Communication strategies for healthcare providers to enhance vaccine discussions with vaccine-hesitant patients
DOI:
https://doi.org/10.38140/ijss-2024.vol4.06Keywords:
vaccine, hesitancy, healthcare providers, communication, trust, Bourdieu, reflexivityAbstract
This study examines vaccine hesitancy as an emerging public health concern that undermines the efficacy of vaccination initiatives. Healthcare providers play a crucial role in addressing vaccine hesitancy; however, many lack effective communication strategies. This study developed evidence-based communication guidelines to assist healthcare providers in discussing vaccines with hesitant patients. Drawing on Bourdieu's theoretical framework, semi-structured interviews were conducted with ten vaccine-hesitant parents and ten paediatricians in Nigeria. Through reflexive thematic analysis of the interview transcripts, this study uncovers power dynamics, legitimacy struggles, and cultural capital's significance in vaccine conversations. The findings reveal that hesitant parents question the legitimacy of vaccine recommendations, feeling marginalised yet constrained by societal norms of responsible parenthood. Similarly, healthcare providers' reliance on biomedical expertise often proves insufficient without rapport building, cultural competency, and addressing patients' unique knowledge assets. The findings of this study contribute to communication theory, medical education, and clinical practice by advocating for power-conscious, dialogue-based strategies to promote vaccination amidst uncertainty and scepticism.
References
Abrams, J. A., Tabaac, A., Jung, S., & Else-Quest, N. M. (2020). Considerations for employing intersectionality in qualitative health research. Social Science & Medicine, 258, 1–10. https://doi.org/10.1016/j.socscimed.2020.113138
Atkins, K., & Lorelle, S. (2022). Cultural humility: Lessons learned through a counselling cultural immersion. Journal of Counselor Preparation and Supervision, 15(1), 1–30. https://digitalcommons.sacredheart.edu/jcps/vol15/iss1/9
Attwell, K., Betsch, C., Dubé, E., Sivelä, J., Gagneur, A., Suggs, L. S., ... & Thomson, A. (2021). Increasing vaccine acceptance using evidence-based approaches and policies: Insights from research on behavioural and social determinants presented at the 7th Annual Vaccine Acceptance Meeting. International Journal of Infectious Diseases, 105, 188-193. https://doi.org/10.1016/j.ijid.2021.02.007
Aulia, A. N. ., & Susilo, E. . (2022). Parent’s satisfaction with immunisation services during the COVID-19 pandemic at Suruh Public Health Centre of Semarang Regency. In Proceedings of Conference on Health Universitas Ngudi Waluyo, 1(1), 95–102.
Bbaale, E. (2013). Factors influencing childhood immunisation in Uganda. Journal of health, population, and nutrition, 31(1), 118–129. https://doi.org/10.3329/jhpn.v31i1.14756
Betsch, C., Schmid, P., Heinemeier, D., Korn, L., Holtmann, C., & Böhm, R. (2018). Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination. PloS one, 13(12), e0208601. https://doi.org/10.1371/journal.pone.0208601
Bourdieu, P. (1985). The social space and the genesis of groups. Social Science Information, 24(2), 195–220. https://doi.org/10.1177/053901885024002001
Bourdieu, P. (1986). The Forms of Capital.” In: J. G. Richardson (Eds.) Handbook of Theory and Research for the Sociology of Education. New York: Greenwood.
Bourdieu, P. (1989). Social space and symbolic power. Sociological theory, 7(1), 14–25. https://doi.org/10.2307/202060
Bourdieu, P. (2004). Science of science and reflexivity. Polity.
Bourdieu, P. (2017). Habitus. In Habitus: A sense of place (pp. 59–66). Routledge.
