By Myles Leslie
A team of researchers has launched an online interactive guide to improve conversations with patients who are hesitant about getting a COVID-19 vaccination. The Vaccine Hesitancy Guide – freely available at www.vhguide.ca – was built for, and alongside, primary care physicians from across Canada.
The Guide is an interactive website that presents advice, approaches and conversational strategies that family doctors are using successfully in their clinics. Presenting crowdsourced wisdom, it is a helpful resource for any healthcare worker who finds themselves suddenly playing the role of vaccine counsellor. With high immunization targets set for controlling the pandemic, turning vaccine hesitancy into vaccine confidence is critical.
I head up the team of applied qualitative researchers who developed the Guide. We are based out of the University of Calgary’s School of Public Policy. My colleagues and I have been studying policy responses to the pandemic since Alberta’s first case was reported in March of 2020. Much of our work has focused on tracking and helping improve how primary care clinics and their teams have dealt with: massive losses in appointment volume; the shift to virtual care; safely re-opening to in-person care; and the introduction of vaccine delivery.
It has been our privilege to work with primary care clinicians who have been at the forefront of managing a pandemic that, as much as it has put pressure on acute care systems, has truly turned primary care on its head.
We began developing the Guide in early January 2021. The psychology literature told us that the decision to vaccinate was a ‘trust sensitive’ one. With this in mind family physicians and their long term trusting relationships with their patients were a natural place to support better conversations about vaccine hesitancy.
Our initial interviews revealed not one form of hesitancy, but many hesitancies that ranged from a fear of needles to mistrust of institutions. We organized these types of hesitancy and validated the resulting list with primary care teams.
We then asked family doctors across the country how they were approaching each of the validated types of hesitancy. Those who were having the most success tended, whether they knew it or not, to follow the principles of Motivational Interviewing. This is a well-established concept in the vaccine hesitancy space. The Guide was created by stitching together the advice, approaches, and strategies of family doctors who were communicating effectively with their vaccine hesitant patients.
The key take-homes from our research, and the principles at the centre of www.vhguide.ca, are that these conversations are more successful when they occur over a longer period of time. Rushing towards a vaccination, or trying to ‘sell’ the vaccine are often ineffective approaches.
A family doctor is more effective when they move out of being a salesperson and into being an empathetic ally. This takes time, and resetting the goals of the conversation. More successful vaccine counsellors do not go into a conversation aiming for a ‘yes.’ Instead, their focus is on helping their patients move towards contemplation and respecting the hesitancies they encountered along the way.
www.vhguide.ca embeds these take-homes and provides pragmatic advice not just for family physicians, but all healthcare workers who find themselves doing vaccine counselling. It is constantly being updated to reflect user feedback and changes in the pandemic and vaccine spaces.
Myles Leslie, PhD is a patient engagement and health services researcher in the Cumming School of Medicine, Department of Community Health Sciences, and an assistant professor at the School of Public Policy in the health and social policy stream at The University of Calgary.