Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
Vaccine. 2023 Mar 3;41(10):1760-1767. doi: 10.1016/j.vaccine.2023.02.010. Epub 2023 Feb 10.
Delay or refusal of childhood vaccines is common and may be increasing. Pediatricians are parents' most trusted source for vaccine information, yet many struggle with how to communicate with parents who resist recommended vaccines. Evidence-based communication strategies for vaccine conversations are lacking. In this manuscript, we describe the development and perceived usefulness of a curriculum to train clinicians on a specific vaccine communication strategy as part of the PIVOT with MI study, a cluster randomized trial testing the effectiveness of this communication strategy on increasing childhood vaccination uptake among 24 pediatric practices in Colorado and Washington. The communication strategy is based on the existing evidence-based communication strategies of a presumptive format for initiating vaccine conversations and use of motivational interviewing if hesitancy persists. Focus groups and semi-structured interviews with pediatric clinicians helped inform the development of the training curriculum, which consisted of an introductory video module followed by 3 training sessions. Between September 2019 and January 2021, 134 pediatric clinicians (92 pediatricians, 42 advanced practice providers) participated in the training as part of the PIVOT with MI study. Of these, 92 % viewed an introductory video module, 93 % attended or viewed a baseline synchronous training, 82 % attended or viewed a 1st refresher training, and 77 % attended or viewed a 2nd refresher training. A follow-up survey was administered August 2020 through March 2021; among respondents (n = 100), >95 % of participants reported that each component of the training program was very or somewhat useful. These data suggest that the PIVOT with MI training intervention is a useful vaccine communication resource with the potential for high engagement among pediatric clinicians.
儿童疫苗的延迟接种或拒绝接种较为常见，且可能呈上升趋势。儿科医生是父母获取疫苗信息最信任的来源，但许多医生在与抵制推荐疫苗的父母沟通时，都会面临困难。目前缺乏针对疫苗接种对话的循证沟通策略。在本手稿中，我们描述了为培训临床医生实施特定疫苗沟通策略的课程的开发和实用性，该课程是 PIVOT with MI 研究的一部分，该研究是一项整群随机试验，旨在测试这种沟通策略是否能提高科罗拉多州和华盛顿州 24 家儿科诊所儿童疫苗接种率。该沟通策略基于现有的循证沟通策略，即采用假设性的疫苗接种对话启动格式，并在存在犹豫时使用动机性访谈。与儿科临床医生进行的焦点小组和半结构化访谈有助于为培训课程的开发提供信息，培训课程包括一个介绍视频模块，随后是 3 次培训课程。2019 年 9 月至 2021 年 1 月期间，作为 PIVOT with MI 研究的一部分，134 名儿科临床医生（92 名儿科医生，42 名高级实践提供者）参加了培训。其中，92%的人观看了介绍视频模块，93%的人参加或观看了基线同步培训，82%的人参加或观看了第 1 次复习培训，77%的人参加或观看了第 2 次复习培训。2020 年 8 月至 2021 年 3 月进行了一项后续调查；在回答者（n=100）中，超过 95%的参与者表示培训计划的每个组成部分都非常有用或有些用处。这些数据表明，PIVOT with MI 培训干预是一种有用的疫苗沟通资源，有可能在儿科临床医生中获得高参与度。
