Perspectives on an Intervention to Increase Confidence in Newborn RSV Immunoprophylaxis

Respiratory syncytial virus (RSV) immunoprophylaxis is efficacious, yet uptake is low in comparison with other recommended newborn interventions. We aimed to identify barriers to and enablers of implementation of an intervention in the well newborn unit to increase parental confidence in newborn RSV immunoprophylaxis.

We conducted individual, semi-structured interviews of purposively sampled clinicians and parents at an urban, quaternary-care hospital well newborn unit between August 13, 2025, and October 22, 2025. Interviews elicited clinicians' and parents' perceptions of RSV immunoprophylaxis, the counseling process, barriers and facilitators, and their perspectives on the design and implementation of an intervention to increase parental confidence. Using both deductive and inductive approaches, 4 investigators independently coded the first 2 transcripts in each stakeholder group to identify themes. Two investigators then applied codes to the remaining transcripts, resolving discrepancies by consensus.

We interviewed 18 clinicians (5 hospitalists, 3 general pediatricians, 3 obstetricians, 7 nurses/nurse managers) and 24 parents. We identified several themes related to an intervention to increase parental confidence, including barriers and facilitators: (1) trust and mistrust of information; (2) differentiation of RSV immunoprophylaxis from a vaccine; and (3) value of providing both data and personal experiences. We also identified themes related to implementation: (1) support for a tool to augment, but not replace, clinician counseling; (2) use of visuals; (3) accessibility for parents of varying health literacy and languages; and (4) importance of timing.

The identified themes can inform the design and implementation of an intervention to increase parental confidence in newborn RSV immunoprophylaxis.