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Aradottir L, Wellman L, Göransson C. Specialist nurse's health promotion work with the national childhood immunization programme: A qualitative study. J SPEC PEDIATR NURS 2024; 29:e12427. [PMID: 38779985 DOI: 10.1111/jspn.12427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Childhood immunizations have proven to be one of the most beneficial interventions to promote public health and prevent childhood deaths due to disease. However, global coverage of childhood immunization has decreased throughout the world due to guardians' growing hesitancy towards immunizations. This study aims to describe how specialist nurses promote legal guardians to adhere to national childhood immunization programmes. DESIGN AND METHODS This study had a qualitative design. Semistructured interviews with 11 specialist nurses, who were paediatric primary care nurses or nurse practitioners, were conducted. Data were analysed using qualitative content analysis. RESULTS The findings, with four main categories including four subcategories, showed nurses using both local guidelines and national guidelines to promote guardians to adhere to the childhood immunization programme. The main intervention the nurses did to promote childhood immunization coverage was giving legal guardians general information about the programme. With hesitant guardians, adopting a person-centred approach towards the legal guardian improved adherence. PRACTICE IMPLICATIONS Further research should focus on how specialist nurses can respond to guardians who decline immunization for their children, as this study identified difficulties in this area. Furthermore, research on guardians' perspectives towards childhood immunization may also help generate further effective guidance on how to promote immunization coverage among children.
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Affiliation(s)
- Louis Aradottir
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Linnea Wellman
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Carina Göransson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Thaker J, Albers AN, Newcomer SR. Nurses' perceptions, experiences, and practices regarding human papillomavirus vaccination: results from a cross-sectional survey in Montana. BMC Nurs 2023; 22:211. [PMID: 37337180 PMCID: PMC10278302 DOI: 10.1186/s12912-023-01379-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/13/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Nationally, much of the focus on improving human papillomavirus (HPV) vaccine uptake has been on effective strategies that physicians use to promote vaccination. However, in large, predominately rural states like Montana, nurses and medical assistants play critical roles in immunization services delivery, and their viewpoints are imperative in designing strategies to increase vaccination rates. We conducted a cross-sectional, descriptive study to determine nurses' perceptions, experiences, and practices regarding human papillomavirus vaccination in a rural and medically underserved region of the United States. METHODS We designed, pilot-tested, and disseminated an online survey instrument to nurses and medical assistants working in clinics participating in the Vaccines for Children program in Montana. The online surveys were administered from November 2020 to March 2021. Survey questions focused on clinic vaccination practices, respondents' perceptions of the HPV vaccine, perceived barriers to vaccine uptake, and general opinions on potential strategies to improve HPV vaccination rates. RESULTS We analyzed data from 227 respondents. Overall, 90% of nurses strongly agreed or agreed that the HPV vaccine is important and had confidence in the vaccine's safety. More nurses reported experiencing greater parental vaccine refusal or delay for male patients regardless of age. About 53.7% of nurses reported that their clinics had reminder/recall systems to encourage parents to bring their children for vaccination. Nurses identified misinformation from social media, infrequent wellness visits, and vaccine safety concerns as barriers to HPV vaccine uptake. CONCLUSIONS Study findings identified several promising initiatives to accelerate vaccination in primarily rural states like Montana, including promoting widespread adoption of reminder/recall systems, training nurses in evidence-based techniques to provide strong vaccine recommendations, and leveraging social media to disseminate consistent messages about the HPV vaccine recommendations for both sexes and its role in cancer prevention.
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Affiliation(s)
- Juthika Thaker
- School of Public and Community Health Sciences, The University of Montana, 32 Campus Drive, Skaggs 173, Missoula, MT, 59803, USA.
