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Best shot: A motivational interviewing approach to address vaccine hesitancy in pediatric outpatient settings

Published:September 13, 2022DOI:https://doi.org/10.1016/j.pedn.2022.08.012

      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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