The use of motivational interviewing to overcome COVID‐19 vaccine hesitancy in primary care settings

Abstract

Vaccine hesitancy is not a new phenomenon. However, the COVID-19 pandemic has highlighted the impact of political, racial, and health disparities on vaccine hesitancy at a global level. With the creation of the COVID-19 vaccine, a resurgence of vaccine hesitancy has emerged and many are reluctant to receive the vaccination. The reluctance varies from concerns about government interference in vaccine development, to the speed of vaccine development, to long-term health outcomes and potential side effects. Health care professionals need to consider evidence-based approaches that are effective in assisting patients with health care decision-making regarding vaccine uptake. Motivational Interviewing (MI) is an effective technique to positively impact behavior change. Definitions and examples of MI techniques are provided to illustrate how MI can be used to support patient autonomy and provide a safe and trusting environment, with the goal of increasing COVID-19 vaccination uptake.

UK ethnic minority healthcare workers’ perspectives on COVID-19 vaccine hesitancy in the UK ethnic minority community: A qualitative study

“…We also noted previously that mistrust associated with CVH in the UKEM community has roots in history and religion, conspiracy theories, vaccine “novelty,” side effects among others. Allaying these suspicions and misgivings through a non-judgmental approach has been demonstrated to be effective in mitigating CVH ( Breckenridge et al, 2021 ).…”

Addressing Barriers to COVID-19 Vaccination Among Older U.S. Veterans

“…These findings may relate to the telephone intervention being offered at a point in the pandemic when most unvaccinated patients had already formed strong opinions related to vaccination, and when patients facing logistical barriers to vaccination in our healthcare system had already had opportunities to receive relevant assistance with scheduling, visit reminders, transportation, etc. This points to the possibility that the relatively small group of unvaccinated patients in our geriatrics clinic might benefit at this point from further discussions of vaccination within the context of established relationships with people they trust [ 5 , 7 , 8 ]. With studying the results of telephone-based intervention with older adult patients at our institution (the “S” of the PDSA cycle), we therefore hypothesized that supporting tailored conversations on vaccination between primary care providers in the geriatrics clinic and unvaccinated patients would be a reasonable next step.…”

“…With studying the results of telephone-based intervention with older adult patients at our institution (the “S” of the PDSA cycle), we therefore hypothesized that supporting tailored conversations on vaccination between primary care providers in the geriatrics clinic and unvaccinated patients would be a reasonable next step. Multiple providers in our geriatrics outpatient clinic participated in training and discussion on addressing barriers to vaccination among their patients, including through use of motivational interviewing techniques and tailoring the content of conversations to the specific barriers being faced [ 7 , 8 ]. It was also discussed that broader public health efforts and encouraging vaccination among younger patients may be particularly important components of vaccination efforts at this point in the COVID-19 pandemic [ 7 ].…”

Case report: Vaccine Brigade Chicago, Illinois: From founding February to July, 2021

“…In a review of 13 studies Khubchandani &Macias ( 2021 ) found the following major predictors of hesitancy: sociodemographic characteristics (e.g., age, gender, income, education, and household size); medical mistrust and history of racial discrimination; exposure to myths and misinformation, perceived risk of getting infected with COVID‐19; beliefs about vaccines and past vaccine compliance, and concerns about the safety, efficacy, and side effects from the COVID‐19 vaccines. Motivational interviewing (MI) has been identified and successfully used as a non‐judgmental framework to overcome vaccine hesitancy in the past, and could help with increasing Covid vaccine uptake (Breckenridge et al., 2021 ). One of the Brigade members was an expert in MI; the group embraced the framework, and conducted multiple internal trainings with members.…”

“…In a review of 13 studies Khubchandani &Macias (2021) found the following major predictors of hesitancy: sociodemographic characteristics (e.g., age, gender, income, education, and household size); medical mistrust and history of racial discrimination; exposure to myths and misinformation, perceived risk of getting infected with COVID-19; beliefs about vaccines and past vaccine compliance, and concerns about the safety, efficacy, and side effects from the COVID-19 vaccines. Motivational interviewing (MI) has been identified and successfully used as a non-judgmental framework to overcome vaccine hesitancy in the past, and could help with increasing Covid vaccine uptake(Breckenridge et al, 2021). One of the Brigade members was an expert in MI; the group embraced the framework, and conducted multiple internal trainings with members.1.7 Protect Chicago plusOak St. Health served as a major clinical partner with the Chicago Department of Public Health (CDPH) in its Protect Chicago Plus, an initiative that "dedicates vaccine and additional resources" to F I G U R E 1 Protect Chicago plus communities in blue (https://www.chicago.gov/city/en/sites/covid-19/home/protectchicago.html) [Color figure can be viewed at wileyonlinelibrary.com] communities most impacted by COVID-19, especially Black and Latinx residents, and then partners with local community stakeholders to develop tailored vaccination and engagement strategies to help community residents get vaccinated (CDPH.org).…”