Training Physicians in Motivational Communication to Address Influenza Vaccine Hesitation: A Proof-of-Concept Study

Abstract

Background: Strategies to support health care professionals on how to address vaccine hesitancy are needed. Methods: We developed a 4-h Motivational Communication (MC) training program tailored to help physicians address hesitancy related to influenza vaccination among patients living with rheumatoid arthritis. Five MC competencies were evaluated at baseline and post-training with a standardized patient using the Motivational Interviewing Treatment Integrity [MITI] scale. Adherence to MC during clinical consultations and changes in vaccine intentions was measured as secondary outcomes. Results: Seven rheumatology physicians participated in the training. MITI scores increased in all participants, and 71% (n = 5) achieved thresholds of clinical competency (i.e., ≥3.5/5 at MITI global score and ≥3/5 on at least 3 individual competency score) post-training. Autonomy/support and empathy competencies reached competency thresholds (+2.4 ± 1.3 to +4.1 ± 0.7 and +2.1 ± 0.7 to +4.1 ± 0.7, respectively). Evocation and collaboration competencies improved but without reaching competency thresholds (+1.4 ± 0.8 to +3.1 ± 1.1; +1.4 ± 0.8 to +2.9 ± 1.1, respectively). Direction did not improve. Among 21 patient consultations post-training, 15 (71%) were MC-consistent. Of the 15 patients, 67% (10/15) intended to receive the influenza vaccine and 33% (5/15) received it. Conclusion: A brief MC training program targeting vaccine hesitancy increased MC competency among rheumatology physicians and promoted behavioral change among patients.

The Application and Outcome Evaluation of a Social Marketing Intervention to Increase Seasonal Influenza Vaccination among University Students

“…According to the intervention results, a mass communication program is only effective in motivating students who are receptive to flu vaccination or who are open to persuasion. This finding echoes prior research that a more person-to-person vaccination program is required to motivate seasonal flu vaccination among those with high vaccine hesitancy [ 22 ].…”

Assessment of training of general practice interns in motivational interviews about vaccination

“…A brief four-hour MI training program targeting vaccine hesitancy increased MI competency among rheumatology physicians and promoted behavioral change among patients. 29 The five MI competencies were evaluated at baseline and post-training with a standardized patient using the Motivational Interviewing Treatment Integrity [MITI] scale. MITI scores increased in this study; however, it involved only seven participants.…”

Training physicians in motivational communication: An integrated knowledge transfer study protocol.

“…The aim was to create an assessment tool that reliably assessed all 11 MC competencies, and that avoided the inherent limitations of role-playing approaches. Detailed methods, participant characteristics, and results can be found in Boucher et al (2022).…”

“…While the present iteration of the 4-hr MOTIVATOR program is centered around behavior change in the context of chronic diseases and targets physician participants, it is designed to be easily adaptable to other clinical issues, populations, and HCPs. For example, an earlier version was used to promote influenza vaccine uptake among rheumatology patients who were vaccine hesitant (Labbé et al, 2022). It has also recently been adapted to offer training to physicians to encourage patients to undergo genetic testing for cancer risk.…”