1887
Research Open Access
Like 0

Abstract

Background

Many countries are grappling with growing numbers of parents who delay or refuse recommended vaccinations for their children. This has created a need for strategies to address vaccine hesitancy (VH) and better support parental decision-making regarding vaccination.

Aim

To assess vaccination intention (VI) and VH among parents who received an individual motivational-interview (MI) based intervention on infant immunisation during post-partum stay at a maternity ward between March 2014 and February 2015.

Methods

This non-controlled pre-/post-intervention study was conducted using the results from parents enrolled in the intervention arm of the PromoVaQ randomised control trial (RCT), which was conducted in four maternity wards across the Province of Quebec. Participants (n = 1,223) completed pre- and post-intervention questionnaires on VI and VH using Opel’s score. Pre-/post-intervention measures were compared using McNemar’s test for categorical variables and Wilcoxon signed-rank test for continuous variables.

Results

Pre-intervention: overall VI was 78% and significantly differed across maternity wards (74%, 77%, 84%, 79%, p = 0.02). Post-intervention: VI rose significantly across maternity wards (89%, 85%, 95%, 93%) and the overall increase in VI was 12% (78% vs 90%, p < 0.0001). VH corroborated these observations, pre- vs post-intervention, for each maternity ward (28% vs 16%, 29% vs 21%, 27% vs 17%, 24% vs 13%). Overall, VH was curbed post-intervention by 40% (27% vs 16%; p < 0.0001).

Conclusions

Compared with pre-intervention status, participants who received the MI-based intervention on immunisation displayed lower hesitancy and greater intention to vaccinate their infant at 2 months of age.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2019.24.36.1800641
2019-09-05
2024-11-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.36.1800641
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/24/36/eurosurv-24-36-3.html?itemId=/content/10.2807/1560-7917.ES.2019.24.36.1800641&mimeType=html&fmt=ahah

