Oct. 17, 2017

NDSU researchers examine methods to gain vaccine acceptance

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Dr. Paul Carson, professor of practice in the Department of Public Health, and NDSU alumna Lauren Dybsand are featured in a recent Pediatric News article discussing their latest research on how physicians can best communicate with parents who are vaccine hesitant.

The article is based on the researchers’ project titled, “Provider Confidence and Satisfaction with Communication Strategies to Address Vaccine Hesitancy.” It was funded with a $50,000 grant from the Otto Bremer Trust and a $50,000 matching grant from the Dakota Medical Foundation.

Kylie Hall, medical professional in the NDSU Department of Public Health and a 2015 graduate of the NDSU MPH program, managed the project. Dr. Jon Ulven, Sanford Health psychologist, provided additional expertise for the project.

In the Oct. 2 Pediatric News article, “Talking with vaccine-hesitant parents takes training and finesse” by Damian McNamara, the researchers answered questions about their recent pilot study on how providers can best communicate with patients who are vaccine hesitant. The interview took place during the annual meeting of the American Academy of Pediatrics.

“For this project, we trained a group of pediatric providers on the use of two communication strategies that are commonly recommended by the American Academy of Pediatrics as a means of garnering vaccine acceptance,” Hall said.

The strategies include the CASE approach – which stands for “Corroborate parents’ concern, talk About me, describe the Science and Explain why they should vaccinate – and motivational interviewing. “They differ in the way the provider approaches the conversation with parents and patients,” Hall explained.

The CASE approach was implemented by these providers for four months, and then they switched and implemented motivational interviewing for another four months.

At the start of the project, providers participated in a day-long retreat focused on vaccine safety and efficacy and how to dispute common vaccine myths. They were also trained to use the communication strategies. “Some intensive training and education on the vaccine safety process and scientific evidence dispelling the common myths about vaccine safety were very helpful in boosting provider confidence,” Carson said in the article.

Throughout the project, the research team assessed providers’ confidence in recommending vaccines and satisfaction with each method. 

“Providers relayed to us that their medical training really does not prepare them to address the array of anti-vaccine concerns that circulate amongst parents, nor how best to deal with these tense encounters. They sometimes feel anxious and uncomfortable when confronted with parents who are strongly vaccine hesitant and find themselves frequently combating an internal desire to just avoid the conflict,” Carson said.

“After we got to know the pediatric providers, we realized the stress they encounter when trying to approach these conversations,” said Dybsand, who earned her Master of Public Health from NDSU this year.

Study results suggest that healthcare providers can benefit from additional education on vaccines and how to dispute the common myths about immunizations. Additionally, providers didn’t believe that one-strategy-fits-all, meaning providers may need to gauge the parent’s beliefs about vaccines before they choose how they will approach the conversation. Pediatric providers believed the CASE approach worked better with accepting and moderately hesitant parents. Providers found that motivational interviewing appeared to be more useful for the more resistant parent.

“For those really resistant parents who have looked at all the websites and are very concerned about vaccines, maybe motivational interviewing is the way to go,” Dybsand was quoted in the article. “You may not be giving that vaccine today, but you may be able to convince them in the future to vaccinate.”

The investigators hope to expand the research to multiple sites, with the goal to test the communication strategies to determine if they increase vaccine acceptance.

The Dakota Medical Foundation grant number is Project FAR0024582, and the Otto Bremer Trust grant number is Project FAR0025031.

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