Articlegreen2015

Risk Communication, Values Clarification, and Vaccination Decisions

Holly O. Witteman · Selma Chipenda Dansokho · Nicole L. Exe · Audrey Dupuis · Thierry Provencher · Brian J. Zikmund‐Fisher

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Vaccine Coverage and Hesitancy Patient-Provider Communication in Healthcare Risk Perception and Management

Abstract

Many health-related decisions require choosing between two options, each with risks and benefits. When presented with such tradeoffs, people often make choices that fail to align with scientific evidence or with their own values. This study tested whether risk communication and values clarification methods could help parents and guardians make evidence-based, values-congruent decisions about children's influenza vaccinations. In 2013-2014 we conducted an online 2×2 factorial experiment in which a diverse sample of U.S. parents and guardians (n = 407) were randomly assigned to view either standard information about influenza vaccines or risk communication using absolute and incremental risk formats. Participants were then either presented or not presented with an interactive values clarification interface with constrained sliders and dynamic visual feedback. Participants randomized to the risk communication condition combined with the values clarification interface were more likely to indicate intentions to vaccinate (β = 2.10, t(399) = 2.63, p < 0.01). The effect was particularly notable among participants who had previously demonstrated less interest in having their children vaccinated against influenza (β = -2.14, t(399) = -2.06, p < 0.05). When assessing vaccination status reported by participants who agreed to participate in a follow-up study six months later (n = 116), vaccination intentions significantly predicted vaccination status (OR = 1.66, 95%CI (1.13, 2.44), p < 0.05) and rates of informed choice (OR = 1.51, 95%CI (1.07, 2.13), p < 0.012), although there were no direct effects of experimental factors on vaccination rates. Qualitative analysis suggested that logistical barriers impeded immunization rates. Risk communication and values clarification methods may contribute to increased vaccination intentions, which may, in turn, predict vaccination status if logistical barriers are also addressed.

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References

1991The theory of planned behavior 2013Vaccine hesitancy 2005Affect, risk, and decision making.2011Addressing the vaccine confidence gap 2008Parents With Doubts About Vaccines: Which Vaccines and Reasons Why 2008A Theory of Medical Decision Making and Health: Fuzzy Trace Theory 2013The Architecture of Provider-Parent Vaccine Discussions at Health Supervision Visits 2010The Influence of Vaccine-critical Websites on Perceiving Vaccination Risks

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2019A Values-Tailored Web-Based Intervention for New Mothers to Increase Infant Vaccine Uptake: Development and Qualitative Study 2021A systematic review and meta-analysis of effectiveness of decision aids for vaccination decision-making 2015Addressing Vaccine Hesitancy With Values 2017Using campaigns to improve perceptions of the value of adult vaccination in the United States: Health communication considerations and insights 2022The intersection of gender and race in older adults’ decision to receive COVID-19 vaccines

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