References

  1. World Health Organization (WHO). New assessment report on progress towards global immunization goals. Geneva: WHO; 2017. Available from: http://wwwwhoint/immunization/global_vaccine_action_plan/sage_gvap_october_2017/en
  2. Nambiar PH, Daza AD, Livornese LL Jr. Clinical Impact of Vaccine Development. Methods Mol Biol. 2016;1403:3-39.  https://doi.org/10.1007/978-1-4939-3387-7_1  PMID: 27076123 
  3. World Health Organization (WHO). Progress and challenges with achieving universal immunization coverage. Geneva: WHO; [accessed Jul 2018]. Available from: https://www.who.int/immunization/monitoring_surveillance/who-immuniz.pdf.
  4. Institut national de santé publique du Québec (INSPQ). Enquête sur la couverture vaccinale des enfants de 1 an et 2 ans au Québec en 2016 [Survey of vaccine coverage of 1-year and 2-year old children in Quebec in 2016]. Québec: INSPQ; 2017. Available from: https://www.inspq.qc.ca/sites/default/files/publications/2341_enquete_couverture_vaccinale_enfants_2016.pdf.
  5. MacDonald NESAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015;33(34):4161-4.  https://doi.org/10.1016/j.vaccine.2015.04.036  PMID: 25896383 
  6. Dubé E, Gagnon D, Ouakki M, Bettinger JA, Witteman HO, MacDonald S, et al. Canadian Immunization Research Network. Measuring vaccine acceptance among Canadian parents: A survey of the Canadian Immunization Research Network. Vaccine. 2018;36(4):545-52.  https://doi.org/10.1016/j.vaccine.2017.12.005  PMID: 29233605 
  7. Guay M, Gosselin V, Petit G, Baron G, Gagneur A. Determinants of vaccine hesitancy in Quebec: a large population-based survey. Hum Vaccin Immunother. 2019;1-7. PMID: 31050594 
  8. Dubé E, Gagnon D, MacDonald NESAGE Working Group on Vaccine Hesitancy. Strategies intended to address vaccine hesitancy: Review of published reviews. Vaccine. 2015;33(34):4191-203.  https://doi.org/10.1016/j.vaccine.2015.04.041  PMID: 25896385 
  9. Kaufman J, Ryan R, Walsh L, Horey D, Leask J, Robinson P, et al. Face-to-face interventions for informing or educating parents about early childhood vaccination. Cochrane Database Syst Rev. 2018;5:CD010038.  https://doi.org/10.1002/14651858.CD010038.pub3  PMID: 29736980 
  10. Dubé È, MacDonald NE. Managing the risks of vaccine hesitancy and refusals. Lancet Infect Dis. 2016;16(5):518-9. https://doi.org/10.1016/S1473-3099(16)00028-1  PMID: 26852724 
  11. Nyhan B, Reifler J, Richey S, Freed GL. Effective messages in vaccine promotion: a randomized trial. Pediatrics. 2014;133(4):e835-42.  https://doi.org/10.1542/peds.2013-2365  PMID: 24590751 
  12. Gagneur A, Lemaître T, Gosselin V, Farrands A, Carrier N, Petit G, et al. A postpartum vaccination promotion intervention using motivational interviewing techniques improves short-term vaccine coverage: PromoVac study. BMC Public Health. 2018;18(1):811.  https://doi.org/10.1186/s12889-018-5724-y  PMID: 29954370 
  13. Gagneur A, Lemaître T, Gosselin V, Farrands A, Carrier N, Petit G, et al. Promoting vaccination at birth using motivational interviewing techniques improves vaccine intention: the PromoVac strategy. J Infect Dis Ther. 2018;6(5):379.  https://doi.org/10.4172/2332-0877.1000379 
  14. Miller W, Rollnick S. Motivational Interviewing: preparing people for change 2012 (3nd edition ed: New York: The Guilford Press):482.
  15. Lemaître T, Carrier N, Farrands A, Gosselin V, Petit G, Gagneur A. Impact of a vaccination promotion intervention using motivational interview techniques on long-term vaccine coverage: the PromoVac strategy. Hum Vaccin Immunother. 2019;15(3):732-9.  https://doi.org/10.1080/21645515.2018.1549451  PMID: 30457421 
  16. Thiese MS. Observational and interventional study design types; an overview. Biochem Med (Zagreb). 2014;24(2):199-210.  https://doi.org/10.11613/BM.2014.022  PMID: 24969913 
  17. Gagneur A, Quach C, Boucher FD, Tapiero B, De Wals P, Farrands A, et al. Promoting vaccination in the province of Québec: the PromoVaQ randomized controlled trial protocol. BMC Public Health. 2019;19(1):160.  https://doi.org/10.1186/s12889-019-6468-z  PMID: 30727991 
  18. Briss PA, Rodewald LE, Hinman AR, Shefer AM, Strikas RA, Bernier RR, et al. Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults. Am J Prev Med. 2000;18(1) Suppl;97-140.  https://doi.org/10.1016/S0749-3797(99)00118-X  PMID: 10806982 
  19. Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51(3):390-5.  https://doi.org/10.1037/0022-006X.51.3.390  PMID: 6863699 
  20. Ministère de la Santé et des Services sociaux (MSSS). Protocole d'immunisation du Québec [Quebec Immunization Protocol]. Edition 7. Québec: MSSS; 2018. French. Available from: http://publications.msss.gouv.qc.ca/msss/document-000105/
