Childhood Vaccine Risk/Benefit Communication in Private Practice Office Settings: A National Survey

Abstract

ABSTRACT. Communication about childhood vaccine risks and benefits has been legally required in pediatric health care for over a decade. However, little is known about the actual practice of vaccine risk/benefit communication.Objectives. This study was conducted to identify current practices of childhood vaccine risk/benefit communication in private physician office settings nationally. Specifically, we wanted to determine what written materials were given, by whom, and when; what information providers thought parents wanted/needed to know, the content of nurse and doctor discussion with parents, and the time spent on discussion. We also wanted to quantify barriers to vaccine risk/benefit discussion and to prioritize materials and dissemination methods preferred as solutions to these barriers.Methods. We conducted 32 focus groups in 6 cities, and then administered a 27-question cross-sectional mailed survey from March to September 1998, to a random national sample of physicians and their office nurses who immunize children in private practices. Eligible survey respondents were active fellows of the American Academy of Pediatrics or American Academy of Family Physicians in private practice who immunized children and a nurse from each physician's office. After 3 mailings, the response rate was 71%.Results. Sixty-nine percent of pediatricians and 72% of family physicians self-reported their offices gave parents the Centers for Disease Control and Prevention Vaccine Information Statement, while 62% and 58%, respectively, gave it with every dose. In ϳ70% of immunization visits, physicians and nurses reported initiating discussion of the following: common side effects, when to call the clinic and the immunization schedule. However, physicians reported rarely initiating discussion regarding contraindications (<50%) and the National Vaccine Injury Compensation Program (<10%). Lack of time was considered the greatest barrier to vaccine risk/benefit communication. Nurses reported spending significantly more time discussing vaccines with parents than pediatricians or family physicians (mean: 3.89 vs 9.20 and 3.08 minutes, respectively). Both physicians and nurses indicated an additional 60 to 90 seconds was needed to optimally discuss immunization with parents under current conditions. Stratified analysis indicated nurses played a vital role in immunization delivery and risk/benefit communication. To improve vaccine risk/benefit communication, 80% of all providers recommended a preimmunization booklet for parents and approximately one half recommended a screening sheet for contraindications and poster for immunization reference. The learning method most highly endorsed by all providers was practical materials (80%). Other desirable learning methods varied significantly by provider type.Conclusions. There was a mismatch between the legal mandate for Vaccine Information Statement distribution and the actual practice in private office settings. The majority of providers reported discussing some aspect of vaccine communication...

Recommendations for Effective Newborn Screening Communication: Results of Focus Groups With Parents, Providers, and Experts

“…Rather, they preferred short handouts, checklists, review articles, and notices or monthly medical newsletters from their professional organizations that provide to-SUPPLEMENT S333 by guest on May 9, 2018 http://pediatrics.aappublications.org/ Downloaded from the-point information to help them educate parents more effectively. This is consistent with previous studies about communicating with parents regarding childhood immunizations, [10][11][12][13] in which physicians indicated that they wanted only a brief checklist of information that would prepare them to educate parents effectively. The to-the-point information providers requested included a list with definitions of the diseases for which testing can be performed, the specific diseases for which testing is performed in their state, and sources of additional information.…”

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Infant Hearing Screening: Stakeholder Recommendations for Parent-Centered Communication

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