title: A cluster randomised controlled trial of a web based decision aid to support parents' decisions about their child's Measles Mumps and Rubella (MMR) vaccination.
abstract: OBJECTIVE
  To evaluate the effectiveness of a web based decision aid versus a leaflet versus, usual practice in reducing parents' decisional conflict for the first dose MMR vaccination decision. The, impact on MMR vaccine uptake was also explored.
  
  
  METHODS
  Three-arm cluster randomised controlled trial.
  
  
  METHODS
  Fifty GP practices in the north of, England.
  
  
  METHODS
  220 first time parents making a first dose MMR decision.
  
  
  METHODS
  Web, based MMR decision aid plus usual practice, MMR leaflet plus usual practice versus usual practice only, (control).
  
  
  METHODS
  Decisional conflict was the primary outcome and used as the, measure of parents' levels of informed decision-making. MMR uptake was a secondary outcome.
  
  
  RESULTS
  Decisional conflict decreased post-intervention for both intervention arms to a level where, parents could make an informed MMR decision (decision aid: effect estimate=1.09, 95% CI -1.36 to -0.82; information leaflet: effect estimate=-0.67, 95% CI -0.88 to -0.46). Trial arm was significantly, associated (p<0.001) with decisional conflict at post-intervention. Vaccination uptake was 100%, 91%, and 99% in the decision aid, leaflet and control arms, respectively (χ(2) (1, N=203)=8.69; p=0.017). Post-hoc tests revealed a statistically significant difference in uptake between the information leaflet, and the usual practice arms (p=0.04), and a near statistically significant difference between the, decision aid and leaflet arms (p=0.05).
  
  
  CONCLUSIONS
  Parents' decisional conflict was reduced in both, the decision aid and leaflet arms. The decision aid also prompted parents to act upon that decision and, vaccinate their child. Achieving both outcomes is fundamental to the integration of immunisation, decision aids within routine practice.
  
  
  BACKGROUND
  ISRCTN72521372.
authors.affiliation: School of Healthcare, University of Leeds, Leeds LS2 9UT, UK.
authors.forename: S
authors.initials: S
authors.lastname: Shourie
authors.forename: C
authors.initials: C
authors.lastname: Jackson
authors.forename: F M
authors.initials: FM
authors.lastname: Cheater
authors.forename: H L
authors.initials: HL
authors.lastname: Bekker
authors.forename: R
authors.initials: R
authors.lastname: Edlin
authors.forename: S
authors.initials: S
authors.lastname: Tubeuf
authors.forename: W
authors.initials: W
authors.lastname: Harrison
authors.forename: E
authors.initials: E
authors.lastname: McAleese
authors.forename: M
authors.initials: M
authors.lastname: Schweiger
authors.forename: B
authors.initials: B
authors.lastname: Bleasby
authors.forename: L
authors.initials: L
authors.lastname: Hammond
mesh_terms: D000328:Adult; D003661:Decision Support Techniques; D004739:England; D005260:Female; D006801:Humans; D007223:Infant; D020407:Internet; D008297:Male; D008457:Measles / Q000517:prevention & control*; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage*; D009107:Mumps / Q000517:prevention & control*; D010290:Parents; D012409:Rubella / Q000517:prevention & control*; D014611:Vaccination / Q000379:methods*
chemical_list: D022542:Measles-Mumps-Rubella Vaccine
keywords: Decision aid; Decisional conflict; Leaflet; MMR; Measles