  21. Gagneur A, Petit G, Valiquette L, De Wals P. An innovative promotion of vaccination in maternity ward can improve childhood vaccination coverage. Report of the Promovac study in the Eastern Townships. [in French] Library and National Archives of Canada 2013;ISBN: 978-2-9813830-0-6 (print version), 978-2- 9813830-1-3 (pdf version).
  22. Rosenstock IM. Historical origins of the health belief model. Health Educ Monogr. 1974;2(4):328-35.  https://doi.org/10.1177/109019817400200403 
  23. Opel DJ, Mangione-Smith R, Taylor JA, Korfiatis C, Wiese C, Catz S, et al. Development of a survey to identify vaccine-hesitant parents: the parent attitudes about childhood vaccines survey. Hum Vaccin. 2011;7(4):419-25.  https://doi.org/10.4161/hv.7.4.14120  PMID: 21389777 
  24. Dubé È, Farrands A, Lemaitre T, Boulianne N, Sauvageau C, Boucher FD, et al. Overview of knowledge, attitudes, beliefs, vaccine hesitancy and vaccine acceptance among mothers of infants in Quebec, Canada. Hum Vaccin Immunother. 2019;15(1):113-20.  https://doi.org/10.1080/21645515.2018.1509647  PMID: 30095325 
  25. Sadaf A, Richards JL, Glanz J, Salmon DA, Omer SB. A systematic review of interventions for reducing parental vaccine refusal and vaccine hesitancy. Vaccine. 2013;31(40):4293-304.  https://doi.org/10.1016/j.vaccine.2013.07.013  PMID: 23859839 
  26. Leask J. Should we do battle with antivaccination activists? Public Health Res Pract. 2015;25(2):e2521515. PMID: 25848733 
  27. Dempsey AF, Pyrznawoski J, Lockhart S, Barnard J, Campagna EJ, Garrett K, et al. Effect of a Health Care Professional Communication Training Intervention on Adolescent Human Papillomavirus Vaccination: A Cluster Randomized Clinical Trial. JAMA Pediatr. 2018;172(5):e180016.  https://doi.org/10.1001/jamapediatrics.2018.0016  PMID: 29507952 
  28. Ames HM, Glenton C, Lewin S. Parents’ and informal caregivers’ views and experiences of communication about routine childhood vaccination: a synthesis of qualitative evidence. Cochrane Database Syst Rev. 2017;2:CD011787.  https://doi.org/10.1002/14651858.CD011787.pub2  PMID: 28169420 
  29. Leask J, Kinnersley P, Jackson C, Cheater F, Bedford H, Rowles G. Communicating with parents about vaccination: a framework for health professionals. BMC Pediatr. 2012;12(1):154.  https://doi.org/10.1186/1471-2431-12-154  PMID: 22998654 
  30. Webb TL, Sheeran P. Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence. Psychol Bull. 2006;132(2):249-68.  https://doi.org/10.1037/0033-2909.132.2.249  PMID: 16536643 
  31. Institut national de santé publique du Québec (INSPQ). Plan québécois de promotion de la vaccination [Quebec plan for the promotion of vaccination]. Québec: INSPQ; 2010. Available from: https://www.inspq.qc.ca/publications/1051.
  32. Niederhauser VP, Baruffi G, Heck R. Parental decision-making for the varicella vaccine. J Pediatr Health Care. 2001;15(5):236-43.  https://doi.org/10.1016/S0891-5245(01)65603-7  PMID: 11562641 
  33. Lehmann BA, Ruiter RAC, Chapman G, Kok G. The intention to get vaccinated against influenza and actual vaccination uptake of Dutch healthcare personnel. Vaccine. 2014;32(51):6986-91.  https://doi.org/10.1016/j.vaccine.2014.10.034  PMID: 25454867 
  34. Dubé E, Vivion M, Sauvageau C, Gagneur A, Gagnon R, Guay M. "Nature Does Things Well, Why Should We Interfere?": Vaccine Hesitancy Among Mothers. Qual Health Res. 2016;26(3):411-25.  https://doi.org/10.1177/1049732315573207  PMID: 25711847 
  35. Centre de Santé et de Services Sociaux. Guay M, Petit G, Ménard S, Clément P, Boyer G. Pourquoi les couvertures vaccinales chez les nourrissons de l’Estrie sont-elles sous-optimales? [Why is vaccine coverage of infants of the Eastern Townships suboptimal?]. Sherbrooke: Centre de Santé et de Services Sociaux; 2009. Available from: https://www.santeestrie.qc.ca/clients/SanteEstrie/Professionnels/Vaccination/Etude_couvertures_vaccinales__nourrissons_Estrie_2011.pdf
  36. Zhang J, Nguyen T-H, Mashinter L, Hanrahan A, Loewen J, Vaudry W, et al. Determinants for immunization coverage by age 2 in a population cohort in the capital health region, Edmonton, Alberta. Canada Communicable Disease Report. 2008;34(9):1-11.
  37. Institut national de la statistique du Québec (INSPQ). Naissance selon l’accoucheur, Québec, 1997-2007 [Birth according to the birth attendant, Quebec, 1997-2007].
  38. Chen LF, Vander Weg MW, Hofmann DA, Reisinger HS. The Hawthorne Effect in Infection Prevention and Epidemiology. Infect Control Hosp Epidemiol. 2015;36(12):1444-50.  https://doi.org/10.1017/ice.2015.216  PMID: 26383964 
  39. Institut de la statistique du Québec (INSPQ). Les naissances au Québec et dans les régions en 2017 [Births in Quebec and in the regions in 2017]. Coup d’œil sociodémographique, 2018. Quebec : INSPQ : 2018. Available from: http://www.stat.gouv.qc.ca/statistiques/population-demographie/bulletins/coupdoeil-no65.pdf
/content/10.2807/1560-7917.ES.2019.24.36.1800641
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error