well as improved opportunistic immunisation of inpatients. New initiatives were implemented including immunisation of needle phobic patients using nitrous oxide sedation. This paper describes the outcomes of employing an Immunisation NP at the RCH, Melbourne. What is currently known about the topic? Nurse Practitioners provide excellent, patient-centred care whilst also contributing to research, education, leadership and management. There is much literature on describing Nurse Practitioner specialty roles however, none in the area of Immunisation. What this paper adds: A Nurse Practitioner (NP) role in the specialty field of immunisation can contribute to improving hospital inpatient rates of immunisation, facilitate uptake of non-scheduled vaccines and decrease pressure on wait times for a specialist clinic appointment. The Immunisation NP reflects the full diversity of nursing practice and addresses the many service gaps in the previous delivery model, that can be emulated by paediatric nurses in other specialist areas.
BACKGROUND: While most Australian children are vaccinated, delays in vaccination can put them at risk from preventable infections. Widespread mobile phone ownership in Australia could allow automated short message service (SMS) reminders to be used as a low-cost strategy to effectively 'nudge' parents towards vaccinating their children on time. METHODS: AuTOMATIC is an adaptive randomised trial which aims to both evaluate and optimise the use of SMS reminders for improving the timely vaccination of children at primary care clinics across Australia. The trial will utilise high levels of digital automation to effect, including eligibility assessment, randomisation, delivery of intervention, data extraction and analysis, thereby allowing healthcare-embedded trial delivery. Up to 10,000 parents attending participating primary care clinics will be randomised to one of 12 different active SMS vaccine reminder content and timing arms or usual practice only (no SMS reminder). The primary outcome is vaccine receipt within 28 days of the scheduled date for the index vaccine (the first scheduled vaccine after randomisation). Secondary analyses will assess receipt and timeliness for all vaccine occasions in all children. Regular scheduled analyses will be performed using Bayesian inference and pre-specified trial decision rules, enabling response adaptive randomisation, suspension of any poorly performing arms and early stopping if a single best message is identified. DISCUSSION: This study will aim to optimise SMS reminders for childhood vaccination in primary care clinics, directly comparing alternative message framing and message timing. We anticipate that the trial will be an exemplar in using Bayesian adaptive methodology to assess a readily implementable strategy in a wide population, capable of delivery due to the levels of digital automation. Methods and findings from this study will help to inform strategies for implementing reminders and embedding analytics in primary health care settings. TRIAL REGISTRATION: ANZCTR: ACTRN12618000789268 .
Grace Currie, James A. Totterdell, Grahame Bowland et al.
In Australia, we used the World Health Organization’s Tailoring Immunization Programmes to identify areas of low immunisation coverage in First Nations children. The qualitative study was led by First Nations researchers using a strength-based approach. In 2019, Tamworth had 179 (23%) children who were overdue for immunisations. Yarning sessions were conducted with 50 parents and health providers. Themes that emerged from this research included: (a) Cultural safety in immunisation services provides a supportive place for families, (b) Service access could be improved by removing physical and cost barriers, (c) Positive stories promote immunisation confidence among parents, (d) Immunisation data can be used to increase coverage rates for First Nations children. Knowledge of these factors and their impact on families helps ensure services are flexible and culturally safe.
Susan L Thomas, Natalie Allan, Paula Taylor et al.
