Background: The goal of measles eradication is still broadly discussed by health care authorities. Several studies suggest negative attitudes of general physicians (GPs) oriented in complementary and alternative medicine (CAM) with regard to measles eradication. We intended to identify prognostic factors for positive/negative attitudes in a survey of German GPs. Methods: In 2004, a total of 732 GPs received a questionnaire to evaluate their attitudes towards the eradication of measles asking for age, gender, medical qualification, license by health insurance, CAM orientation, monthly number of early detection checkups, patients per day, appraisal of significance of legal aspects and parents' autonomy. We carried out a QUEST decision tree analysis to identify predictors for a positive/negative attitude towards the eradication of measles. Results: 621 GPs (348 conventional vs. 273 CAM-oriented GPs) sufficiently completed the questionnaire and were included in this analysis. 256 physicians (41%) had a negative attitude towards the eradication of measles. In a 3-level decision tree we found a high number of early detection checkups (U9) in children being the first predictor for a positive attitude, followed in the second node by the CAM orientation. Based on this decision tree only 27 attitudes of GPs (4.4%) were falsely classified as yielding to a kappa index of agreement of k = 0.91 (95% CI: 0.88-0.94). Discussion: The CAM orientation of the physicians is not the only predictor for positive or negative attitudes towards measles eradication. In particular, the number of early detection checkups of children seems to play a major role in this context. Future research should focus on this aspect.

1.
Enders JF: Vaccination against measles: Francis Home Redivivus. Yale J Biol Med 1961-1962;34:239-260.
[PubMed]
2.
Meissner HC, Strebel PM, Orenstein WA: Measles vaccines and the potential for worldwide eradication of measles. Pediatrics 2004;114:1065-1069.
[PubMed]
3.
World Health Organization: Measles. Fact sheet no. 286, February 2013. www.who.int/mediacentre/factsheets/fs286/en/ (accessed 02.10.2013).
4.
Hussey PS, Anderson GF, Osborn R, Feek C, McLaughlin V, Millar J, Epstein A: How Does the Quality of Care Compare in Five Countries? Health Aff (Millwood) 2004;23:89-99.
[PubMed]
5.
LeBaron CW, Rodewald L, Humiston S: How much time is spent on well-child care and vaccinations? Arch Pediatr Adolesc Med 1999;153:1154-1159.
[PubMed]
6.
Siedler A, Tischer A, Mankertz A, Santibanez S: Two outbreaks of measles in Germany 2005. Eur Surveill 2006;11:131-134.
[PubMed]
7.
Wichmann O, Siedler A, Sagebiel D, et al.: Further efforts need to achieve measles elimination in Germany: results of an outbreak investigation. Bull World Health Organ 2009;87:108-115.
[PubMed]
8.
Nasir L: Reconnoitering the anti-vaccination web sites: news from the front. J Fam Pract 2000;49:731-733.
[PubMed]
9.
Ernst E: Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination. Vaccine 2002;20 (suppl 1):S90-S93.
[PubMed]
10.
Alm J, Swartz J, Lilja G, Scheynius A, Pershagen G: Atopy in children of families with an anthroposophic lifestyle. Lancet 1999;353:1485-1488.
[PubMed]
11.
Rosenlund H, Bergström A, Alm JS, Swartz J, Scheynius A, van Hage M, Johansen K, Brunekreef B, von Mutius E, Ege MJ, Riedler J, Braun-Fahrländer C, Waser M, Pershagen G; PARSIFAL Study Group: Allergic disease and atopic sensitization in children in relation to measles vaccination and measles infection. Pediatrics 2009;123:771-781.
[PubMed]
12.
Alfvén T, Braun-Fahrländer C, Brunekreef B, von Mutius E, Riedler J, Scheynius A, van Hage M, Wickman M, Benz MR, Budde J, Michels KB, Schram D, Ublagger E, Waser M, Pershagen G; PARSIFAL study group: Allergic diseases and atopic sensitization in children related to farming and anthroposophic lifestyle - the PARSIFAL study. Allergy 2006;61:414-421.
[PubMed]
13.
Loh W, Shih Y: Split selection methods for classification trees. Stat Sinica 1997;7:815-840.
14.
Zuzak TJ, Zuzak-Siegrist I, Rist L, Staubli G, Simoes-Wüst AP: Attitudes towards vaccination: users of complementary and alternative medicine versus non-users. Swiss Med Wkly 2008;138:713-718.
[PubMed]
15.
Schmidt K, Ernst E: MMR vaccination advice over the Internet. Vaccine 2003;21:1044-1047.
[PubMed]
16.
Schmidt J, Hoffmann W, Weigel M, Rautmann C, Weitmann K, Bruns R: Pediatricians in private practice and their attitude towards vaccination: a comparison between homeopaths and non-homeopaths. Eur J Integr Med 2010;2:236-237.
17.
Betsch C, Sachse K: Debunking vaccination myths: strong risk negations can increase perceived vaccination risks. Health Psychol 2013;32:146-155.
[PubMed]
18.
Creavin ST, Creavin AL, Mallen CD: Do GPs respond to postal questionnaire surveys? A comprehensive review of primary care literature. Fam Pract 2011 28:461-467.
[PubMed]
19.
World Health Organization: Stopping measles and rubella with one combined vaccine. www.who.int/immunization/newsroom/measles_rubella/en/index.html (accessed 02.10.2013).
20.
World Health Organization: Eliminating Measles and Rubella and Preventing Congenital Rubella Infection. WHO European Region Strategic Plan 2005-2010. Kopenhagen, WHO, 2005. www.euro.who.int/__data/assets/pdf_fle/0008/79028/E87772.pdf (accessed 02.10.2013).
You do not currently have access to this content.