Background:
Parents’ attitudes and beliefs in vaccination are important to understand for shaping vaccine acceptance and demand interventions. Little research has focused on developing a validated scale to measure parents’ attitudes towards vaccinations in low and middle-income countries; Ghana provided an opportunity develop a caregiver vaccination attitudes scale (CVAS) validated against childhood vaccine compliance.
Methods:
We conducted a cluster survey of 373 households with children aged 12–35 months of age from Northern Region, Ghana. Caregivers responded to 22 vaccination behavior and belief survey items and provided the child’s vaccination status. In exploratory factor analysis (EFA) to assess CVAS content validity, we used parallel analysis to guide the number of factors to extract and principal axis factor analysis for factor extraction. Reliability of the scale was assessed using McDonald’s Omega coefficient. Criterion validity of scale and subscales was assessed against receipt of vaccinations by 12 months of age and vaccination delay, using number of days undervaccinated.
Results:
EFA of CVAS responses resulted in removing 11 of 22 survey items due to loadings <0.30 and development of a 5-factor structure with subscales for Vaccine-Preventable Disease (VPD) Awareness, Vaccine Benefits, Past Behavior, Vaccine Efficacy and Safety, and Trust. The 5 factors accounted for 69% of the common variance and omega coefficients were >0.73 for all subscales. Validity analysis indicated that for every unit increase in the parent’s scale score, the odds of the child being vaccinated decreased by 0.58 (95% confidence interval [CI]: 0.37,0.68) and the number of days under-vaccinated increased by 86 (95%CI: 28,143). The final 3-factor scale included Vaccine Benefits, Past Behavior, and Vaccine Efficacy and Safety.
Discussion:
The final CVAS included three factors associated with vaccine compliance in Ghana, although several survey items suggested for use in vaccine acceptance scales were dropped. Replicating this study in several country settings will provide additional evidence to assist in refining a tool for use in routine vaccine acceptance and demand surveillance efforts.
Drying and b-carotenes retention kinetics were predicted using models in relative humidity (RH) drying condition. This was achieved by drying carrot slices using RH-convective hot-air dryer at 60, 70 and 80°C under RH (10% 20% and 30%) conditions at 2.0 m/s air velocity. Three mathematical models describing thin layer were compared to their goodness of fit in terms of coefficient of correlation (R 2), root mean square error (RMSE) and reduced Chi square (v 2). The Wang and Singh model could satisfactorily describe RH-convective drying of carrot slices with R 2 , RMSE and v 2 in the ranges of 0.996-0.999, 5.4 9 10-4-9.4 9 10-4 and 0.0150-0.03353 respectively. The results reveal that a range of 3.61-8.2% retention of bcarotene was observed for every 10% increase in RH in various drying air temperature. In summary, higher temperatures were mainly responsible for b-carotenes degradation however this can be mitigated when drying is conducted under higher RH. Keywords b-Carotene Á Carrot Á Drying Á Relative humidity Á Modelling List of symbols R 2 Coefficient of correlation v 2 Chi square RMSE Root mean square error E a Activation energy DG Gibbs free energy change DH Enthalpy change DS Entropy change DE Ã Total color difference D eff Effective moisture diffusivity RH Relative humidity k; k 1 ; a; n and b Kinetic constants C Arrhenius constant d.m. Dry matter Aw Water activity r Person's coefficient of correlation Electronic supplementary material The online version of this article (
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