Higher vaccine rates associated with indicative language by provider, more efficient
Provider recommendation style impacts the length of adolescent vaccine discussions and vaccination rates
(Press-News.org) BOSTON - New research from Boston Medical Center finds that using clear, unambiguous language when recommending HPV vaccination both increases vaccine acceptance and increases conversation efficiency while preserving patient satisfaction. Published in Vaccine, the new research findings show that adolescents are nine times more likely to receive a vaccine when providers introduce the topic to parents with a simple statement like "your child is due for vaccines today." It also results in a shorter vaccine discussion.
In this study, the acceptance of the HPV vaccine and the meningococcal vaccine were compared. The indicated style of language, for example saying "you are due for a vaccine" was compared to the elective style of language, for example saying "would you like to vaccinate?" The indicated style was associated with more efficient visits, allowing for more time for patients to discuss other health concerns with their provider. Neither indicative nor elective styles compromised patient satisfaction with the interaction.
"Patients look to their provider as a source of education on vaccinations, so as providers, we must approach the discussion in a way that most effectively addresses their goals and prioritizes their most pressing health concerns," says Rebecca Perkins, MD, obstetrician and gynecologist at Boston Medical Center and lead author on this study. "At a time where vaccination hesitancy is at an all-time high, these findings can offer further insight into best approaches for discussing vaccination, whether it be for HPV or the more recent COVID-19 vaccines."
The indicated presentation of the vaccine is a normal communication tactic for providers, but it is not normal for all vaccines. It is less frequently used for the HPV vaccine than for the meningococcal vaccination, which may lower vaccine acceptance and lead to parental confusion. Parents of children who need vaccinations look to providers for guidance, and the disparity in communication suggests parents may not receive equally clear messaging on all vaccines. The indicated recommendation style is associated with lower rates of cumulative under-immunization over time and this style is associated with better vaccine uptake and efficiency of conversation. Primary care providers face great time pressure, an often-cited reason for not providing certain aspects of care, including HPV vaccinations. The elective style led to longer discussions due to the framing of a question and the patients need to probe more to learn about the provider's view and recommendations.
The observational study included 106 conversations between parents, providers, and adolescent patients between January 2016 and March 2018 across five sites that were participating in DOSE-HPV, a multi-component intervention to improve HPV vaccination rates. The clinical encounters were audio-recorded and vaccination discussions transcribed to capture natural patient-provider interactions.
"We are at a time where educating people on vaccines and the process of vaccination is so important for both individual health and the greater public good," says Perkins, also an associate professor of obstetrics and gynecology at Boston University School of Medicine. "The use of language can make a difference in how likely patients are to accept vaccination, and also how much time providers have to address other health concerns."
Professional organizations including the Center for Disease Control and the American Academy of Pediatrics recommend using clear, unambiguous language to recommend vaccines following studies that suggest strong recommendations increase the likelihood of vaccination.
Funding for this study was supported by an American Cancer Society Research Scholar Grant (grant number 128607-RSG-15-150-01-CPHPS).
About Boston Medical Center
Boston Medical Center (BMC) is a private, not-for-profit, 514-bed, academic medical center that is the primary teaching affiliate of Boston University School of Medicine. It is the largest and busiest provider of trauma and emergency services in New England. BMC offers specialized care for complex health problems and is a leading research institution, receiving more than $166 million in sponsored research funding in fiscal year 2019. It is the 13th largest funding recipient in the U.S. from the National Institutes of Health among independent hospitals. In 1997, BMC founded Boston Medical Center Health Plan, Inc., now one of the top ranked Medicaid MCOs in the country, as a non-profit managed care organization. Boston Medical Center and Boston University School of Medicine are partners in Boston HealthNet - 12 community health centers focused on providing exceptional health care to residents of Boston. For more information, please visit http://www.bmc.org.
ELSE PRESS RELEASES FROM THIS DATE:
A recent statewide survey of Californians uncovered that 30% of Black adults and 13% of Hispanic adults felt that they have been judged or treated differently by a health care provider because of their race/ethnicity or language. One out of six Black and Latino Californians were more likely to report strong mistrust of their health care providers. Researchers at the Charles R. Drew University in Los Angeles analyzed data from more than 2,300 White, Hispanic, and non-Hispanic Black adults who asked to report on perceived discrimination due to race, ethnicity, language, income, and insurance status or type. Black and Hispanic adults reported higher rates ...
