Using behavior change techniques to identify components for adapting a vaccination in pregnancy communication...

Vaccine communication is critical to improve pregnancy and childhood vaccination uptake. However, communication about vaccination in pregnancy between health care providers and patients is suboptimal. The Sharing Knowledge About Immunization (SKAI) is an Australian multicomponent intervention aimed at improving vaccine communication to increase vaccine uptake in pregnancy and childhood. However, it is unclear whether and how effective the intervention would be in the Canadian context.

The objectives of this study were to (1) determine what components of SKAI addressed vaccine communication and barriers identified by providers and parents in Canada, and (2) if necessary, identify additional intervention components that could improve vaccine communication during pregnancy in Canada.

This multi-method study used the Behaviour Change Wheel and the Theory and Techniques Tool to (1) identify behavior change techniques (BCTs) in the SKAI intervention; (2) map the identified BCTs to the barriers and enablers of vaccination in pregnancy communication, as reported by providers and parents in Canada, using the Theoretical Domains Framework; and (3) if the BCTs identified did not address reported barriers, develop a shortlist of possible BCTs to target barriers reported in Canada but not identified in SKAI.

A total of 22/93 BCTs were identified in the SKAI intervention materials for providers and 8/93 BCTs in the materials for patients. The majority of BCTs from both the providers' and the patients' materials targeted the barrier domains, Knowledge and Environmental Context and Resources, focusing on providing information. The domains with the fewest BCTs identified were Intention and Behavior Regulation. BCTs that targeted barriers in Skills, Belief About Capabilities , and Behavior Regulation for providers and Reinforcement, Social Influences , and Emotions for parents and not identified in SKAI were shortlisted (n = 26) for the Canadian intervention.

A tailored Canadian intervention aimed at improving vaccine communication during pregnancy should move beyond simply providing information, and should include BCTs that target Skills , Belief About Capabilities , and Behavior Regulation for providers. For parents, BCTs should target Reinforcement, Social Influences , and Emotions . Including BCTs that target these barriers that are unique to the Canadian context will increase the likelihood of changing patients' and providers' communication behavior and improving vaccine acceptance during pregnancy.

http://links.lww.com/IJEBH/A427.