Graduation Semester and Year
Spring 2026
Language
English
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Dr. Tiffany Trent DNP
Second Advisor
Yungfei Kao, Ph.D.
Third Advisor
Dr Jose L Alejandro-White
Abstract
Introduction
Despite the Centers for Disease Control and Prevention's recommendations to vaccinate children against measles, a decline in measles vaccination rates has been observed at a rural family medicine clinic. While numerous factors contribute to the decline in vaccination rates—including parental doubts about the necessity of vaccination, concerns about vaccine side effects, and insufficient education—the latter remains a fundamental underlying cause of suboptimal vaccination coverage.
Objectives
This project focused on surveying, educating, and boosting parents' confidence in measles vaccines for children under five to raise the measles vaccination rate.
Methods
This project used a pre- and post-intervention bundle over an eight-week period. Children were screened prior to their appointments to determine eligibility for measles vaccination, and their parent or guardian completed pre- and post-surveys regarding measles vaccine hesitation. A paired t-test was used to analyze changes in vaccine hesitancy. Quantitative data were evaluated using an ordinal scale, while qualitative data were assessed using a nominal scale.
Results
120 children were screened with a 100% completion rate over eight weeks. Chi-square analysis revealed a significant increase in vaccine completion from 23/66 pre-intervention to 33/54 post-intervention, χ² = 8.231, p = .004. A paired t-test showed screening scores decreased from 3.22 to 1.65 (t(53) = 7.189, p < .001), indicating reduced measles vaccine hesitancy with a large effect size (Cohen’s d = .978).
Conclusion
The MMR vaccine bundle successfully boosted the rate of measles vaccination and reduced vaccine hesitancy among caregivers. The completed bundle was easy to implement, making providers more relatable to caregivers and facilitating joint vaccine decisions making.
Keywords
measles, vaccine, hesitancy, pediatric
Disciplines
Family Practice Nursing | Pediatric Nursing | Public Health and Community Nursing | Public Health Education and Promotion | Rural Health
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Malone, Ramie, "Measles Vaccine Hesitancy Improvement Bundle to Improve Vaccination Rates in a Rural Outpatient Clinic" (2026). Doctor of Nursing Practice (DNP) Scholarly Projects. 118.
https://mavmatrix.uta.edu/nursing_dnpprojects/118
Included in
Family Practice Nursing Commons, Pediatric Nursing Commons, Public Health and Community Nursing Commons, Public Health Education and Promotion Commons, Rural Health Commons