'presumptively Initiating Vaccines and Optimizing Talk with Motivational Interviewing' (PIVOT with MI) Trial: a Protocol for a Cluster Randomised Controlled Trial of a Clinician Vaccine Communication Intervention.

Douglas J. Opel, Seattle Children's Research Institute
Jeffrey D. Robinson, Portland State University
Heather Spielvogle, Seattle Children's Research Institute
Christine Spina, Children's Hospital Colorado
Kathleen Garrett, Children's Hospital Colorado
Amanda F. Dempsey, Children's Hospital Colorado
Cathryn Perreira, Children's Hospital Colorado
Miriam Dickinson, Children's Hospital Colorado
Chuan Zhou, Seattle Children's Research Institute
multiple additional authors

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.


A key contributor to underimmunisation is parental refusal or delay of vaccines due to vaccine concerns. Many clinicians lack confidence in communicating with vaccine-hesitant parents (VHP) and perceive that their discussions will do little to change parents' minds. Improving clinician communication with VHPs is critical to increasing childhood vaccine uptake.