title: Physician Communication Training and Parental Vaccine Hesitancy: A Randomized Trial.
abstract: OBJECTIVE
  Physicians have a major influence on parental vaccine decisions. We tested a physician-targeted communication intervention designed to (1) reduce vaccine hesitancy in mothers of infants seen by trained physicians and (2) increase physician confidence in communicating about vaccines.
  
  
  METHODS
  We conducted a community-based, clinic-level, 2-arm cluster randomized trial in Washington State. Intervention clinics received physician-targeted communications training. We enrolled mothers of healthy newborns from these clinics at the hospital of birth. Mothers and physicians were surveyed at baseline and 6 months. The primary outcome was maternal vaccine hesitancy measured by Parental Attitudes on Childhood Vaccines score; secondary outcome was physician self-efficacy in communicating with parents by using 3 vaccine communication domains.
  
  
  RESULTS
  We enrolled 56 clinics and 347 mothers. We conducted intervention trainings at 30 clinics, reaching 67% of eligible physicians; 26 clinics were randomized to the control group. Maternal vaccine hesitancy at baseline and follow-up changed from 9.8% to 7.5% in the intervention group and 12.6% to 8.0% in the control group. At baseline, groups were similar on all variables except maternal race and ethnicity. The intervention had no detectable effect on maternal vaccine hesitancy (adjusted odds ratio 1.22, 95% confidence interval 0.47-2.68). At follow-up, physician self-efficacy in communicating with parents was not significantly different between intervention and control groups.
  
  
  CONCLUSIONS
  This physician-targeted communication intervention did not reduce maternal vaccine hesitancy or improve physician self-efficacy. Research is needed to identify physician communication strategies effective at reducing parental vaccine hesitancy in the primary care setting.
authors.affiliation: Group Health Research Institute, Seattle, Washington; henrikson.n@ghc.org.
authors.forename: Nora B
authors.initials: NB
authors.lastname: Henrikson
authors.affiliation: Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington; Departments of Pediatrics, and.
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Opel
authors.affiliation: Group Health Research Institute, Seattle, Washington;
authors.forename: Lou
authors.initials: L
authors.lastname: Grothaus
authors.affiliation: Group Health Research Institute, Seattle, Washington;
authors.forename: Jennifer
authors.initials: J
authors.lastname: Nelson
authors.affiliation: Group Health Research Institute, Seattle, Washington;
authors.forename: Aaron
authors.initials: A
authors.lastname: Scrol
authors.affiliation: Group Health Research Institute, Seattle, Washington;
authors.forename: John
authors.initials: J
authors.lastname: Dunn
authors.affiliation: WithinReach, Seattle, Washington; and.
authors.forename: Todd
authors.initials: T
authors.lastname: Faubion
authors.affiliation: State of Washington, Department of Health, Seattle, Washington.
authors.forename: Michele
authors.initials: M
authors.lastname: Roberts
authors.affiliation: Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington; Departments of Pediatrics, and.
authors.forename: Edgar K
authors.initials: EK
authors.lastname: Marcuse
authors.affiliation: Group Health Research Institute, Seattle, Washington; Departments of Pediatrics, and Health Services, University of Washington, Seattle, Washington;
authors.forename: David C
authors.initials: DC
authors.lastname: Grossman
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010290:Parents / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D011368:Professional-Family Relations; D014611:Vaccination / Q000523:psychology*; D014612:Vaccines; D014861:Washington
chemical_list: D014612:Vaccines