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Garrison A, Fressard L, Mitilian E, Gosselin V, Berthiaume P, Casanova L, Gagneur A, Verger P. Motivational interview training improves self-efficacy of GP interns in vaccination consultations: A study using the Pro-VC-Be to measure vaccine confidence determinants. Hum Vaccin Immunother 2023; 19:2163809. [PMID: 36703495 PMCID: PMC10012912 DOI: 10.1080/21645515.2022.2163809] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Immunization-specific motivational interviewing (MI), a patient-centered communication style used to encourage internal motivation for attitudinal and behavioral change, can provide healthcare professionals (HCPs) with the skills and practice required to respond to patients' doubts and concerns related to vaccines. We sought to assess the impact of an MI-training of General Practitioner (GP) interns on the psychosocial determinants of their vaccine confidence and behaviors. French GP interns participated in a virtual three-day MI-workshop in southeastern France. We used the validated Pro-VC-Be questionnaire - before and after the MI-workshop spanning over three months - to measure the evolution of these determinants. Scores before and after workshop trainings were compared in pairs. Participants' scores for commitment to vaccination (+10.5 ± 20.5, P = .001), perceived self-efficacy (+36.0 ± 25.8, P < .0001), openness to patients (+18.7 ± 17.0, P < .0001), and trust in authorities (+9.5 ± 17.2, P = 0.01) significantly increased after the training sessions, but not the score for confidence in vaccines (+1.5 ± 11.9, P = .14). The effect sizes of the four score improvements were moderate to large, with self-efficacy and openness to patients having the largest effect sizes (P = .83 and 0.78, respectively). This study provides evidence that certain determinants of overall vaccine confidence in HCPs, reflected respectively in the openness to patients and self-efficacy scores of the Pro-VC-Be, improve after immunization MI-training workshops. Incorporating immunization-specific MI-training in the curriculum for HCPs could improve several necessary skills to improve HCP-patient relationships and be useful for vaccination and other healthcare services.
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Affiliation(s)
- Amanda Garrison
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
| | - Lisa Fressard
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
| | - Eva Mitilian
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France.,Faculté des Sciences Médicales et Paramédicales, Département Universitaire de Médecine Générale (DUMG), Aix Marseille Université, Marseille, France
| | - Virginie Gosselin
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | | | - Ludovic Casanova
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France.,Faculté des Sciences Médicales et Paramédicales, Département Universitaire de Médecine Générale (DUMG), Aix Marseille Université, Marseille, France
| | - Arnaud Gagneur
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.,Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Pierre Verger
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
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Verger P, Cogordan C, Fressard L, Gosselin V, Donato X, Biferi M, Verlomme V, Sonnier P, Meur H, Malfait P, Berthiaume P, Ramalli L, Gagneur A. A postpartum intervention for vaccination promotion by midwives using motivational interviews reduces mothers' vaccine hesitancy, south-eastern France, 2021 to 2022: a randomised controlled trial. Euro Surveill 2023; 28:2200819. [PMID: 37733238 PMCID: PMC10515496 DOI: 10.2807/1560-7917.es.2023.28.38.2200819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/17/2023] [Indexed: 09/22/2023] Open
Abstract
BackgroundDespite childhood vaccine mandates imposed in 2018 in France, parental vaccine hesitancy (VH) remains frequent. Interventions in Quebec, Canada, applying motivational interviewing (MI) techniques have successfully reduced parents' VH for childhood immunisations.AimTo determine whether MI intervention for mothers in maternity wards in the days after birth in France could significantly reduce VH, increase intentions to vaccinate (VI) their child at 2 months and reduce VH social inequalities.MethodsWe conducted a parallel-arm multicentre randomised controlled trial from November 2021 to April 2022 to compare impacts of MI performed by MI-trained midwives (intervention) vs a vaccination leaflet (control). We included 733 mothers from two maternity hospitals in south-eastern France, randomly assigned either arm. The validated Parents Attitudes about Childhood Vaccines questionnaire was used before and after MI or leaflet to assess mothers' VH (13 items, 0-100 score) and VI (1 item, 1-10 score). Difference-in-difference (D-I-D) models were used to estimate net impact of MI vs leaflet for the entire sample and stratified by VH and education level.ResultsMotivational interview intervention reduced mothers' VH score by 33% (p < 0.0001) and increased VI by 8% (p < 0.0001); the effect was largest for the highest initial VH levels. D-I-D analyses estimated net VH decrease at 5.8/100 points (p = 0.007) and net VI increase at 0.6/10 points (p = 0.005). Net VH decrease was highest for high initial VH levels and low education levels.ConclusionsOur results show positive effects of MI intervention, and means of its implementation should be investigated in France.
