Nora B Henrikson1, Douglas J Opel2, Lou Grothaus3, Jennifer Nelson3, Aaron Scrol3, John Dunn3, Todd Faubion4, Michele Roberts5, Edgar K Marcuse2, David C Grossman6. 1. Group Health Research Institute, Seattle, Washington; henrikson.n@ghc.org. 2. Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington; Departments of Pediatrics, and. 3. Group Health Research Institute, Seattle, Washington; 4. WithinReach, Seattle, Washington; and. 5. State of Washington, Department of Health, Seattle, Washington. 6. Group Health Research Institute, Seattle, Washington; Departments of Pediatrics, and Health Services, University of Washington, Seattle, Washington;
Abstract
BACKGROUND AND OBJECTIVES: Physicians have a major influence on parental vaccine decisions. We tested a physician-targeted communication intervention designed to (1) reduce vaccine hesitancy in mothers of infants seen by trained physicians and (2) increase physician confidence in communicating about vaccines. METHODS: We conducted a community-based, clinic-level, 2-arm cluster randomized trial in Washington State. Intervention clinics received physician-targeted communications training. We enrolled mothers of healthy newborns from these clinics at the hospital of birth. Mothers and physicians were surveyed at baseline and 6 months. The primary outcome was maternal vaccine hesitancy measured by Parental Attitudes on Childhood Vaccines score; secondary outcome was physician self-efficacy in communicating with parents by using 3 vaccine communication domains. RESULTS:We enrolled 56 clinics and 347 mothers. We conducted intervention trainings at 30 clinics, reaching 67% of eligible physicians; 26 clinics were randomized to the control group. Maternal vaccine hesitancy at baseline and follow-up changed from 9.8% to 7.5% in the intervention group and 12.6% to 8.0% in the control group. At baseline, groups were similar on all variables except maternal race and ethnicity. The intervention had no detectable effect on maternal vaccine hesitancy (adjusted odds ratio 1.22, 95% confidence interval 0.47-2.68). At follow-up, physician self-efficacy in communicating with parents was not significantly different between intervention and control groups. CONCLUSIONS: This physician-targeted communication intervention did not reduce maternal vaccine hesitancy or improve physician self-efficacy. Research is needed to identify physician communication strategies effective at reducing parental vaccine hesitancy in the primary care setting.
RCT Entities:
BACKGROUND AND OBJECTIVES: Physicians have a major influence on parental vaccine decisions. We tested a physician-targeted communication intervention designed to (1) reduce vaccine hesitancy in mothers of infants seen by trained physicians and (2) increase physician confidence in communicating about vaccines. METHODS: We conducted a community-based, clinic-level, 2-arm cluster randomized trial in Washington State. Intervention clinics received physician-targeted communications training. We enrolled mothers of healthy newborns from these clinics at the hospital of birth. Mothers and physicians were surveyed at baseline and 6 months. The primary outcome was maternal vaccine hesitancy measured by Parental Attitudes on Childhood Vaccines score; secondary outcome was physician self-efficacy in communicating with parents by using 3 vaccine communication domains. RESULTS: We enrolled 56 clinics and 347 mothers. We conducted intervention trainings at 30 clinics, reaching 67% of eligible physicians; 26 clinics were randomized to the control group. Maternal vaccine hesitancy at baseline and follow-up changed from 9.8% to 7.5% in the intervention group and 12.6% to 8.0% in the control group. At baseline, groups were similar on all variables except maternal race and ethnicity. The intervention had no detectable effect on maternal vaccine hesitancy (adjusted odds ratio 1.22, 95% confidence interval 0.47-2.68). At follow-up, physician self-efficacy in communicating with parents was not significantly different between intervention and control groups. CONCLUSIONS: This physician-targeted communication intervention did not reduce maternal vaccine hesitancy or improve physician self-efficacy. Research is needed to identify physician communication strategies effective at reducing parental vaccine hesitancy in the primary care setting.
Authors: Rachel M Cunningham; G Brady Kerr; Jessica Orobio; Flor M Munoz; Armando Correa; Natalie Villafranco; Ana C Monterrey; Douglas J Opel; Julie A Boom Journal: Hum Vaccin Immunother Date: 2019-03-27 Impact factor: 3.452
Authors: Ekaterina Nekrasova; Melissa S Stockwell; Russell Localio; Justine Shults; Chelsea Wynn; Laura P Shone; Lindsay Berrigan; Chelsea Kolff; Miranda Griffith; Andrew Johnson; Alessandra Torres; Douglas J Opel; Alexander G Fiks Journal: Hum Vaccin Immunother Date: 2020-02-04 Impact factor: 3.452
Authors: Noel T Brewer; Megan E Hall; Teri L Malo; Melissa B Gilkey; Beth Quinn; Christine Lathren Journal: Pediatrics Date: 2016-12-05 Impact factor: 7.124