Highlights
- •A motivational interviewing education session may decrease vaccine hesitancy in parents of children 0-12 months of age.
- •Providers identified motivational interviewing as a feasible tool to use during a well child visit.
- •Regular screening for vaccine hesitancy can be helpful in identifying and addressing concerns of caregivers.
- •The COVID-19 pandemic negatively impacted the number of well child visits seen.
Abstract
Background
Vaccine hesitancy in parents and childhood vaccine refusal is increasing. A standard
of care to address this problem has not been identified.
Purpose
To identify if the use of motivational interviewing by pediatric providers during
routine well child visits, when compared to standard of care, would increase vaccine
rates in children 0–12 months of age. Factors associated with vaccine hesitancy were
also investigated.
Methods
A quasi-experimental study was completed on a convenience sample of pediatric providers
(N = 6) and caregivers of children 0–12 months of age (N = 66). Four providers were trained to use motivational interviewing. During the well
child visit the Parent Attitudes About Childhood Vaccines survey was completed, and
the motivational interviewing intervention was implemented. Clinic's data were compared
with other clinic data of non-trained providers.
Findings
Vaccine refusal/delays rate was 11.4% among caregivers. Vaccine refusal rate decreased
after the intervention (9.00% pre-intervention and 6.40% post-intervention). An ordinal
regression identified caregivers with higher vaccine hesitancy scores and more children
were more likely to delay or refuse vaccines, while caregivers ≥30 years or with high
income were less likely to delay/refuse vaccines. A difference in difference analysis
identified that an additional 2.6% of children received vaccines when seen by trained
providers compared to non-trained (β = −0.330, OR = 0.719, p = 0.470).
Discussion
Findings indicate a condensed motivational interviewing education session may be clinically
significant in decreasing vaccine hesitancy among this population.
Applications to practice
A more robust study to confirm these findings is recommended prior to practice implementation.
Keywords
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Article info
Publication history
Published online: September 13, 2022
Accepted:
August 15,
2022
Received in revised form:
August 1,
2022
Received:
November 16,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.