title: The Influence of Provider Communication Behaviors on Parental Vaccine Acceptance and Visit Experience.
abstract: OBJECTIVE
  We investigated how provider vaccine communication behaviors influence parental vaccination acceptance and visit experience.
  
  
  METHODS
  In a cross-sectional observational study, we videotaped provider-parent vaccine discussions (n = 111). We coded visits for the format providers used for initiating the vaccine discussion (participatory vs presumptive), parental verbal resistance to vaccines after provider initiation (yes vs no), and provider pursuit of recommendations in the face of parental resistance (pursuit vs mitigated or no pursuit). Main outcomes were parental verbal acceptance of recommended vaccines at visit's end (all vs ≥ 1 refusal) and parental visit experience (highly vs lower rated).
  
  
  RESULTS
  In multivariable models, participatory (vs presumptive) initiation formats were associated with decreased odds of accepting all vaccines at visit's end (adjusted odds ratio [AOR] = 0.04; 95% confidence interval [CI] = 0.01, 0.15) and increased odds of a highly rated visit experience (AOR = 17.3; 95% CI = 1.5, 200.3).
  
  
  CONCLUSIONS
  In the context of 2 general communication formats used by providers to initiate vaccine discussions, there appears to be an inverse relationship between parental acceptance of vaccines and visit experience. Further exploration of this inverse relationship in longitudinal studies is needed.
authors: Douglas J. Opel, Rita Mangione-Smith, Chuan Zhou, and James A. Taylor are with the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA. Jeffrey D. Robinson is with the Department of Communication, Portland State University, Portland, OR. John Heritage is with Department of Sociology, University of California, Los Angeles. Victoria DeVere and Halle S. Salas are with the Seattle Children's Research Institute, Seattle, WA.
authors: Douglas J
authors: DJ
authors: Opel
authors: Douglas J. Opel, Rita Mangione-Smith, Chuan Zhou, and James A. Taylor are with the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA. Jeffrey D. Robinson is with the Department of Communication, Portland State University, Portland, OR. John Heritage is with Department of Sociology, University of California, Los Angeles. Victoria DeVere and Halle S. Salas are with the Seattle Children's Research Institute, Seattle, WA.
authors: Rita
authors: R
authors: Mangione-Smith
authors: Douglas J. Opel, Rita Mangione-Smith, Chuan Zhou, and James A. Taylor are with the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA. Jeffrey D. Robinson is with the Department of Communication, Portland State University, Portland, OR. John Heritage is with Department of Sociology, University of California, Los Angeles. Victoria DeVere and Halle S. Salas are with the Seattle Children's Research Institute, Seattle, WA.
authors: Jeffrey D
authors: JD
authors: Robinson
authors: Douglas J. Opel, Rita Mangione-Smith, Chuan Zhou, and James A. Taylor are with the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA. Jeffrey D. Robinson is with the Department of Communication, Portland State University, Portland, OR. John Heritage is with Department of Sociology, University of California, Los Angeles. Victoria DeVere and Halle S. Salas are with the Seattle Children's Research Institute, Seattle, WA.
authors: John
authors: J
authors: Heritage
authors: Douglas J. Opel, Rita Mangione-Smith, Chuan Zhou, and James A. Taylor are with the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA. Jeffrey D. Robinson is with the Department of Communication, Portland State University, Portland, OR. John Heritage is with Department of Sociology, University of California, Los Angeles. Victoria DeVere and Halle S. Salas are with the Seattle Children's Research Institute, Seattle, WA.
authors: Victoria
authors: V
authors: DeVere
authors: Douglas J. Opel, Rita Mangione-Smith, Chuan Zhou, and James A. Taylor are with the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA. Jeffrey D. Robinson is with the Department of Communication, Portland State University, Portland, OR. John Heritage is with Department of Sociology, University of California, Los Angeles. Victoria DeVere and Halle S. Salas are with the Seattle Children's Research Institute, Seattle, WA.
authors: Halle S
authors: HS
authors: Salas
authors: Douglas J. Opel, Rita Mangione-Smith, Chuan Zhou, and James A. Taylor are with the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA. Jeffrey D. Robinson is with the Department of Communication, Portland State University, Portland, OR. John Heritage is with Department of Sociology, University of California, Los Angeles. Victoria DeVere and Halle S. Salas are with the Seattle Children's Research Institute, Seattle, WA.
authors: Chuan
authors: C
authors: Zhou
authors: Douglas J. Opel, Rita Mangione-Smith, Chuan Zhou, and James A. Taylor are with the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA. Jeffrey D. Robinson is with the Department of Communication, Portland State University, Portland, OR. John Heritage is with Department of Sociology, University of California, Los Angeles. Victoria DeVere and Halle S. Salas are with the Seattle Children's Research Institute, Seattle, WA.
authors: James A
authors: JA
authors: Taylor
mesh_terms: D000328:Adult; D002648:Child; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D011368:Professional-Family Relations; D011795:Surveys and Questionnaires; D014611:Vaccination; D014861:Washington