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Affiliation(s)
- Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Chloé Cogordan
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Lisa Fressard
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | | | - Xavier Donato
- Maternity ward, Saint-Joseph Hospital, Marseille, France
| | | | | | - Pierre Sonnier
- Comité Régional d'Education pour la Santé Provence-Alpes-Côte-D'Azur, Marseille, France
| | - Hervé Meur
- Agence Régionale de Santé Provence-Alpes-Côte-D'Azur, Marseille, France
| | - Philippe Malfait
- Santé publique France (French National Public Health Agency), Marseille, France
| | | | - Lauriane Ramalli
- Santé publique France (French National Public Health Agency), Marseille, France
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Cogordan C, Fressard L, Ramalli L, Rebaudet S, Malfait P, Dutrey-Kaiser A, Attalah Y, Roy D, Berthiaume P, Gagneur A, Verger P. Motivational interview-based health mediator interventions increase intent to vaccinate among disadvantaged individuals. Hum Vaccin Immunother 2023; 19:2261687. [PMID: 37772602 PMCID: PMC10543359 DOI: 10.1080/21645515.2023.2261687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/19/2023] [Indexed: 09/30/2023] Open
Abstract
Coverage for recommended COVID-19 and diphtheria-tetanus-poliomyelitis (DTP) booster shots is often inadequate, especially among disadvantaged populations. To help health mediators (HMs) involved in outreach programs deal with the problems of vaccine hesitancy (VH) in these groups, we trained them in motivational interviewing (MI). We evaluated the effectiveness of this training among HMs on their MI knowledge and skills (objective 1) and among the interviewees on their vaccination readiness (VR) and intention to get vaccinated or accept a booster against COVID-19 and/or DTP (objective 2). Two MI specialists trained 16 HMs in a two-day workshop in May 2022. The validated MISI questionnaire evaluated HMs' acquisition of MI knowledge and skills (objective 1). Trained HMs offered an MI-based intervention on vaccination to people in disadvantaged neighborhoods of Marseille (France). Those who consented completed a questionnaire before and after the interview to measure VR with the 7C scale and intentions regarding vaccination/booster against COVID-19 and DTP (objective 2). The training resulted in HMs acquiring good MI skills (knowledge, application, self-confidence in using it). HMs enrolled 324 interviewees, 96% of whom completed both questionnaires. VR increased by 6%, and intentions to get vaccinated or update COVID-19 and DTP vaccination increased by 74% and 52% respectively. Nearly all interviewees were very satisfied with the interview, although 21% still had questions about vaccination. HMs assimilated MI principles well. MI use in outreach programs appears to show promise in improving vaccine confidence and intentions among disadvantaged people.
