Online Program

Collaborative patient-provider communication maximizes adolescent vaccination

Monday, November 2, 2015 : 9:15 a.m. - 9:30 a.m.

Jennifer Moss, PhD, MSPH, Surveillance Research Program, National Cancer Institute, Bethesda, MD
Barbara Rimer, DrPH, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
Noel Brewer, PhD, Department of Health Behavior, University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC
Background. Ethical and empirical literatures offer diverging recommendations on whether a collaborative or directive patient-provider communication style is ideal for promoting routine vaccination. Charles and Gafni (1997; 2006) suggested that collaborative communication, including information exchange, deliberation, and decision, is associated with optimal health outcomes. We examined the hypothesis that vaccination would be more common among adolescents whose parents reported that providers used a more collaborative communication style compared to other styles.

Methods. Using 2010 National Immunization Survey-Teen data, we examined coverage of tetanus, diphtheria, and pertussis booster (Tdap), meningococcal vaccine, and human papillomavirus (HPV) vaccine among adolescents ages 13-17. Then, we categorized conversations about vaccines with healthcare providers by the degree of collaboration (minimal, intermediate, optimal) according to whether or not they included information exchange, deliberation, and decision. We measured HPV vaccine initiation among adolescent females only since the U.S. only recommended routine HPV vaccination for males in 2011.

Results. Parents most frequently reported that providers used an optimally collaborative communication style (Tdap: 46%; meningococcal vaccine: 40%; HPV vaccine: 53%). Compared to minimal collaboration with providers, uptake was higher when parents reported intermediate collaboration (Tdap: odds ratio [OR] =1.50, 95% confidence interval [CI] =1.09, 2.05; HPV vaccine: OR=1.68, 95% CI=1.00, 2.84) or optimal collaboration (meningococcal vaccine: OR=1.63, 95% CI=1.22, 2.18; HPV vaccine: OR=1.86, 95% CI=1.42, 2.42)

Conclusions. Parents’ perceptions about the degree of collaboration with healthcare providers in discussions about adolescent vaccines influence vaccine uptake. Physician education about how to discuss vaccines collaboratively with adolescent patients and their parents could improve coverage with recommended vaccines.

Learning Areas:

Administer health education strategies, interventions and programs
Communication and informatics
Ethics, professional and legal requirements
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify three components of collaborative patient-provider communication. Describe the relationship between providers’ communication style and adolescent vaccination.

Keyword(s): Adolescents, Immunizations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have studied adolescent vaccination for five years (10 peer-reviewed publication). One of my areas of interest around adolescent vaccination is the way providers discuss adolescent vaccines (especially how they discuss the three recommended vaccines differently) and the effects on uptake.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.