Transforming provider-patient vaccine conversations: a randomised trial on presumptive communication training

Despite the widespread availability of many vaccines and health providers' favourable attitudes towards vaccines, suboptimal immunisation rates persist worldwide. This study investigates the impact of presumptive (opt-out) communication training and social norms-based messaging on healthcare providers' self-reported vaccination recommendation behaviour.

Two cross-cultural, preregistered, longitudinal randomised controlled trials were conducted involving 413 physicians and healthcare providers in the USA and Brazil. The study design was a 2 (presumptive communication training vs control information) × 2 (high social proof vs control information) experimental design. Participants were surveyed at baseline, 30, 60 and 90 days to assess changes in self-reported vaccination recommendation behaviour.

Physicians and healthcare providers who received presumptive communication training reported a significant increase in use of presumptive language in their vaccination recommendations 90 days post-training, by 59.5% (=24.1 pp) in the USA and 25.3% (=16.2 pp) in Brazil. Additionally, social norms-based messaging led to a significant increase in perceived patient trust among providers in Brazil at 60-day and 90-day follow-ups.

The study relied on voluntary participation as well as self-report data, which may be influenced by social desirability bias and/or demand effects.

Online, presumptive (opt-out) communication training for physicians and healthcare providers can substantially boost the self-reported use of presumptive language when communicating with patients about vaccination.

The research presents a novel approach to combining presumptive communication training and social norms-based messaging to close the gap between healthcare provider intentions and actual vaccination recommendation behaviour. This shows how health systems researchers and clinical leaders can draw on insights from behavioural science to help clinicians communicate more effectively with patients.