Sponsor
Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under award 1K23HD06947.
Published In
Academic Pediatrics
Document Type
Post-Print
Publication Date
1-8-2018
Subjects
Communication in medicine, Immunization of children, Preventive health services
Abstract
Objective: Presumptive formats to initiate childhood vaccine discussions (e.g. “Well we have to do some shots.”) have been associated with increased vaccine acceptance after one visit compared to participatory formats (e.g. “How do you feel about vaccines?”). We characterize discussion format patterns over time and the impact of their repeated use on vaccine acceptance.
Methods: We conducted a longitudinal prospective cohort study of children of vaccine-hesitant parents enrolled in a Seattle-based integrated health system. After the child’s 2, 4, and 6 month visits, parents reported the format their child’s provider used to begin the vaccine discussion (presumptive, participatory, or other). Our outcome was the percentage of days under-immunized of the child at 8 months old for 6 recommended vaccines. We used linear regression and generalized estimating equations to test the association of discussion format and immunization status.
Results: We enrolled 73 parent/child dyads and obtained data from 82%, 73%, and 53% after the 2, 4, and 6 month visits, respectively. Overall, 65% of parents received presumptive formats at ≥1 visit and 42% received participatory formats at ≥1 visit. Parental receipt of presumptive formats at 1 and ≥2 visits (vs. no receipt) was associated with significantly less underimmunization of the child, while receipt of participatory formats at ≥2 visits was associated with significantly more under-immunization. Visit-specific use of participatory (vs. presumptive) formats was associated with a child being 10.1% (95% CI: 0.3, 19.8; P=.04) more days underimmunized (amounting to, on average, 98 more days under-immunized for all 6 vaccines combined).
Conclusions: Presumptive (vs. participatory) discussion formats are associated with increased immunization.
Rights
© 2018
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Locate the Document
DOI
10.1016/j.acap.2017.12.009
Persistent Identifier
http://archives.pdx.edu/ds/psu/24094
Citation Details
Published as: Douglas J. Opel, Chuan Zhou, Jeffrey D. Robinson, Nora Henrikson, Katherine Lepere, Rita Mangione-Smith, James A. Taylor, Impact of the Childhood Vaccine Discussion Format Over Time on Immunization Status, Academic Pediatrics (2018), https://doi.org/10.1016/j.acap.2017.12.009
Description
This is the author’s version of a work that was accepted for publication in Academic Pediatrics. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Academic Pediatrics, Jun; 18(4): 430-436. doi: 10.1016/j.acap.2017.12.009.