title: Managing controversy through consultation: a qualitative study of communication and trust around MMR vaccination decisions.
abstract: BACKGROUND
  Controversy over the measles, mumps, and rubella (MMR) vaccine has reduced uptake, raising concerns of a future disease epidemic.
  
  
  OBJECTIVE
  To explore parents' accounts of decision making relating to the MMR vaccine controversy, identifying uptake determinants and education needs.
  
  
  METHODS
  Qualitative interviews analysed using the 'framework' approach.
  
  
  METHODS
  Five general practices in the Leeds area, 2002-2003.
  
  
  METHODS
  Sixty-nine interviews conducted with parents of children aged between 4 and 5 years, and 12 interviews with primary care practitioners, managers and immunisation coordinators serving participating sites. Participants were interviewed one-to-one in a place of their choice.
  
  
  RESULTS
  The vaccination decision is primarily a function of parental assessments of the relative acceptability and likelihood of possible outcomes. For most parents the evidence of science and medicine plays little role in the decision. Although local general practitioners and health visitors are trusted information sources, the influence of primary care providers on the vaccination decision is limited by concerns over consultation legitimacy, discussion opportunity, and perceptions of financial and political partiality. Parents and practitioners identify a need for new approaches to support decisions and learning when faced with this and similar healthcare controversies. These include new collaborative approaches to information exchange designed to transform rather than supplant existing parent knowledge as part of an ongoing learning process.
  
  
  CONCLUSIONS
  The study identified new ways in which parents and practitioners need to be supported in order to increase understanding of medical science and secure more informed decisions in the face of health controversy.
authors.affiliation: Durham Business School, University of Durham. r.m.mcmurray@durham.ac.uk
authors.forename: Robert
authors.initials: R
authors.lastname: McMurray
authors.forename: Francine M
authors.initials: FM
authors.lastname: Cheater
authors.forename: Anna
authors.initials: A
authors.lastname: Weighall
authors.forename: Carolyn
authors.initials: C
authors.lastname: Nelson
authors.forename: Martin
authors.initials: M
authors.lastname: Schweiger
authors.forename: Suzanne
authors.initials: S
authors.lastname: Mukherjee
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003142:Communication; D003657:Decision Making; D004739:England; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine; D010290:Parents / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011639:Public Opinion; D035502:Trust / Q000523:psychology*; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D022542:Measles-Mumps-Rubella Vaccine