title: Improving vaccine risk/benefit communication with an immunization education package: a pilot study.
abstract: BACKGROUND
  The National Childhood Vaccine Injury Act (NCVIA) requires that physicians distribute the appropriate Vaccine Information Statements (VIS) at each immunization visit and discuss the risks/benefits of every vaccine given. In a national study, 31% of pediatricians reported not using the VIS and 56% indicated that time was a barrier to vaccine risk/benefit communication. Parents, however, indicated they want their primary providers to personally tell them about risks/benefits.
  
  
  OBJECTIVE
  To test the feasibility of an Immunization Education Package (IEP) intervention to improve compliance with the federal mandate and to improve physician/parent vaccine risk/benefit communication.
  
  
  METHODS
  Two multi-physician private pediatric practices in Shreveport, La.
  
  
  METHODS
  A before-after trial with comparison of 130 pre-intervention and 78 post-intervention visits. Research assistants recorded content and duration of immunization discussions during well-baby visits during which immunizations were scheduled. Clinic staffs were masked as to variables recorded.
  
  
  METHODS
  The IEP was a multifaceted intervention, involving a practice-based in-service and distribution and discussion of ready-to-use materials including an exam room poster entitled "7 Questions Parents Need To Ask About Baby Shots."
  
  
  RESULTS
  Patients were 90% white and 96% privately insured. Pre and post results revealed a significant increase in VIS distribution (33% vs 91%, P <.001) and physician and nurse initiation of verbal teaching about the vaccine (65% vs 100%, 32% vs 72%, respectively; P <.001 for both), and parent initiation of questions (0% vs 32%, P <.001). A significant increase was found in the discussion of 6 of 8 major immunization IEP topics: contraindications, common side effects, treatment of common side effects, severe side effects, management of severe side effects, and schedule of the next vaccination. These vaccine communication improvements were made with a very small (20-s) increase in physician time. In post-intervention focus groups, provider staff endorsed the IEP method.
  
  
  CONCLUSIONS
  This IEP was a feasible way to facilitate compliance with the NCVIA. A significant amount of additional information was provided to parents with only a slight increase in time.
authors.affiliation: Louisiana State University Health Sciences Center-Shreveport, Department of Pediatrics, 71130, USA. tdavis1@lsuhsc.edu
authors.forename: Terry C
authors.initials: TC
authors.lastname: Davis
authors.forename: Doren D
authors.initials: DD
authors.lastname: Fredrickson
authors.forename: Claire
authors.initials: C
authors.lastname: Bocchini
authors.forename: Connie L
authors.initials: CL
authors.lastname: Arnold
authors.forename: Kristen W
authors.initials: KW
authors.lastname: Green
authors.forename: Sharon G
authors.initials: SG
authors.lastname: Humiston
authors.forename: Errol
authors.initials: E
authors.lastname: Wilder
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Bocchini
mesh_terms: D000328:Adult; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D010865:Pilot Projects; D011368:Professional-Family Relations; D018570:Risk Assessment; D014611:Vaccination