Danchin, M., & Nolan, T. (2014). A positive approach to parents with concerns about vaccination for the family physician. Australian Family Physician, 43(10), 690–694. https://core.ac.uk/download/pdf/30673632.pdf
Dubé, È., Farrands, A., Lemaitre, T., Boulianne, N., Sauvageau, C., Boucher, F. D., ... & Gagneur, A. (2019). Overview of knowledge, attitudes, beliefs, vaccine hesitancy and vaccine acceptance among mothers of infants in Quebec, Canada. Human vaccines & immunotherapeutics, 15(1), 113-120. https://doi.org/10.1080/21645515.2018.1509647
Dubé, E., Gagnon, D., MacDonald, N., Bocquier, A., Peretti-Watel, P., & Verger, P. (2018). Underlying factors impacting vaccine hesitancy in high-income countries: A review of qualitative studies. Expert Review of Vaccines, 17(11), 989-1004. https://doi.org/10.1080/14760584.2018.1541406
Dubé, E., Gagnon, D., Nickels, E., Jeram, S., & Schuster, M. (2014). Mapping vaccine hesitancy—Country-specific characteristics of a global phenomenon. Vaccine, 32(49), 6649-6654. https://doi.org/10.1016/j.vaccine.2014.09.039
Dubé, E., Laberge, C., Guay, M., Bramadat, P., Roy, R., & Bettinger, J. A. (2013). Vaccine hesitancy: an overview. Human vaccines and immunotherapeutics, 9(8), 1763-1773. https://doi.org/10.4161/hv.24657
Edwards, B., Biddle, N., Gray, M., & Sollis, K. (2021). COVID-19 vaccine hesitancy and resistance: Correlates in a nationally representative longitudinal survey of the Australian population. PloS one, 16(3), e0248892. https://doi.org/10.1371/journal.pone.0248892
Freed, G. L., Clark, S. J., Butchart, A. T., Singer, D. C., & Davis, M. M. (2011). Sources and perceived credibility of vaccine-safety information for parents. Pediatrics, 127(Supplement 1), S107-S112. https://doi.org/10.1542/peds.2010-1722P
Goldthorpe, J. H. (2007). "Cultural Capital": Some Critical observations. Sociologica, 1(2), 0-0. https://doi.org/10.2383/24755
Hammond, J. (2020). Vaccine confidence, coverage, and hesitancy worldwide: A literature analysis of vaccine hesitancy and potential causes worldwide [Senior Thesis, University of South Carolina] University of South Carolina-Columbia. https://scholarcommons.sc.edu/senior_theses/344
Huang, X. (2019). Understanding Bourdieu-cultural capital and habitus. Review European Studies, 11(3) 45–49. https://doi.org/10.5539/res.v11n3p45
Hyland-Wood, B., Gardner, J., Leask, J., & Ecker, U. K. (2021). Toward effective government communication strategies in the era of COVID-19. Humanities and Social Sciences Communications, 8(1), 1–11. https://doi.org/10.1057/s41599-020-00701-w
Jarrett, C., Wilson, R., O’Leary, M., Eckersberger, E., & Larson, H. J. (2015). Strategies for addressing vaccine hesitancy–A systematic review. Vaccine, 33(34), 4180–4190. https://doi.org/10.1016/j.vaccine.2015.04.040
Kadono, M., (2020). ‘It’s Been a Huge Stress’: An In-Depth, Exploratory Study of Vaccine Hesitant Parents in Southern California. USF Tampa Graduate Theses and Dissertations. https://digitalcommons.usf.edu/etd/8953
Kaufman, J., Tuckerman, J., Bonner, C., Durrheim, D. N., Costa, D., Trevena, L., ... & Danchin, M. (2021). Parent-level barriers to uptake of childhood vaccination: a global overview of systematic reviews. BMJ Global Health, 6(9), 1-11. http://dx.doi.org/10.1136/bmjgh-2021-006860
Kempe, A., Saville, A. W., Albertin, C., Zimet, G., Breck, A., Helmkamp, L., ... & Szilagyi, P. G. (2020). Parental hesitancy about routine childhood and influenza vaccinations: a national survey. Pediatrics, 146(1), e20193852. https://doi.org/10.1542/peds.2019-3852
Kennedy, A., LaVail, K., Nowak, G., Basket, M., & Landry, S. (2011). Confidence about vaccines in the United States: understanding parents’ perceptions. Health Affairs, 30(6), 1151–1159. https://doi.org/10.1377/hlthaff.2011.0396
Kennedy, J. (2019). Populist politics and vaccine hesitancy in Western Europe: an analysis of national-level data. European journal of public health, 29(3), 512–516. https://doi.org/10.1093/eurpub/ckz004
Kim, J., Han, K., Chung, S. J., & Kim, C. (2023). Psychometric validation of the Korean versions of the Vaccine Hesitancy Scale and Vaccination Attitudes Examination Scale. Vaccine, 41(2), 4685–4692. https://doi.org/10.1016/j.vaccine.2023.06.046
