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ISSUES AND PURPOSE: Despite numerous programs aimed at improving immunization rates among American children, under-immunization remains a significant problem. This study was conducted to gain insight into parents'/guardians' knowledge and attitudes regarding childhood immunizations. DESIGN AND METHODS: Thirteen African-American mothers and grandmothers participated in semistructured, audiotaped focus-group interviews. RESULTS: Four major themes emerged: health knowledge and beliefs about immunizations, system barriers that impede obtaining immunizations, facilitators that enhance obtaining immunizations, and suggestions for change. PRACTICE IMPLICATIONS: Immunizations are one of the most important health advantages available to children. Therefore, nurses must become aware of the problem of underimmunization and work to address some of the concerns caregivers have identified in this study. The health and lives of the nation's children depend on it.
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