Objectives. We investigated how provider vaccine communication behaviors influence parental vaccination acceptance and visit experience.
Methods. In a cross-sectional observational study, we videotaped provider–parent vaccine discussions (n = 111). We coded visits for the format providers used for initiating the vaccine discussion (participatory vs presumptive), parental verbal resistance to vaccines after provider initiation (yes vs no), and provider pursuit of recommendations in the face of parental resistance (pursuit vs mitigated or no pursuit). Main outcomes were parental verbal acceptance of recommended vaccines at visit’s end (all vs ≥ 1 refusal) and parental visit experience (highly vs lower rated).
Results. In multivariable models, participatory (vs presumptive) initiation formats were associated with decreased odds of accepting all vaccines at visit’s end (adjusted odds ratio [AOR] = 0.04; 95% confidence interval [CI] = 0.01, 0.15) and increased odds of a highly rated visit experience (AOR = 17.3; 95% CI = 1.5, 200.3).
Conclusions. In the context of 2 general communication formats used by providers to initiate vaccine discussions, there appears to be an inverse relationship between parental acceptance of vaccines and visit experience. Further exploration of this inverse relationship in longitudinal studies is needed.
- Douglas J. Opel, Rita Mangione-Smith, Chuan Zhou, and James A. Taylor are with the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA. Jeffrey D. Robinson is with the Department of Communication, Portland State University, Portland, OR. John Heritage is with Department of Sociology, University of California, Los Angeles. Victoria DeVere and Halle S. Salas are with the Seattle Children’s Research Institute, Seattle, WA.