Kumar, M., Singh, J. B., Chandwani, R., & Gupta, A. (2022). Locating resistance to healthcare information technology: A Bourdieusian analysis of doctors' symbolic capital conservation. Information Systems Journal, 32(2), 377–413. https://doi.org/10.1111/isj.12357
Leask, J., Kinnersley, P., Jackson, C., Cheater, F., Bedford, H., & Rowles, G. (2012). Communicating with parents about vaccination: a framework for health professionals. BMC Pediatrics, 12(1), 1–11. https://doi.org/10.1186/1471-2431-12-154
Mahachi, K., Kessels, J., Boateng, K., Baptiste, A. E. J., Mitula, P., Ekeman, E., ... & Gabrielli, A. F. (2022). Zero-or missed-dose children in Nigeria: contributing factors and interventions to overcome immunisation service delivery challenges. Vaccine, 40(37), 5433-5444. https://doi.org/10.1016/j.vaccine.2022.07.058
Martinez Leal, I., Njoh, J., Chen, T. A., Foreman-Hays, F., Reed, B. C., Haley, S. A., ... & Obasi, E. M. (2023). Exploring COVID-19 Vaccine Attitudes among Racially and Ethnically Minoritized Communities: Community Partners’ and Residents’ Perspectives. International Journal of Environmental Research and Public Health, 20(4), 3372. https://doi.org/10.3390/ijerph20043372
Mosher, D. K., Hook, J. N., Captari, L. E., Davis, D. E., DeBlaere, C., & Owen, J. (2017). Cultural humility: A therapeutic framework for engaging diverse clients. Practice Innovations, 2(4), 221-233. https://doi.org/10.1037/pri0000055
Nugraha, I. S., & Udi, W. W. (2022). The correlation of pharmaceutical services to the level of satisfaction with COVID-19 vaccination participants in RS Tingkat II Udayana. Journal Pharmaceutical Science and Application, 4(2), 45-50. https://doi.org/10.24843/JPSA.2022.v04.i02.p01
O’Leary, S. T., Trefren, L., Roth, H., Moss, A., Severson, R., & Kempe, A. (2021). Number of childhood and adolescent vaccinations administered before and after the COVID-19 outbreak in Colorado. JAMA pediatrics, 175(3), 305-307. https://doi.org/10.1001/jamapediatrics.2020.4733
Oku, A., Oyo-Ita, A., Glenton, C., Fretheim, A., Eteng, G., Ames, H., ... & Lewin, S. (2017). Factors affecting the implementation of childhood vaccination communication strategies in Nigeria: a qualitative study. BMC Public Health, 17(1), 1-12. https://doi.org/10.1186/s12889-017-4020-6
Olson, O., Berry, C., & Kumar, N. (2020). Addressing parental vaccine hesitancy towards childhood vaccines in the United States: a systematic literature review of communication interventions and strategies. Vaccines, 8(4), 1–25. https://doi.org/10.3390/vaccines8040590
Ophori, E. A., Tula, M. Y., Azih, A. V., Okojie, R., & Ikpo, P. E. (2014). Current trends of immunisation in Nigeria: Prospect and challenges. Tropical medicine and health, 42(2), 67-75. https://doi.org/10.2149/tmh.2013-13
Paterson, P., Meurice, F., Stanberry, L. R., Glismann, S., Rosenthal, S. L., & Larson, H. J. (2016). Vaccine hesitancy and healthcare providers. Vaccine, 34(52), 6700–6706. https://doi.org/10.1016/j.vaccine.2016.10.042
SAGE Working Group (2014). SAGE Working Group on Vaccine Hesitancy http://www.who.int/immunization/sage/sage_wg_vaccine_hesitancy_apr12/en/
Schneider-Kamp, A. (2021). Health capital: Toward a conceptual framework for understanding the construction of individual health. Social Theory & Health, 19(3), 205-219. https://doi.org/10.1057/s41285-020-00145-x
Shapiro, G. K., Kaufman, J., Brewer, N. T., Wiley, K., Menning, L., Leask, J., ... & Wiysonge, C. S. (2021). A critical review of measures of childhood vaccine confidence. Current Opinion in Immunology, 71, 34–45. https://doi.org/10.1016/j.coi.2021.04.002
Shim, J. K. (2010). Cultural health capital: a theoretical approach to understanding health care interactions and the dynamics of unequal treatment. Journal of health and social behavior, 51(1), 1–15. https://doi.org/10.1177/0022146509361185
Swidler, A. (1986). Culture in action: Symbols and strategies. American Sociological Review, 51(2), 273–286. https://doi.org/10.2307/2095521
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