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 Researchers invited physicians at 30 clinics in Washington state to
attend 45-minute classes led by a pediatric immunization expert and
health educator. But doctors who attended the sessions were no
better at lowering vaccine resistance than their colleagues at 26
other clinics where training wasn’t offered.
“It’s possible that a longer, higher-intensity version of the
training might be more effective,” lead study author Nora Henrikson,
a specialist in patient behavior at Group Health Research Institute
in Seattle, said by email.
On average, about 95 percent of children in most states are up to
date on the recommended childhood vaccinations against diseases
including measles, mumps, rubella, tetanus and pertussis, according
to the U.S. Centers for Disease Control and Prevention.
But clusters of much lower vaccination rates in certain communities,
driven in large part by parents’ resistance to inoculation, leave
some members of those communities vulnerable to serious and
potentially fatal illnesses, according to the CDC.
To understand how parents felt about vaccination in Washington
state, Henrikson and colleagues reached out to mothers of newborns
at four hospitals in two counties, inviting them to participate in
the study if their babies had no medical complications and they
planned to receive routine well-child care from a clinic
participating in the study.
Researchers spoke to 347 mothers about their perception of vaccines
once when the babies were 4 to 6 weeks old and again six months
later.
In the months between interviews with the mothers, researchers
offered communications training to some of the physicians treating
their babies.
The training classes emphasized the importance of establishing trust
with families to improve vaccination rates, and participants also
received access to additional web-based training, monthly email
reminders on communication strategies and handouts for parents
explaining the value of vaccines.
At the start of the study, about 11 percent of the mothers were
hesitant about vaccinating their babies, and 2 percent of them were
extremely resistant.
Among women who took their babies to pediatricians who received
training, vaccine resistance dropped from 9.8 percent at the start
of the study to 7.5 percent six months later.
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When doctors didn’t receive training, the mothers’ resistance
dropped from 12.6 percent initially to 8 percent at the end of the
study.
One limitation of the study is that not all clinics that agreed to
participate saw mothers who also enrolled in the trial. Also, many
doctors and parents who initially agreed to help with the experiment
failed to complete all the surveys.
It’s also possible that the training didn’t appear very effective
because the number of mothers who were resistant to vaccines at the
start of the study was lower than expected, Henrikson said.
Doctors who need to improve their communication skills may also need
more than a single class to accomplish this goal, said Julie Leask,
a public health researcher at the University of Sydney, New South
Wales in Australia, who wrote an editorial accompanying the study in
the journal Pediatrics.
Moreover, the physicians who choose to attend extra training
sessions may very well be the ones who already have decent
communications skills, leaving less room for improvement, she said.
“Only two thirds of the doctors actually attended the training, and
the session was pragmatically brief to fit in with the realities of
busy clinicians,” Leask said by email.
“We need to be very careful in not abandoning an intervention that
may have not been delivered to enough people in enough of a dose.”
SOURCE: http://bit.ly/1dHFNKM
Pediatrics, online June 1, 2015.
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