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Affiliation(s)
- Chloé Cogordan
- Southeastern Health Regional Observatory, ORS PACA, Marseille, France
| | - Lisa Fressard
- Southeastern Health Regional Observatory, ORS PACA, Marseille, France
| | - Lauriane Ramalli
- Santé publique France (French National Public Health Agency), Marseille, France
| | - Stanislas Rebaudet
- Hôpital Européen, Marseille, France
- UMR1252 SESSTIM, Aix-Marseille University, Inserm, IRD, ISSPAM, Marseille, France
| | - Philippe Malfait
- Santé publique France (French National Public Health Agency), Marseille, France
| | | | | | - David Roy
- Centre de recherche du CHUS, Sherbrooke, QC, Canada
| | | | - Arnaud Gagneur
- Centre de recherche du CHUS, Sherbrooke, QC, Canada
- Department of Pediatrics, Sherbrooke University, Sherbrooke, QC, Canada
| | - Pierre Verger
- Southeastern Health Regional Observatory, ORS PACA, Marseille, France
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Mitilian E, Gosselin V, Casanova L, Fressard L, Berthiaume P, Verger P, Gagneur A. Assessment of training of general practice interns in motivational interviews about vaccination. Hum Vaccin Immunother 2022; 18:2114253. [PMID: 36494997 PMCID: PMC9746523 DOI: 10.1080/21645515.2022.2114253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The effectiveness of motivational interviewing (MI) for reducing vaccine hesitancy (VH) has been demonstrated in Quebec. We conducted a study to evaluate the acquisition of MI skills after MI training via videoconferencing for interns training as general practitioners (GPs) in southeastern France. A vaccination-specific MI training workshop was offered to interns in 2021, consisting of two separate Zoom videoconference sessions. Participants completed the Motivational Interviewing Skills in Immunization questionnaire before and after the training to measure skills acquisition. We used pairwise exact Wilcoxon-Pratt signed rank tests for the analysis. Among 45 GP interns enrolled in the first MI session, 34 (75.6%) attended both sessions and completed the questionnaire at 3 different time points. After the first session, MI knowledge scores improved significantly (+21.1 ± 21.6; P < .0001), as did application of MI skills (+36.8 ± 36.7; P < .0001), and MI practice confidence (+21.2 ± 11.1; P < .0001). The second MI session maintained the skills developed after the first session without further improvement. Participant satisfaction was high. This is the first study in France assessing the impact of a vaccination-specific MI training for GP interns. It shows a substantial improvement in knowledge, application of MI skills, and self-confidence in the practice of MI. GP interns were highly satisfied with the training despite the videoconference format. These promising results will allow the integration of MI training in GP medical curricula in order to prepare future GPs for communication in the field of vaccination.
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Affiliation(s)
- Eva Mitilian
- Aix Marseille Univ, DUMG, département universitaire de médecine générale, Marseille, France,ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France,CONTACT Eva Mitilian Aix Marseille Univ, DUMG, département universitaire de médecine générale, 40, rue Saint-Bruno, Marseille13004
| | - Virginie Gosselin
- Centre de Recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Ludovic Casanova
- Aix Marseille Univ, DUMG, département universitaire de médecine générale, Marseille, France,ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France
| | - Lisa Fressard
- ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France
| | | | - Pierre Verger
- ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France
| | - Arnaud Gagneur
- Centre de Recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada,Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Chéret A, Durier C, Noël N, Bourdic K, Legrand C, D'Andréa C, Hem E, Goujard C, Berthiaume P, Consoli SM. Motivational interviewing training for medical students: A pilot pre-post feasibility study. Patient Educ Couns 2018; 101:1934-1941. [PMID: 29958765 DOI: 10.1016/j.pec.2018.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/05/2018] [Accepted: 06/20/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate the impact of brief training in motivational interviewing (MI) from a non-specialist professional for medical students. METHODS Students (n = 20) received three four-hour sessions of MI training over one week. They interviewed caregivers acting as patients in two standardised medical situations, six weeks before and three weeks after training. Global scores from the MITI-3.1.1 code, including "MI- Spirit", were attributed to the audiotaped interviews by two independent coders, blind the pre- or post-training status of the interview. Secondary outcomes were: caregivers' perception of students' empathy (CARE questionnaire), students' evaluation of self-efficacy to engage in a patient-centred relationship (SEPCQ score), and students' satisfaction with their own performance (analogue scale). RESULTS MI-Spirit score increased significantly after training (p < 0.0001, effect size 1.5). Limited improvements in CARE score (p = 0.034, effect size 0.5) and one of the SEPCQ dimensions (sharing information and power with the patient; p = 0.047, effect size 0.5) were also noted. Students' satisfaction score was unaffected (p = 0.69). CONCLUSION These findings suggest that brief MI training can improve communication skills in medical students. PRACTICE IMPLICATIONS Such an intervention is feasible and could be generalised during medical studies.
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Affiliation(s)
- Antoine Chéret
- Internal Medicine Unit, Le Kremlin-Bicêtre Hospital, APHP, France.
