Physicians’ rhetorical strategies for motivating HPV vaccination

Abstract

Rationale. Receiving a healthcare provider's recommendation is a well-documented predictor of human papillomavirus (HPV) vaccination, and yet recommendations remain understudied and undertheorized. Objective. To qualitatively describe strategies providers use to motivate HPV vaccination. Method. We surveyed a national sample of 771 U.S. primary care physicians. Data came from an open-ended item that assessed physicians' perspectives on the most effective thing they could say to persuade parents to get HPV vaccine for their 11- to 12-year-old children. Using a standardized codebook and two independent coders, we conducted a thematic analysis to identify rhetorical strategies underlying physicians' responses. Results. We identified two sets of strategies for motivating HPV vaccination. One set drew parents' attention to specific actors or vaccine characteristics. Physicians using these strategies asked parents to consider their children's individual risk in the short-term, named specific diseases that could be prevented, emphasized the novelty of HPV vaccine as a cancer prevention tool, and gave their personal endorsement for HPV vaccination. In contrast, the second set of strategies was more distancing and impersonal. Physicians using these strategies referenced future risk, described cancer prevention in general terms, framed HPV vaccine as similar to other vaccines, and shared organizational endorsements for HPV vaccination. Across these two sets of strategies, a tension emerged between the goals of engaging parents' perceptions of HPV as a threat to their children versus framing HPV vaccination as a normative standard of care. Conclusions. Our findings suggest that theoretical frameworks, such as Construal Level Theory, may be helpful for positioning provider recommendations in the broader literature on persuasive communication. By identifying competing approaches to motivating HPV vaccination, this study lays the groundwork for future research to test the acceptability and impact of strategies for recommending routine preventive care.

Development of a Codebook of Online Anti-Vaccination Rhetoric to Manage COVID-19 Vaccine Misinformation

“…Work in the field of public health messaging has demonstrated that messaging that focuses on narrative and rhetoric (form) tends to yield better persuasive outcomes than messaging that focuses on facts alone (i.e., content) [ 55 , 60 , 62 , 72 , 73 , 74 ]. A variety of studies from the field of advertising, media, and communication studies suggest that narrative messaging yields more effective outcomes than analytic and informative messages [ 66 , 67 , 75 ].…”

Increasing trust and vaccine uptake: Offering invitational rhetoric as an alternative to persuasion in pediatric visits with vaccine-hesitant parents (VHPs)

“…Research suggests the communication techniques healthcare providers adopt with vaccine-hesitant parents play a role in parents’ vaccination plans for their children [2] , [5] , [6] , [7] . Therefore, communication research generally can help healthcare providers engage in conversations about vaccines with parents, caregivers, and families [8] , [9] , [10] , [11] , [12] . Rhetoric specifically—or the study of persuasion—can help healthcare practitioners better achieve their desired goals with patients and families, such as “improving communication, patient engagement with the healthcare system, and better health outcomes for communities” [12] .…”

“…Traditional persuasive responses to vaccine hesitancy in the past have included using fear-based messaging about the risks of not vaccinating [10] , [13] , [14] and attempting to educate parents about vaccinations by debunking vaccination myths and giving them evidence-based information instead [2] , [3] , [8] , [15] . Research has demonstrated that these traditional strategies do not lead to increased vaccination and can instead increase hesitancy and negatively affect the provider/family relationship [8] , [13] , [16] , [17] , [18] , [19] .…”

Development of a Codebook of Online Anti-Vaccination Rhetoric to Manage COVID-19 Vaccine Misinformation

“…Work in the field of public health messaging has demonstrated that messaging which focuses on narrative and rhetoric (form) tends to yield better persuasive outcomes than messaging which focuses on facts alone (i.e. content) (Adebayo et al, 2020; Bryan et al, 2019; Gilkey et al, 2020; Kreuter et al, 2010; Liu & Yang, 2020; Murphy et al, 2015). A variety of studies from the field of advertising, media, and communication studies suggest that narrative messaging yields more effective outcomes than analytic and informative messages (Bilandzic & Busselle, 2013; Escalas, 2006; Igartua & Barrios, 2012).…”