Date of Award

Spring 5-2-2015

Document Type


Degree Name

Doctor of Nursing Practice (DNP)




Patricia Keane, Ph.D., RN

First Committee Member

Jackie Haverkamp, DNP, RN, CNP, NHA

Second Committee Member

Julie Miller, RN, MSN


Amish, Immunizations, Measles, Vaccinations, Knox County, Ohio

Subject Categories

Family Practice Nursing | Pediatric Nursing | Public Health and Community Nursing



Children living in Amish communities in Ohio are under-immunized and under-immunized communities are reservoirs for preventable childhood diseases. A recent measles outbreak in central Ohio involved 9 counties and 377 cases of this vaccine-preventable disease. There were 5 hospitalizations related to this measles outbreak in Knox County. Vaccine-preventable illnesses contribute to pediatric morbidity and mortality and are cost prohibitive to individuals and society.

The purpose of this study was to identify real and perceived barriers to immunizations among Amish parents in Knox County, Ohio. The information obtained in this study will be disseminated to the Knox County Health Department to be utilized to improve vaccination rates among children in these communities. A qualitative research design was used for this study. Criteria for subject participation included parents of Amish children ages 0-18 who live in Knox County, Ohio. Interviews with parents of Amish children explored research questions regarding the current vaccination status of their children, their perceptions of immunization safety, risks, side effects, perceived severity of vaccine-preventable illness, and perceived and real barriers to vaccinations. NVivo software was utilized to analyze the content of the interviews. Qualitative analysis revealed common themes among the interview responses.

The findings of this study indicate that concerns about side effects are the most significant barrier to vaccinations among Amish parents in Knox County, Ohio. Identifying strategies to allay concerns related to side effects and other barriers to vaccinations among Amish families will be valuable in improving vaccination compliance among these communities, leading to decreased outbreaks of vaccine-preventable diseases.



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