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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Childhood Vaccination with MMR, Flu, and HPV.

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Strategy. Addressing Vaccine Hesitancy

Approach. Promote motivational interviewing as a method to address vaccine hesitancy in parents to increase childhood vaccinations.

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Overview. Promoting motivational interviewing. (MI) as a method to address vaccine hesitancy involves training healthcare professionals in a communication technique that fosters collaboration with parents.[1] This approach offers a patient-centered strategy to explore parental concerns, identify underlying motivations, and support informed decision-making regarding childhood vaccinations.[1] A successful public health approach requires a multi-pronged strategy.[1] First, healthcare professionals should receive training in core MI techniques, such as reflective listening, open-ended questions, and affirming parental autonomy.[1] Second, integrating MI into routine well-child visits allows for tailored conversations that address specific concerns and build trust. Finally, providing ongoing support and resources can empower parents to overcome hesitancy and confidently navigate the childhood vaccination schedule.[1] Examples of public health programs promoting MI include initiatives by the Centers for Disease Control and Prevention. (CDC) offering online training modules and toolkits specifically focused on applying MI to vaccine conversations, and similar programs by state health departments providing in-person workshops for pediatricians and family physicians.[2, 3] Peer-reviewed research suggests MI is a promising approach for addressing vaccine hesitancy. Studies have shown that MI can improve communication between healthcare providers and parents, decrease vaccine hesitancy, and increase childhood vaccination rates.[1]

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Parent Attitudes about Childhood Vaccines (PACV) Survey
  • Qualitative data from parent interviews
  • Healthcare provider communication records

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Health Teaching (Education and Promotion) (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Individual/Family-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of healthcare providers trained in motivational interviewing techniques to address parental vaccine hesitancy. (Measures workforce capacity building)
  • Number of motivational interviewing sessions conducted with vaccine-hesitant parents in healthcare settings. (Shows utilization of the approach)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of motivational interviewing sessions that adhere to best practices and fidelity markers for the method. (Assesses quality of implementation)
  • Percent of motivational interviewing sessions conducted with vaccine-hesitant parents in healthcare settings. (Shows utilization of the approach)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of providers who demonstrate proficiency in motivational interviewing skills through competency assessments and supervision. (Measures provider capability and effectiveness)
  • Number of collaborative learning networks established for providers to share best practices and challenges in implementing motivational interviewing that report high levels of engagement. (Fosters continuous improvement)
  • Number of provider teams that consistently achieve high childhood vaccination rates and parental satisfaction through the use of motivational interviewing. (Measures care team performance)
  • Number of communities that experience reductions in vaccine-preventable disease outbreaks due to increased vaccine acceptance and uptake. (Indicates population health impact)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of providers who demonstrate proficiency in motivational interviewing skills through competency assessments and supervision. (Measures provider capability and effectiveness)
  • Percent of collaborative learning networks established for providers to share best practices and challenges in implementing motivational interviewing that report high levels of engagement. (Fosters continuous improvement)
  • Percent of provider teams that consistently achieve high childhood vaccination rates and parental satisfaction through the use of motivational interviewing. (Measures care team performance)
  • Percent of communities that experience reductions in vaccine-preventable disease outbreaks due to increased vaccine acceptance and uptake. (Indicates population health impact)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Gagneur, A., Gosselin, V., & Dubé, È. (2018). Motivational interviewing: A promising tool to address vaccine hesitancy.

[2] Fundamentals of Motivational Interviewing for HIV | Treat | Effective Interventions | HIV/AIDS | CDC. (n.d.). https://www.cdc.gov/hiv/effective-interventions/treat/motivational-interviewing/index.html

[3] Digital vaccine record. (n.d.). https://myvaccinerecord.cdph.ca.gov/

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.