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

Author: D J OpelJ D RobinsonJ HeritageC KorfiatisJ A TaylorAll authors
Edition/Format: Article Article : English
Publication:Vaccine, v30 n7 (20120208): 1269-1275
Database:Copyright 2014 Elsevier B.V. All rights reserved
Other Databases: Academic Search CompleteWorldCatWorldCatElsevier
Summary:
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  Read more...
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Details

Document Type: Article
All Authors / Contributors: D J Opel; J D Robinson; J Heritage; C Korfiatis; J A Taylor; R Mangione-Smith
ISSN:0264-410X
DOI: 10.1016/j.vaccine.2011.12.129
Language Note: English
Unique Identifier: 775515414
Awards:

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.
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