Traditional gendered patterns of child care persisted during the COVID-19 shutdown, with more than a third of couples relying on women to provide most or all of it, according to a study from University of Georgia researcher Kristen Shockley.
Some previous research has found that typical familial patterns may get upended during crises, but that's not what Shockley and her colleagues found in the early months of the COVID-19 shutdown.
"Most people have never undergone anything like this before, where all of a sudden they can't rely on their normal child care, and most people's work situation ...
North Carolina did not expand Medicaid eligibility under the Affordable Care Act, which continued to put many low-income women at risk for losing health care coverage post partum. The state did comply with ACA standards for simplifying Medicaid enrollment, automating the process and removing a stringent and often cumbersome financial assessment process. Analysis from researchers at Duke University found that these reforms enabled more low-income women to qualify for full Medicaid and reduced the number of women who instead qualified for more limited benefits under the state's ...
A rapid, evidence-based review summarizes the effectiveness of cloth masks in protecting health care clinicians from respiratory viral infections, such as COVID-19. Nine studies were included in the review, and all but one were conducted prior to the COVID-19 pandemic. The only randomized trial of cloth face masks published at the time of this review compared the infection rates of influenza-like illness among groups of health care professionals who wore cloth masks, medical masks, or inconsistent mask use in the hospital setting. That study reported wide-ranging confidence intervals ...
Despite having some of the densest living spaces and the highest number of international visitors, Hong Kong, Singapore, and Beijing have utilized their respective primary health care systems to keep their COVID-19 cases and deaths relatively low. Researchers studied the primary health care systems in the three cities to identify features of each system that other cities can use as examples to prepare for and prevent deaths in future health crises. Wong et al write that all three cities have made use of primary care in performing public health surveillance and ...
Physical pain and social pain may be more closely related than previously thought. Social pain, which typically results from interpersonal rejection or abuse, has been viewed as a non-medical response to external factors. However, recent research suggests that some physical and social stress responses may arise because of shared processing in the brain. Long-term usage of opioid medications could perpetuate a cycle of experiencing both physical and social pain and may increase risk of addiction. The authors, both of whom prescribe opioid medications, caution, "We must recognize ...
Despite seeing gains in insurance coverage for preventive health services under the Affordable Care Act, the US has seen a declining rate of primary care visits over the past fifteen years. Are fewer individuals seeing primary care physicians? The authors of this study compared two factors that contribute to that decline to determine whether it was the number of primary care patients or the frequency of their clinical visits that contributed most to the overall decline. Over a fifteen year period from 2002 to 2017, both the number of unique patients seeing PCPs and the number of visits per patient declined. At the start of their analysis in 2002, most Americans saw a primary care physician about 4.3 times in a two-year span. By the end of the study in 2016, frequency ...
Patients are sometimes asked to share their personal health information for research purposes. Informed consent and trust are critical components in a patient's decision to participate in research. Researchers at the University of Florida conducted a three-arm randomized controlled trial to compare the effects on patient experiences of three electronic consent (e-consent) designs that asked them to share PHI for research purposes. Participants were randomized to a standard e-consent form (standard); an e-consent that contained standard information plus hyperlinks to additional interactive details (interactive); or an e-consent that contained standard information, interactive hyperlinks, and factual ...
URBANA, Ill. - Soil erosion is a major challenge in agricultural production. It affects soil quality and carries nutrient sediments that pollute waterways. While soil erosion is a naturally occurring process, agricultural activities such as conventional tilling exacerbate it. Farmers implementing no-till practices can significantly reduce soil erosion rates, a new University of Illinois study shows.
Completely shifting to no-till would reduce soil loss and sediment yield by more than 70%, says Sanghyun Lee, doctoral student in the Department of Agricultural and Biological Engineering at U of I and lead author on the study, published in Journal of Environmental Management.
But even a partial change in tilling practices could have significant results, he adds.
"If we ...
Harmful medical practices, like inappropriate prescribing of opioids and racial and income-based discrimination in clinical settings, can vary across medical practices and individuals. Patients may find that even common primary care health services, like getting a chest x-rays or a referral to a heart or lung specialist, can differ widely depending on your doctor or clinic location. These variations in medical practice can have serious consequences for the quality, equity and cost of one's health care; however, it's unclear whether these disparities can be attributed to individual differences, from one ...
LAST 30 PRESS RELEASES:
[Press-News.org] Higher vaccine rates associated with indicative language by provider, more efficient
Provider recommendation style impacts the length of adolescent vaccine discussions and vaccination rates