| | | | - Nicolas Noël
- Internal Medicine Unit, Le Kremlin-Bicêtre Hospital, APHP, France
| | - Katia Bourdic
- Internal Medicine Unit, Le Kremlin-Bicêtre Hospital, APHP, France
| | - Chantal Legrand
- Direction of Care, Georges Pompidou Hospital, APHP, Paris, France
| | | | - Evelyne Hem
- Internal Medicine Unit, Le Kremlin-Bicêtre Hospital, APHP, France
| | - Cécile Goujard
- Internal Medicine Unit, Le Kremlin-Bicêtre Hospital, APHP, France
| | | | - Silla M Consoli
- Paris Descartes University, Sorbonne Paris Cité, Paris, France; Consultation-Liaison Psychiatry Unit, Department of Adult and Elderly Psychiatry, European Georges Pompidou Hospital, APHP, Paris, France
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Ludwig A, Berthiaume P, Richer J, Tinline R, Bigras-Poulin M. A simple geometric validation approach to assess the basic behaviour of space- and time- distributed models of epidemic spread - an example using the Ontario rabies model. Transbound Emerg Dis 2013; 61:147-55. [PMID: 23750567 DOI: 10.1111/tbed.12010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Indexed: 11/28/2022]
Abstract
Dynamic mathematical modelling and stochastic simulation of disease-host systems for the purpose of epidemiological analysis offer great opportunities for testing hypotheses, especially when field experiments are impractical or when there is a need to evaluate multiple experimental scenarios. This, combined with the ever increasing computer power available to researchers, has contributed to the development of many mathematical models for epidemic simulations, such as the individual-based model (IBM). Nevertheless, few of these models undergo extensive validation and proper assessment of intrinsic variability. The Ontario rabies model (ORM) will be used here to exemplify some advantages of appropriate model behaviour validation and to illustrate the use of a simple geometric procedure for testing directional bias in distributed stochastic dynamic model of spread of diseases. Results were obtained through the comparison of 10 000 epizootics resulting from 100 epidemic simulations started using 100 distinct base populations. The analysis results demonstrated a significant directional bias in epidemic dispersion, which prompted further verification of the model code and the identification of a coding error, which was then corrected. Subsequent testing of the corrected code showed that the directional bias could no longer be detected. These results illustrate the importance of proper validation and the importance of sufficient knowledge of the model behaviour to ensure the results will not confound the objectives of the end-users.
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Affiliation(s)
- A Ludwig
- Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, St-Hyacinthe, QC, Canada; Groupe de Recherche en Épidémiologie et Santé Publique (GREZOSP), Faculty of Veterinary Medicine, University of Montréal, St-Hyacinthe, QC, Canada
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Shwiff S, Aenishaenslin C, Ludwig A, Berthiaume P, Bigras-Poulin M, Kirkpatrick K, Lambert L, Bélanger D. Bioeconomic modelling of raccoon rabies spread management impacts in Quebec, Canada. Transbound Emerg Dis 2012; 60:330-7. [PMID: 22709550 DOI: 10.1111/j.1865-1682.2012.01351.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Beginning in 2006, point infection control operations and aerial distribution of oral rabies vaccines along the US border were performed in Quebec, Canada, to control the potential spread of raccoon rabies. A benefit-cost analysis assessed the economic efficiency of this rabies control programme into the future. In this study, a mathematical simulation model was used to determine the potential spread of raccoon rabies from the 2006 index case, and incidence rates of human post-exposure prophylaxis (PEP), animal testing and human exposure investigations were calculated. Benefits were calculated as the potential savings from reduced numbers of human PEP, animal testing and human exposure investigations owing to control, which ranged from $47 million to $53 million. Programme cost scenarios were based on projections of total expenditures, which ranged from $33 million to $49 million. Economic efficiency was indicated for approximately half of the modelled scenarios, with the greatest benefit-cost ratios resulting from reduced future programme costs.
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Affiliation(s)
- S Shwiff
- National Wildlife Research Center, 4101 LaPorte Ave., Fort Collins, CO 80521, USA.
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Berthiaume P, Fortier D. [Motivational interview]. Perspect Infirm 2012; 9:34-37. [PMID: 22448436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Ravel A, Berthiaume P, Brazeau S, Bigras-Poulin M. P51 - Étude de la faisabilité et de l’utilité d’un indicateur de pression hygiénique animale (IPHA) pour la gestion agroenvironnementale en santé publique. Rev Epidemiol Sante Publique 2005. [DOI: 10.1016/s0398-7620(05)84673-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Berthiaume P, Ravel A, Brazeau S, Bigras-Poulin M. A7 - Développement d’un indicateur de pression hygiénique animale (IPHA) pour la gestion agroenvironnementale en santé publique. Rev Epidemiol Sante Publique 2005. [DOI: 10.1016/s0398-7620(05)84685-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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