- Center for Population Health Research, The University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA.
| | - Alexandria N Albers
- School of Public and Community Health Sciences, The University of Montana, 32 Campus Drive, Skaggs 173, Missoula, MT, 59803, USA
- Center for Population Health Research, The University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Sophia R Newcomer
- School of Public and Community Health Sciences, The University of Montana, 32 Campus Drive, Skaggs 173, Missoula, MT, 59803, USA
- Center for Population Health Research, The University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
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Lucas Ramanathan P, Baldesberger N, Dietrich LG, Speranza C, Lüthy A, Buhl A, Gisin M, Koch R, Nicca D, Suggs LS, Huber BM, Deml MJ, Tarr PE. Health Care Professionals' Interest in Vaccination Training in Switzerland: A Quantitative Survey. Int J Public Health 2022; 67:1604495. [PMID: 36531605 PMCID: PMC9749818 DOI: 10.3389/ijph.2022.1604495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/14/2022] [Indexed: 08/27/2023] Open
Abstract
Objectives: Health care professionals (HCPs) play an important role for patients' vaccination decisions. To counsel patients/clients appropriately, HCPs need current factual knowledge about vaccines and strong communication skills. Methods: We conducted an online survey with physicians, pharmacists, nurses, and midwives in Switzerland (01.11.2020-31.03.2021). We evaluated: 1) interest in vaccination knowledge and counseling training; 2) vaccination recommendation practices; 3) experience with vaccination counseling/administration; 4) comfort level in addressing vaccine hesitancy (VH); 5) perspectives on patient/client VH, delays, and refusals. Results: In total, 1,933 practicing HCPs responded (496 physicians, 226 pharmacists, 607 nurses, 604 midwives). 43% physicians, 31% pharmacists, 15% nurses, and 23% midwives felt comfortable counseling VH patients/clients. 96% physicians, 98% pharmacists, 85% nurses, and 91% midwives were interested in additional vaccination-related training. All professionals mentioned safety, efficacy, and side effects as topics of most interest for additional training. Conclusion: Results demonstrate a high interest among HCPs for additional vaccination-related training. In addition to factual information about vaccination, such training will likely benefit from a communication component, given the low rates of comfort reported by HCPs when counseling VH patients/clients.
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Affiliation(s)
- Pia Lucas Ramanathan
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
- Pharmaceutical Care Research Group, Basel, Switzerland
| | - Nadja Baldesberger
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
- Pharmaceutical Care Research Group, Basel, Switzerland
| | - Léna G. Dietrich
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
| | - Camilla Speranza
- Institute of Public Health, and Institute of Communication and Public Policy, Università della Svizzera italiana, Lugano, Switzerland
| | - Alyssa Lüthy
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
| | - Andrea Buhl
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
| | - Martina Gisin
- Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland
| | | | - Dunja Nicca
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - L. Suzanne Suggs
- Institute of Public Health, and Institute of Communication and Public Policy, Università della Svizzera italiana, Lugano, Switzerland
- Swiss School of Public Health, Zurich, Switzerland
| | - Benedikt M. Huber
- Center for Integrative Pediatrics, Department of Pediatrics, Fribourg Hospital HFR, Fribourg, Switzerland
- Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Michael J. Deml
- Institute of Sociological Research, Department of Sociology, University of Geneva, Geneva, Switzerland
| | - Philip E. Tarr
- University Department of Medicine and Infectious Diseases Service, Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
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Abstract
PURPOSE OF REVIEW We reviewed the literature about parental vaccine hesitancy, focusing on publications from October 2019 to April 2021 to describe patterns and causes of hesitancy and interventions to address hesitancy. RECENT FINDINGS Recent studies expand understanding of the prevalence of vaccine hesitancy globally and highlight associated individual and contextual factors. Common concerns underlying hesitancy include uncertainty about the need for vaccination and questions about vaccine safety and efficacy. Sociodemographic factors associated with parental vaccine hesitancy vary across locations and contexts. Studies about psychology of hesitancy and how parents respond to interventions highlight the role of cognitive biases, personal values, and vaccination as a social contract or norm. Evidence-based strategies to address vaccine hesitancy include presumptive or announcement approaches to vaccine recommendations, motivational interviewing, and use of immunization delivery strategies like standing orders and reminder/recall programs. A smaller number of studies support use of social media and digital applications to improve vaccination intent. Strengthening school vaccine mandates can improve vaccination rates, but policy decisions must consider local context. SUMMARY Vaccine hesitancy remains a challenge for child health. Future work must include more interventional studies to address hesitancy and regular global surveillance of parental vaccine hesitancy and vaccine content on social media.
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Affiliation(s)
- Jessica R Cataldi
- Department of Pediatrics, University of Colorado School of Medicine
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Sean T O'Leary
- Department of Pediatrics, University of Colorado School of Medicine
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
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