title: How do Midwives and Physicians Discuss Childhood Vaccination with Parents?
abstract: Even if vaccination is often described as one of the great achievements of public health, results of recent studies have shown that parental acceptance of vaccination is eroding. Health providers' knowledge and attitudes about vaccines are important determinants of their own vaccine uptake, their intention to recommend vaccines to patients and the vaccine uptake of their patients. The purpose of this article is to compare how midwives and physicians address vaccination with parents during pregnancy and in postpartum visits. Thirty semi-structured interviews were conducted with midwives and physicians practicing in the province of Quebec, Canada. Results of our analysis have shown that physicians adopt an "education-information" stance when discussing vaccination with parents in the attempt to "convince" parents to vaccinate. In contrast, midwives adopted a neutral stance and gave information on the pros and cons of vaccination to parents while leaving the final decision up to them. Findings of this study highlight the fact that physicians and midwives have different views regarding their role and responsibilities concerning vaccination. It may be that neither of these approaches is optimal in promoting vaccination uptake.
authors.affiliation: Quebec National Institute of Public Health, Quebec G1E 7G9, Canada. eve.dube@inspq.qc.ca.|Laval University Hospital Research Center, Quebec G1V 4G5, Canada. eve.dube@inspq.qc.ca.
authors.forename: Eve
authors.initials: E
authors.lastname: Dubé
authors.affiliation: Quebec National Institute of Public Health, Quebec G1E 7G9, Canada. maryline.vivion@inspq.qc.ca.
authors.forename: Maryline
authors.initials: M
authors.lastname: Vivion
authors.affiliation: Quebec National Institute of Public Health, Quebec G1E 7G9, Canada. chantal.sauvageau@inspq.qc.ca.|Laval University Hospital Research Center, Quebec G1V 4G5, Canada. chantal.sauvageau@inspq.qc.ca.
authors.forename: Chantal
authors.initials: C
authors.lastname: Sauvageau
authors.affiliation: Department of Pediatrics, Étienne Le-Bel Research Center of Sherbrooke University Hospital, Quebec J1H 5N4, Canada. arnaud.gagneur@usherbrooke.ca.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Gagneur
authors.affiliation: University at Trois-Rivières, Quebec G9A 5H7, Canada. raymonde.gagnon@uqtr.ca.
authors.forename: Raymonde
authors.initials: R
authors.lastname: Gagnon
authors.affiliation: Quebec National Institute of Public Health, Quebec G1E 7G9, Canada. maryse.guay.agence16@ssss.gouv.qc.ca.
authors.forename: Maryse
authors.initials: M
authors.lastname: Guay
keywords: Canada; attitudes; decision-making; knowledge; midwives; physicians; practices; vaccination