Addressing Pediatric Vaccine Hesitancy: The Use of a Vaccine Hesitancy Screening Tool on Modifying Provider Communication and Education

Abstract

Background: Vaccine hesitancy contributes to 1.5 million preventable deaths each year worldwide. Evidence demonstrates the essential role of family physicians and nurse practitioners delivering tailored patient/family communication and education to address barriers in parental vaccine acceptance.

Local Problem: Within a local children’s hospital health system’s primary care network, providers do not know their patients’ caregivers’ hesitancy toward vaccination; therefore, it was impossible to adjust practice behaviors (communication and/or education) without knowledge of parental attitudes.

Methods: This evidenced-based practice project was conducted in one primary care office in Pennsylvania among caregivers (of children 1 – 24 months of age) and physician providers. The pilot project implemented the Parents Attitudes About Childhood Vaccines (PACV) survey to quantitatively measure caregivers’ vaccine hesitancy and included the directed delivery of caregivers’ scores to providers. Interventions: Three interventions were implemented among 19 caregivers and three physicians at the primary care office: (1) facilitation of caregivers’ completion of the PACV via telephone before the next scheduled well child visit, (2) communication of the results of the parents’ PACV to the physicians directly before the scheduled well child visit, and (3) facilitation of 1:1 interviews with physician providers immediately after the well child visits to determine if providers changed their approaches to communication or education knowing the caregivers’ PACV results.

Results: Across the three providers’ well child visits for four weeks, 73 caregivers met project inclusion criteria. Among the 73, 39 (53%) caregivers were able to be contacted. Nineteen (48.7%) caregivers expressed interest and completed the PACV tool before their children’s next scheduled well child visits. The mean PACV score among all caregivers was 16.8 (range 0-93). 89% (n=17/19) of caregivers were identified as “low” (PACV score 0-49), and 11% (n=2/19) identified as “extreme” hesitancy (PACV score 70-100). Providers reported more instances of “no change” to communication or education (n=X, 58%) after learning caregivers’ vaccine hesitancy scores.

Conclusions: This project demonstrates pilot feasibility of implementing the PACV in a primary care practice setting; however, there is a need to continue exploration in this area to expand the number and diversity of caregivers to better understand the implications on providers’ practices. Future implications include tailored caregiver education and provider-based communication training programs.

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Work Title Addressing Pediatric Vaccine Hesitancy: The Use of a Vaccine Hesitancy Screening Tool on Modifying Provider Communication and Education
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Open Access
Creators
  1. Ashley Willie
License In Copyright (Rights Reserved)
Work Type Project
Acknowledgments
  1. Kristen Bransby DNP, CRNP, CPNP-PC, PMHS (The Pennsylvania State University Carol and Rose Nese College of Nursing)
  2. Sheri Matter PhD, RN, NEA-BC (The Pennsylvania State University Carol and Rose Nese College of Nursing)
  3. Sandra Halbruner DNP, CRNP, FNP-BC (The Pennsylvania State University Carol and Rose Nese College of Nursing)
  4. Elizabeth Froh PhD, RN (The Center for Pediatric Nursing Research & Evidenced- Based Practice (EBP) at Children's Hospital of Philadelphia)
  5. Julie Ginsberg DNP, RN, CPNP-PC, AE-C, NEA-BC (The Center for Pediatric Nursing Research & Evidenced- Based Practice (EBP) at Children's Hospital of Philadelphia)
  6. Oluwamuyiwa Winifred Adebayo, PhD, RN (The Pennsylvania State University Carol and Rose Nese College of Nursing)
  7. Lisa Kitko PhD, RN, FAHA, FAAN (The Pennsylvania State University Carol and Rose Nese College of Nursing)
Publication Date March 25, 2023
Deposited March 25, 2023

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Version 1
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  • Updated Acknowledgments Show Changes
    Acknowledgments
    • Kristen Bransby DNP, CRNP, CPNP-PC, PMHS (The Pennsylvania State University Carol and Rose Nese College of Nursing), Sheri Matter PhD, RN, NEA-BC (The Pennsylvania State University Carol and Rose Nese College of Nursing), Sandra Halbruner DNP, CRNP, FNP-BC (The Pennsylvania State University Carol and Rose Nese College of Nursing), Elizabeth Froh PhD, RN (The Center for Pediatric Nursing Research & Evidenced- Based Practice (EBP) at Children's Hospital of Philadelphia), Julie Ginsberg DNP, RN, CPNP-PC, AE-C, NEA-BC (The Center for Pediatric Nursing Research & Evidenced- Based Practice (EBP) at Children's Hospital of Philadelphia), Oluwamuyiwa Winifred Adebayo, PhD, RN (The Pennsylvania State University Carol and Rose Nese College of Nursing), Lisa Kitko PhD, RN, FAHA, FAAN (The Pennsylvania State University Carol and Rose Nese College of Nursing)
  • Added Creator Ashley Willie
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    License
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Version 2
published

  • Created
  • Updated Description Show Changes
    Description
    • Abstract
    • Background: Vaccine hesitancy contributes to 1.5 million preventable deaths each year worldwide. Evidence demonstrates the essential role of family physicians and nurse practitioners delivering tailored patient/family communication and education to address barriers in parental vaccine acceptance.
    • Local Problem: Within a local children’s hospital health system’s primary care network, providers do not know their patients’ caregivers’ hesitancy toward vaccination; therefore, it was impossible to adjust practice behaviors (communication and/or education) without knowledge of parental attitudes.
    • Methods: This evidenced-based practice project was conducted in one primary care office in Pennsylvania among caregivers (of children 1 – 24 months of age) and physician providers. The pilot project implemented the Parents Attitudes About Childhood Vaccines (PACV) survey to quantitatively measure caregivers’ vaccine hesitancy and included the directed delivery of caregivers’ scores to providers.
    • Interventions: Three interventions were implemented among 19 caregivers and three physicians at the primary care office: (1) facilitation of caregivers’ completion of the PACV via telephone before the next scheduled well child visit, (2) communication of the results of the parents’ PACV to the physicians directly before the scheduled well child visit, and (3) facilitation of 1:1 interviews with physician providers immediately after the well child visits to determine if providers changed their approaches to communication or education knowing the caregivers’ PACV results.
    • Results: Across the three providers’ well child visits for four weeks, 73 caregivers met project inclusion criteria. Among the 73, 39 (53%) caregivers were able to be contacted. Nineteen (48.7%) caregivers expressed interest and completed the PACV tool before their children’s next scheduled well child visits. The mean PACV score among all caregivers was 16.8 (range 0-93). 89% (n=17/19) of caregivers were identified as “low” (PACV score 0-49), and 11% (n=2/19) identified as “extreme” hesitancy (PACV score 70-100). Providers reported more instances of “no change” to communication or education (n=X, 58%) after learning caregivers’ vaccine hesitancy scores.
    • Conclusions: This project demonstrates pilot feasibility of implementing the PACV in a primary care practice setting; however, there is a need to continue exploration in this area to expand the number and diversity of caregivers to better understand the implications on providers’ practices. Future implications include tailored caregiver education and provider-based communication training programs.
  • Published
  • Updated Work Title Show Changes
    Work Title
    • Addressing Pediatric Vaccine Hesitancy Through Integration of the Parents Attitudes About Childhood Vaccines (PACV) Screening Tool in an Ambulatory Outpatient Setting
    • Addressing Pediatric Vaccine Hesitancy: The Use of a Vaccine Hesitancy Screening Tool on Modifying Provider Communication and Education
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