Abstract

BackgroundVaccine hesitancy among parents leads to childhood undervaccination and outbreaks of vaccine-preventable disease. As the reasons for vaccine hesitancy are diverse, there is often not enough time during regular clinical visits for medical providers to adequately address all the concerns that parents have. Providing individually tailored vaccine information via the internet before a clinical visit may be a good mechanism for effectively allaying parents’ vaccination concerns while also being time efficient. Including tailoring based on values is a promising, but untested, approach to message creation.ObjectiveThis study aimed to describe the process by which we developed a Web-based intervention that is being used in an ongoing randomized controlled trial aimed at improving the timeliness of infant vaccination by reducing parental vaccine hesitancy.MethodsDevelopment of the intervention incorporated evidence-based health behavior theories. A series of interviews, surveys, and feedback sessions were used to iteratively develop the intervention in collaboration with vaccination experts and potential end users.ResultsIn all, 41 specific content areas were identified to be included in the intervention. User feedback elucidated preferences for specific design elements to be incorporated throughout the website. The tile-based architecture chosen for the website was perceived as easy to use. Creating messages that were two-sided was generally preferred over other message formats. Quantitative surveys identified associations between specific vaccine values and vaccination beliefs, suggesting that values tailoring should vary, depending on the specific belief being endorsed.ConclusionsUsing health behavior theories, qualitative and quantitative data, and significant expert and end user input, we created a novel, Web-based intervention to improve infant vaccination timeliness. The intervention is based on tailoring messages according to each individual’s values and beliefs. This intervention is currently being tested in a controlled randomized clinical trial.

Highlights

  • Vaccine HesitancyVaccination is widely recognized as one of the most effective public health interventions ever [1]

  • Measles, which was considered eradicated from the United States in 2000, caused infections among more than 2000 people between 2014 and 2018 alone, with the majority of cases occurring in individuals under- or unvaccinated against the virus [6]

  • Using the electronic health record, we identified a random sample of 271 English-speaking mothers of children aged 6 months to 4 years currently enrolled in Kaiser Permanente Colorado (KPCO) and not part of the previous study [32]

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Summary

Introduction

Vaccine HesitancyVaccination is widely recognized as one of the most effective public health interventions ever [1]. Despite the well-established safety and effectiveness of vaccines, a growing number of parents are choosing to delay or forgo them for their children because of questions about vaccines’ necessity and safety ( sometimes because of firmly held religious or political beliefs) This phenomenon is referred to as vaccine hesitancy [2,3]. Objective: This study aimed to describe the process by which we developed a Web-based intervention that is being used in an ongoing randomized controlled trial aimed at improving the timeliness of infant vaccination by reducing parental vaccine hesitancy. Conclusions: Using health behavior theories, qualitative and quantitative data, and significant expert and end user input, we created a novel, Web-based intervention to improve infant vaccination timeliness. This intervention is currently being tested in a controlled randomized clinical trial

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