Characterizing providers' immunization communication practices during health supervision visits with vaccine-hesitant parents: a pilot study

Vaccine. 2012 Feb 8;30(7):1269-75. doi: 10.1016/j.vaccine.2011.12.129. Epub 2012 Jan 9.

Abstract

Objective: To determine the feasibility of using direct observation of provider-parent immunization discussions and to characterize provider communication practices with vaccine-hesitant parents.

Methods: Over a 6 month period in 2010, we videotaped immunization discussions between pediatric providers and vaccine-hesitant parents during health supervision visits involving children 2-15 months old (N=24) in the Seattle area, Washington, USA. Videotapes were analyzed using the qualitative method of conversation analysis.

Results: We approached 96 parents seen by 9 different providers. Of those who were eligible (N=56), we enrolled 43% (N=24). Four videotaped visits were excluded from analysis for failure to obtain parental HIPAA authorization. Of the remaining 20 visits, there were ≥2 visits each that involved children aged 2, 4, 6, 9, 12, and 15 months, and all videotaped visits contained at least a brief immunization discussion. We identified 6 communication practices and several behavior types within each practice relevant to immunization: Practice 1, providers' initiations of the topic of vaccination; Types: participatory or presumptive format; Practice 2, parents' responses to providers' topic initiations; Types: strong or weak acceptance or resistance; Practice 3, providers' follow-ups to parent's responses; Types: no, immediate, or delayed pursuit; Practice 4, parents' vaccine-related questions or statements; Types: fact- or concern-based; Practice 5, providers' explicit solicitations of parent's questions/concerns; Types: designed to discourage or encourage discussion; and Practice 6, parents' responses to providers' solicitations of questions/concerns; Types: no question or fact- or concern-based inquiry.

Conclusion: Direct observation of immunization discussions in the primary care pediatric setting is feasible and yields insight into several provider-parent immunization communication practices that are worthy of further study to determine which are effective at improving parental acceptance of immunization.

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Bacterial Infections / immunology
  • Bacterial Infections / microbiology
  • Bacterial Infections / prevention & control*
  • Feasibility Studies
  • Female
  • Health Communication / ethics
  • Health Communication / methods*
  • Humans
  • Infant
  • Longitudinal Studies
  • Male
  • Parents
  • Patient Acceptance of Health Care
  • Physician-Patient Relations / ethics*
  • Pilot Projects
  • Vaccination*
  • Vaccines* / adverse effects
  • Video Recording
  • Virus Diseases / immunology
  • Virus Diseases / prevention & control*
  • Virus Diseases / virology
  • Washington

Substances

  • Vaccines