Articlehybrid2005

Effects of a web based decision aid on parental attitudes to MMR vaccination: a before and after study

Cate Wallace · Julie Leask · Lyndal Jane Trevena

101 citations0/0 files storedBMJ

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Vaccine Coverage and Hesitancy Patient-Provider Communication in Healthcare Ethics and Legal Issues in Pediatric Healthcare

Abstract

OBJECTIVE: To determine whether an evidence based decision aid on the measles, mumps, and rubella (MMR) vaccine changed parents' attitudes towards vaccination. DESIGN: Before and after study. SETTING: Website promoted through search engines and online parenting and health websites. PARTICIPANTS: 158 people completing online questions out of 1277 who accessed the website. INTERVENTION: Evidence based decision aid with text and graphical representation of the possible outcomes of measles, mumps, and rubella diseases compared with MMR vaccination. MAIN OUTCOME MEASURES: Attitudes towards MMR vaccination. RESULTS: Significantly more participants indicated they were "leaning towards" vaccination after using the decision aid (39% before v 55% after, P < 0.001). Compared with those who were undecided or "leaning away from" vaccination after using the decision aid, participants "leaning towards" it were more likely to strongly value its potential to protect their children from the serious side effects of disease (98% v 84%) and other children who could not be vaccinated for medical reasons (68% v 25%). Participants with an unfavourable attitude to vaccination were more likely to be very concerned about the rare side effects of vaccination (78% v 57%), have residual concerns about autism and bowel disease (78% v 27%), and anticipate guilt should their child have an adverse reaction (77% v 50%). Those with a positive attitude to vaccination after using the decision aid were also more likely to feel well informed (83% v 48%). CONCLUSIONS: A web based decision aid significantly improved parental attitudes to MMR vaccination. Residual concerns about autism and bowel disease and the rare chance of serious complications remained as attitudinal barriers to some parents.

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References

2003Culture, Media, Language 1982Culture, Media, Language 1990Reluctance to vaccinate: Omission bias and ambiguity 1999Protected Values and Omission Bias 1995Outcome Knowledge, Regret, and Omission Bias 2004Understanding and Predicting Parental Decisions About Early Childhood Immunizations.2001Choosing not to immunize: are parents making informed decisions?

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2011More support for mothers: a qualitative study on factors affecting immunisation behaviour in Kampala, Uganda 2012The Role of Herd Immunity in Parents’ Decision to Vaccinate Children: A Systematic Review 2017The Immunity Community: A Community Engagement Strategy for Reducing Vaccine Hesitancy 2023Behavioral interventions for vaccination uptake: A systematic review and meta-analysis 2013A cluster randomised controlled trial of a web based decision aid to support parents’ decisions about their child's Measles Mumps and Rubella (MMR) vaccination 2014Personal attitudes and misconceptions, not official recommendations guide occupational physicians’ vaccination decisions

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