Model B.

Parents make important vaccination decisions for their children and many variables affect parents’ decisions to accept or decline vaccines. Parents are tasked with locating, understanding, and applying information to inform health decisions often using online resources; however, the digital health literacy levels of parents are unknown. The purpose of this study was to investigate parents’ digital health literacy levels, their sources for vaccine information, and analyze how demographics, digital health literacy, health literacy, parental attitudes and vaccine beliefs, trust, and vaccine information sources predict vaccine acceptance. Quantitative findings of a mixed methods study that examined parental vaccine decision making across the continuum of vaccine hesitant to vaccine accepting is reported. An online survey of parents of young children living in Ontario, Canada was conducted in 2022. Multiple linear regression determined predictors of vaccine acceptance. 219 participants completed the survey and on average reported adequate digital health literacy skill. Healthcare providers were reported as the most commonly used source of vaccine information. Two models were retained that predicted vaccine acceptance, both models predicted about 50% of the variability in vaccine acceptance. Model A identified that trust predicted parent vaccine acceptance and model B identified that digital health literacy, and the vaccine information sources healthcare providers, family and friends, and alternate healthcare providers predicted vaccine acceptance. Family and friends and alternate healthcare providers negatively predicted vaccine acceptance. Most parents in our study had high levels of digital health literacy. Opportunities exist for further research and policy change focused on trust at a systemic public health level. While clinical level implications included the importance of healthcare providers as a vaccine information source and adequate digital health literacy to facilitate parental vaccine decision making. Continued efforts to develop awareness on the importance of digital health literacy among the public and healthcare providers is needed, including further research on the digital health literacy levels of Canadians.

家长为子女做出至关重要的疫苗接种决策，诸多变量会影响家长接受或拒绝疫苗的决定。家长通常需借助在线资源搜寻、理解并应用信息以指导健康决策，但家长的数字健康素养（digital health literacy）水平尚不明确。本研究旨在调查家长的数字健康素养水平、疫苗信息来源，并分析人口统计学特征、数字健康素养、健康素养（health literacy）、家长态度与疫苗信念、信任度以及疫苗信息来源如何预测疫苗接受度。本研究为混合方法研究（mixed methods study），覆盖从疫苗犹豫到疫苗接受的全谱系家长疫苗决策行为，本文报告其定量研究结果。2022年，研究团队针对加拿大安大略省的幼儿家长开展了一项在线调查。研究采用多元线性回归（multiple linear regression）确定疫苗接受度的预测因素。共有219名参与者完成调查，其平均数字健康素养技能水平达标。医疗保健提供者是最常用的疫苗信息来源。最终保留了两个可预测疫苗接受度的模型，两个模型均可解释约50%的疫苗接受度变异。模型A显示信任度可预测家长的疫苗接受度；模型B显示数字健康素养、医疗保健提供者、亲友以及替代医疗保健提供者作为疫苗信息来源可预测疫苗接受度，其中亲友与替代医疗保健提供者对疫苗接受度呈负向预测作用。本研究中大多数家长的数字健康素养水平较高。未来可在系统性公共卫生层面围绕信任度开展进一步研究与政策调整。临床层面的启示包括：医疗保健提供者作为疫苗信息来源的重要性，以及充足的数字健康素养对辅助家长做出疫苗接种决策的价值。仍需持续开展工作以提升公众与医疗保健从业者对数字健康素养重要性的认知，包括针对加拿大人的数字健康素养水平开展进一步研究。