Evaluation of Learning Outcomes and Influencing Factors of Self-Directed Online Vaccination Education

Vaccination is one of the most cost-effective public health interventions, yet parental knowledge gaps remain a barrier to timely childhood immunization. Digital health platforms offer new opportunities for scalable education. Objective: To evaluate the effectiveness of an online parental vaccination education program delivered via the "Suzhou Vaccination" WeChat official account in improving parents' knowledge about vaccination, and to explore the application value of online education in parental health initiatives. Methods: A before-and-after study design was employed. Data were collected via questionnaires completed by parents before the implementation of the online program (late January 2023) and one year after implementation (early February 2024). The changes in the awareness rate of vaccine knowledge (scores) and influencing factors were analyzed and compared. Results: A total of 6029 pre-intervention and 3790 post-intervention valid questionnaires were included. The pass rate of knowledge awareness after the intervention (55.57%, 2106/3790) was statistically higher than that before the intervention (52.33%, 3155/6029) (p < 0.05). Among the 10 knowledge items, the difference in correct response rates for 5 items was statistically significant (p < 0.05) before and after the intervention. The correct response rates for three items significantly increased (50.29% vs. 52.93%; 63.23% vs. 67.65%; 83.73% vs. 85.36%), while the rates for two items significantly decreased (92.50% vs. 90.71%; 53.11% vs. 49.68%); all these changes were statistically significant (p < 0.05). Multivariate logistic regression identified six independent factors significantly associated with higher post-intervention knowledge scores (all p < 0.05): younger child's age (0-2 years), parent age ≥ 26 years, university education or above, employment as teachers/medical professionals/civil servants, higher household income (≥¥150,000), and being the child's mother. Conclusions: The online parental education platform was associated with a statistically significant but modest improvement in parents' vaccination knowledge, and the child's age, the respondent's age, occupation, education level, annual household income, and relationship to the child influenced the post-intervention knowledge scores.