title: Randomised cluster trial to support informed parental decision-making for the MMR vaccine.
abstract: BACKGROUND
  In the UK public concern about the safety of the combined measles, mumps and rubella [MMR] vaccine continues to impact on MMR coverage. Whilst the sharp decline in uptake has begun to level out, first and second dose uptake rates remain short of that required for population immunity. Furthermore, international research consistently shows that some parents lack confidence in making a decision about MMR vaccination for their children. Together, this work suggests that effective interventions are required to support parents to make informed decisions about MMR. This trial assessed the impact of a parent-centred, multi-component intervention (balanced information, group discussion, coaching exercise) on informed parental decision-making for MMR.
  
  
  METHODS
  This was a two arm, cluster randomised trial. One hundred and forty two UK parents of children eligible for MMR vaccination were recruited from six primary healthcare centres and six childcare organisations. The intervention arm received an MMR information leaflet and participated in the intervention (parent meeting). The control arm received the leaflet only. The primary outcome was decisional conflict. Secondary outcomes were actual and intended MMR choice, knowledge, attitude, concern and necessity beliefs about MMR and anxiety.
  
  
  RESULTS
  Decisional conflict decreased for both arms to a level where an 'effective' MMR decision could be made one-week (effect estimate = -0.54, p < 0.001) and three-months (effect estimate = -0.60, p < 0.001) post-intervention. There was no significant difference between arms (effect estimate = 0.07, p = 0.215). Heightened decisional conflict was evident for parents making the MMR decision for their first child (effect estimate = -0.25, p = 0.003), who were concerned (effect estimate = 0.07, p < 0.001), had less positive attitudes (effect estimate = -0.20, p < 0.001) yet stronger intentions (effect estimate = 0.09, p = 0.006). Significantly more parents in the intervention arm reported vaccinating their child (93% versus 73%, p = 0.04).
  
  
  CONCLUSIONS
  Whilst both the leaflet and the parent meeting reduced parents' decisional conflict, the parent meeting appeared to enable parents to act upon their decision leading to vaccination uptake.
authors.affiliation: Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Cath
authors.initials: C
authors.lastname: Jackson
authors.forename: Francine M
authors.initials: FM
authors.lastname: Cheater
authors.forename: Wendy
authors.initials: W
authors.lastname: Harrison
authors.forename: Rose
authors.initials: R
authors.lastname: Peacock
authors.forename: Hilary
authors.initials: H
authors.lastname: Bekker
authors.forename: Robert
authors.initials: R
authors.lastname: West
authors.forename: Brenda
authors.initials: B
authors.lastname: Leese
mesh_terms: D016000:Cluster Analysis; D003657:Decision Making; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data; D007407:Interviews as Topic; D022542:Measles-Mumps-Rubella Vaccine / Q000627:therapeutic use*; D010290:Parents; D011795:Surveys and Questionnaires; D006113:United Kingdom
chemical_list: D022542:Measles-Mumps-Rubella Vaccine