Clinician-parent discussions about influenza vaccination of children and their association with vaccine acceptance |
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| Institution: | 1. Department of Pediatrics, University of Washington, Seattle, WA, United States;2. Seattle Children’s Research Institute, Seattle, WA, United States;3. Department of Communication, Portland State University, Portland, OR, United States;1. Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, China;2. Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;3. Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China;1. Flinders University, Sturt Road, Bedford Park 5042, Australia;2. SingHealth Polyclinics, 167 Jalan Bukit Merah, Connection One Tower 5, #15-10, Singapore 160267, Singapore;1. University of Michigan School of Public Health, Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI 48109, USA;2. Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA;1. Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch Institute, Seestrasse 10, 13353 Berlin, Germany;3. Department for Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Strasse 62-66, 12101 Berlin, Germany;4. Charité - University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany;1. Public Health England, York, UK;2. Public Health England, Birmingham, UK;3. Public Health, Staffordshire University, Staffordshire, UK;1. Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, United States;2. Leidos Inc., Atlanta, GA, United States;3. RTI International, Research Triangle Park, NC, United States |
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| Abstract: | ObjectiveTo examine how clinicians communicate with parents about influenza vaccination and the effect of these communication behaviors on parental vaccine decision-making.Study designWe performed a secondary analysis of data obtained from a cross-sectional observational study in which health supervision visits between pediatric clinicians and English-speaking parents of young children were videotaped. Eligible visits occurred during the 2011–2012 and 2013–2014 influenza seasons, included children ≥6 months, and contained an influenza vaccine discussion. A coding scheme of 10 communication behaviors was developed and applied to each visit. Associations between clinician communication behaviors and parental verbal vaccine acceptance and parental visit experience were examined using bivariate analysis and generalized linear mixed models.ResultsFifty visits involving 17 clinicians from 8 practices were included in analysis. The proportion of parents who accepted influenza vaccine was higher when clinicians initiated influenza vaccine recommendations using presumptive rather than participatory formats (94% vs. 28%, p < 0.001; adjusted odds ratio 48.2, 95% CI 3.5–670.5). Parental acceptance was also higher if clinicians pursued (vs. did not pursue) original recommendations when parents voiced initial resistance (80% vs. 13%, p < 0.05) or made recommendations for influenza vaccine concurrent with (vs. separate from) recommendations for other vaccines due at the visit (83% vs. 33%, p < 0.01). Parental visit experience did not differ significantly by clinician communication behaviors.ConclusionPresumptive initiation of influenza vaccine recommendations, pursuit in the face of resistance, and concurrent vaccine recommendations appear to increase parental acceptance of influenza vaccine without negatively affecting visit experience. |
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| Keywords: | Communication Pediatricians Nurse practitioners Parents Infants Influenza vaccines Vaccination Vaccination refusal |
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