Jessica Kaufman1, Rebecca Ryan2, Simon Lewin3, Xavier Bosch-Capblanch4, Claire Glenton5, Julie Cliff6, Angela Oyo-Ita7, Artur Manuel Muloliwa8, Afiong Oku9, Heather Ames10, Gabriel Rada11, Yuri Cartier12, Sophie Hill13. 1. Centre for Health Communication and Participation, Health Sciences 2, School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC 3086, Australia. Electronic address: j.kaufman@latrobe.edu.au. 2. Centre for Health Communication and Participation, Health Sciences 2, School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC 3086, Australia. Electronic address: r.ryan@latrobe.edu.au. 3. Norwegian Institute of Public Health, Boks 7004, St Olavs plass, 0130 Oslo, Norway; Health Systems Research Unit, South African Medical Research Council, P.O. Box 19070, 7505 Tygerberg, Cape Town, South Africa. Electronic address: Simon.Lewin@fhi.no. 4. Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box CH-4002, Basel, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland. Electronic address: x.bosch@unibas.ch. 5. Norwegian Institute of Public Health, Boks 7004, St Olavs plass, 0130 Oslo, Norway. Electronic address: Claire.Glenton@fhi.no. 6. Faculdade de Medicina, Eduardo Mondlane University, CP 257 Maputo, Mozambique. Electronic address: julie.cliff@gmail.com. 7. University of Calabar, PMB 1115 Calabar, Cross River State, Nigeria. Electronic address: oyo_ita@yahoo.com. 8. Provincial Directorate of Health, Av. Samora Machel n° 1016 R/C, C.P. N° 14, Nampula, Mozambique. Electronic address: muloliwa@yahoo.com.br. 9. University of Calabar, PMB 1115 Calabar, Cross River State, Nigeria. Electronic address: afyokuene@gmail.com. 10. Norwegian Institute of Public Health, Boks 7004, St Olavs plass, 0130 Oslo, Norway. Electronic address: heather.melanie.ames@gmail.com. 11. Pontifical Catholic University of Chile, Avda. Libertador Bernardo O'Higgins 340, Santiago, Chile. Electronic address: radagabriel@gmail.com. 12. International Union for Health Promotion and Education, 42 Boulevard de la Libération, 93203 Saint-Denis, France. Electronic address: ycartier@gmail.com. 13. Centre for Health Communication and Participation, Health Sciences 2, School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC 3086, Australia. Electronic address: Sophie.hill@latrobe.edu.au.
Abstract
BACKGROUND: Communication interventions for childhood vaccination are promising strategies to address vaccine hesitancy, but current research is limited by the outcomes measured. Most studies measure only vaccination-related outcomes, with minimal consideration of vaccine hesitancy-relevant intermediate outcomes. This impedes understanding of which interventions or elements are effective. It is also unknown which outcomes are important to the range of stakeholders affected by vaccine hesitancy. Outcome selection shapes the evidence base, informing future interventions and trials, and should reflect stakeholder priorities. Therefore, our aim was to identify which outcome domains (i.e. broad outcome categories) are most important to different stakeholders, identifying preliminary core outcome domains to inform evaluation of three common vaccination communication types: (i) communication to inform or educate, (ii) remind or recall, and (iii) enhance community ownership. METHODS: We conducted a two-stage online Delphi survey, involving four stakeholder groups: parents or community members, healthcare providers, researchers, and government or non-governmental organisation representatives. Participants rated the importance of eight outcome domains for each of the three communication types. They also rated specific outcomes within one domain ("attitudes or beliefs") and provided feedback about the survey. RESULTS: Collectively, stakeholder groups prioritised outcome domains differently when considering the effects of different communication types. For communication that aims to (i) inform or educate, the most important outcome domain is "knowledge or understanding"; for (ii) reminder communication, "vaccination status and behaviours"; and for (iii) community engagement communication, "community participation". All stakeholder groups rated most outcome domains as very important or critical. The highest rated specific outcome within the "attitudes or beliefs" domain was "trust". CONCLUSION: This Delphi survey expands the field of core outcomes research and identifies preliminary core outcome domains for measuring the effects of communication about childhood vaccination. The findings support the argument that vaccination communication is not a single homogenous intervention - it has a range of purposes, and vaccination communication evaluators should select outcomes accordingly.
BACKGROUND: Communication interventions for childhood vaccination are promising strategies to address vaccine hesitancy, but current research is limited by the outcomes measured. Most studies measure only vaccination-related outcomes, with minimal consideration of vaccine hesitancy-relevant intermediate outcomes. This impedes understanding of which interventions or elements are effective. It is also unknown which outcomes are important to the range of stakeholders affected by vaccine hesitancy. Outcome selection shapes the evidence base, informing future interventions and trials, and should reflect stakeholder priorities. Therefore, our aim was to identify which outcome domains (i.e. broad outcome categories) are most important to different stakeholders, identifying preliminary core outcome domains to inform evaluation of three common vaccination communication types: (i) communication to inform or educate, (ii) remind or recall, and (iii) enhance community ownership. METHODS: We conducted a two-stage online Delphi survey, involving four stakeholder groups: parents or community members, healthcare providers, researchers, and government or non-governmental organisation representatives. Participants rated the importance of eight outcome domains for each of the three communication types. They also rated specific outcomes within one domain ("attitudes or beliefs") and provided feedback about the survey. RESULTS: Collectively, stakeholder groups prioritised outcome domains differently when considering the effects of different communication types. For communication that aims to (i) inform or educate, the most important outcome domain is "knowledge or understanding"; for (ii) reminder communication, "vaccination status and behaviours"; and for (iii) community engagement communication, "community participation". All stakeholder groups rated most outcome domains as very important or critical. The highest rated specific outcome within the "attitudes or beliefs" domain was "trust". CONCLUSION: This Delphi survey expands the field of core outcomes research and identifies preliminary core outcome domains for measuring the effects of communication about childhood vaccination. The findings support the argument that vaccination communication is not a single homogenous intervention - it has a range of purposes, and vaccination communication evaluators should select outcomes accordingly.
Authors: Karine E Manera; Allison Tong; Jonathan C Craig; Jenny Shen; Shilpa Jesudason; Yeoungjee Cho; Benedicte Sautenet; Armando Teixeira-Pinto; Martin Howell; Angela Yee-Moon Wang; Edwina A Brown; Gillian Brunier; Jeffrey Perl; Jie Dong; Martin Wilkie; Rajnish Mehrotra; Roberto Pecoits-Filho; Saraladevi Naicker; Tony Dunning; Nicole Scholes-Robertson; David W Johnson Journal: Kidney Int Date: 2019-03-29 Impact factor: 10.612