The Influence of Provider Communication Behaviors on Parental Vaccine Acceptance and Visit Experience
The Influence of Provider Communication Behaviors on Parental Vaccine Acceptance and Visit Experience
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DOI：
10.2105/ajph.2014.302425
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发表时间：
2015-10-01
影响因子：
12.7
通讯作者：
Taylor, James A.
中科院分区：
文献类型：
--
作者：
Opel, Douglas J.;Mangione-Smith, Rita;Taylor, James A.
目标.我们调查了疫苗提供者的沟通行为如何影响父母的疫苗接种接受和访问经验。在一项横断面观察性研究中，我们对提供者-父母疫苗讨论进行了录像（n = 111）。我们对用于启动疫苗讨论的形式提供者（参与式与假定式）、提供者启动后父母对疫苗的口头抵制（是与否）以及提供者在面对父母抵制时对建议的追求（追求与减轻或不追求）进行了编码。主要结果是父母在访视结束时对推荐疫苗的口头接受（所有vs >= 1拒绝）和父母访视经验（高评分vs低评分）。在多变量模型中，参与性（与假定性）启动形式与访视结束时接受所有疫苗的几率降低（调整后的比值比[AOR] = 0.04; 95%置信区间[CI] = 0.01，0.15）和高评价访视经历的几率增加（AOR = 17.3; 95% CI = 1.5，200.3）相关。在供应商用于启动疫苗讨论的2种一般沟通形式的背景下，父母对疫苗的接受程度与访视经验之间似乎存在反比关系。需要在纵向研究中进一步探索这种反向关系。
Objectives. We investigated how provider vaccine communication behaviors influence parental vaccination acceptance and visit experience.Methods. In a cross-sectional observational study, we videotaped provider-parent vaccine discussions (n = 111). We coded visits for the format providers used for initiating the vaccine discussion (participatory vs presumptive), parental verbal resistance to vaccines after provider initiation (yes vs no), and provider pursuit of recommendations in the face of parental resistance (pursuit vs mitigated or no pursuit). Main outcomes were parental verbal acceptance of recommended vaccines at visit's end (all vs >= 1 refusal) and parental visit experience (highly vs lower rated).Results. In multivariable models, participatory (vs presumptive) initiation formats were associated with decreased odds of accepting all vaccines at visit's end (adjusted odds ratio [AOR] = 0.04; 95% confidence interval [CI] = 0.01, 0.15) and increased odds of a highly rated visit experience (AOR = 17.3; 95% CI = 1.5, 200.3).Conclusions. In the context of 2 general communication formats used by providers to initiate vaccine discussions, there appears to be an inverse relationship between parental acceptance of vaccines and visit experience. Further exploration of this inverse relationship in longitudinal studies is needed.