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DECIDE, A Pregnancy-specific Patient-provider Communication Approach: Multi-method and Codesign
Medea Myers-Stewart1, Monica Santosh Surti1, Madison Kennedy1
1From the Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta.
The Pediatric Infectious Disease Journal
|February 14, 2025
Summary
Low vaccination uptake in pregnancy necessitates a new communication strategy. The DECIDE approach balances shared decision-making with clear recommendations, empowering both patients and healthcare providers for better vaccine communication.
Area of Science:
- Maternal and Child Health
- Health Communication
- Vaccinology
Background:
- Vaccination during pregnancy is crucial for maternal and infant health but faces low uptake.
- Existing communication strategies for childhood vaccines are insufficient for the unique context of pregnancy.
- Understanding nuanced decision-making in pregnant individuals is key to improving vaccine acceptance.
Purpose of the Study:
- To codesign a pregnancy-specific, person-centered communication approach for vaccinations.
- To address the low uptake of recommended vaccines in pregnant populations.
- To develop a tool that supports shared decision-making between healthcare providers and pregnant individuals.
Main Methods:
- Utilized a multi-method study employing the double diamond design framework.
- Conducted extensive research including scoping reviews, surveys, qualitative interviews with patients and healthcare providers (HCPs), and community outreach.
- Iteratively developed and refined the communication approach through prototyping, role-playing, and usability testing with patient partners and HCPs.
Main Results:
- Confirmed the need for a pregnancy-specific communication strategy and identified critical gaps in current practices.
- Developed the DECIDE (determine, elicit, consent, interactive discussion, deliver, empower) communication approach.
- The DECIDE approach balances shared decision-making with clear recommendations, supporting patient autonomy and enhancing HCP confidence and communication skills.
Conclusions:
- The DECIDE communication approach is a novel, pregnancy-specific strategy designed to improve vaccine uptake.
- This balanced approach addresses the desire for autonomy among pregnant individuals while providing practical tools for HCPs.
- The DECIDE framework holds potential applicability for other health interventions beyond vaccination.
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