Underpinning of the sharing knowledge about immunisation (SKAI) communication approach: A qualitative study using recorded observations

Patient Educ Couns. 2020 Jun;103(6):1118-1124. doi: 10.1016/j.pec.2019.12.014. Epub 2019 Dec 26.


Objective: To refine communication strategies to assist clinician conversations with vaccine hesitant and declining parents as part of the Sharing Knowledge About Immunisation (SKAI) package.

Methods: We recorded and analysed consultations held in two Specialist Immunisation Clinics in tertiary hospitals in Australia between consenting clinicians and parents. We undertook content analysis that was both iterative and informed by the Calgary Cambridge Model of health communication and motivational interviewing.

Results: We found common strengths and opportunities in clinician's communication styles. Strengths included: rapport building; communicating care for both the parent and child; exhibiting depth of vaccination-specific communication skill and content knowledge. Opportunities for strengthening communication practices included: eliciting parents' concerns to saturation early in the consultation; structuring the consultation to prioritise and address parents' concerns; recognising and responding to parents' motivation to vaccinate; effectively closing consultations.

Conclusion: This study has synthesised clinical communication strategies from expert vaccination communicators using well-established communication frameworks to advance a unique approach to the challenging task of addressing vaccine hesitancy and refusal.

Practice implications: The clinic observations helped us to create a structured consultation guide that can enhance and provide greater structure to a clinician's existing communication skills.

Keywords: Shared decision-making; Vaccination communication; Vaccine hesitancy; Vaccine refusal.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Australia
  • Child
  • Communication*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Parents / psychology*
  • Patient Acceptance of Health Care*
  • Qualitative Research
  • Vaccination* / psychology
  • Vaccines


  • Vaccines