Improving Communication with Patients Expressing Vaccine Hesitancy in Primary Care

Abstract

Purpose: This quality improvement project aimed to determine whether providers and patient care staff at a primary care clinic in Tucson, Arizona would report increased knowledge, self-efficacy, and intent to change practice after receiving an educational presentation on evidence-based communication with patients expressing vaccine hesitancy.Background: Data show that vaccine hesitancy is increasing among patients in the United States, and the World Health Organization has named vaccine hesitancy a top threat to global health. The literature supports high quality vaccine recommendations from primary care providers to improve patient acceptance of vaccines. There is evidence to support presumptive language and motivational interviewing along with clinician confidence as keys to high quality vaccine recommendations. However, most primary care providers have little or no training in the use of evidence-based and therapeutic communication techniques. Methods: An original educational presentation based on findings from the literature was created by the project director and hosted by YouTube. Recruited participants were asked to complete identical surveys in the online platform Qualtrics before and after viewing the presentation. A four-week period was allowed for asynchronous completion of the surveys and education. Survey items used a five-point Likert scale and survey content was designed to assess knowledge, self-efficacy, and intent to change practice. Data were analyzed for changes from pre- to post-intervention using descriptive statistics for variability and central tendency. Results: Twelve participants completed the pre-survey and intervention, with eleven also completing the post-survey. After receiving the intervention, participants reported increases in both knowledge of the evidence-based methods and intent to change practice. More modest 10 increases were seen in self-efficacy, and self-efficacy scores remained lower at both baseline and follow-up compared to the other two outcomes of interest. Conclusions: The results of this project suggest that at this clinic, an online presentation may be a feasible and effective method for improving knowledge and incorporation of evidence-based communication with vaccine hesitant patients. The small sample size did not allow for evaluation of statistical significance, and further studies are needed to determine the effect of therapeutic communication on vaccination rates.