Can the Way Doctors Communicate with Parents Help Curb an Outbreak?
The recent California measles outbreak radiated out across the country, quickly becoming — according a Forbes blog — the worst outbreak in two decades. Forbes was not alone in running with the story. From network news to social media feeds, thousands have debated the merits of vaccines, often with great vitriol. Politicians have weighed in on the subject. Public schools are considering whether students should be required to have up-to-date vaccination records prior to enrollment.
Now that everyone is talking, healthcare providers need to use the opportunity to begin a new dialog and build a patient engagement strategy that activates — not alienates — parents who haven’t vaccinated their children.
Taking a Proactive Stance
In a recent H&HN magazine article, Patsy Stinchfield, the director of infection prevention and control and infectious disease pediatric nurse practitioner at Children’s Hospitals and Clinics of Minnesota, suggests two critical components for changing the conversation:
- Own the conversation. Many healthcare providers leave an opening for parents to opt out of vaccines for their children by asking how they feel about immunizations. But just as it would be unthinkable for a cardiologist to say, “‘How do you feel about repairing the hole in your child’s heart?’” Stinchfield says, healthcare providers need to take a more proactive approach, opening the dialog with the presumption that parents come to the doctor for the best advice for the health of their children.
- Listen more closely. When healthcare providers meet resistance to vaccinations, listening skills are critical. They need to understand the motivations behind the resistance — is there a religious objection or a bad experience with a vaccine in the past that needs consideration? Improving listening skills will, says Stinchfield, “go a long way toward building trust.”
At Children’s Hospitals and Clinics of Minnesota, Stinchfield practices what she preaches. In addition to launching an outreach program to educate parents about the benefits of childhood immunizations, clinicians at the health system review a child’s vaccine schedule with parents whether the visit is for a check-up or a sprained ankle. “I have seen children die of vaccine-preventable disease,” Stinchfield told H&HN. Now, she views every patient interaction is an opportunity to engage.
Given the furor over the latest outbreak, a proactive approach may be a necessity for other reasons. Many healthcare providers are reporting increasing pressure from parents of their most vulnerable patients — children under the age of one who are too young to be immunized.
One doctor in Southern California, Dr. Eric Ball, told NPR that, “I have several patients a day who have threatened to leave our practice if we are still going to see patients that are unvaccinated.” Just last year, 20 patients were exposed to measles when a new — and unvaccinated patient — arrived in the office with a fever and rash. As a result, Ball’s pediatric group will no longer accept patients who choose to go against best practices for immunizations — and current patients will need to get caught up on vaccinations or find new pediatricians.
Different Rationales Demand Different Approaches
One look at the comments section for any article covering the recent measles outbreak, and it is clear that healthcare providers have a challenging road ahead when it comes to developing a patient engagement strategy for the ‘anti-vax’ crowd. As we’ve mentioned previously, a common diagnosis — or in this case, a common practice — does not equate to a common mindset.
With psychographic segmentation, healthcare providers can gain useful insights into what motivates these parent-patients, allowing them to craft more targeted communications.
Recent market research found that 54 percent of the general population strongly disagreed or disagreed with the statement that “Getting a shot to prevent illnesses such as Flu, Tetanus, Diphtheria, etc., is potentially harmful for you or your family members.” However, when broken into psychographic segments, the results varied considerably.
Two psychographic segments, Balance Seekers and Willful Endurers, were significantly more likely to agree that vaccinations could be potentially harmful — in fact, they were twice as likely as the other three psychographic segments (Priority Jugglers, Self Achievers, Direction Takers) to believe this.
The fact that the anti-vax mentality is so clearly represented in two of the psychographic segments is fascinating, but what makes this all the more interesting is that Balance Seekers and Willful Endurers may appear completely opposite in most other health behaviors. Balance Seekers are proactive and wellness-oriented, while Willful Endurers are reactive and disengaged in health and wellness. While Balance Seekers invest heavily in nutrition, fitness and self-improvement, 37% of Willful Endurers admitted to being a “couch potato” in PatientBond's study!
What unites the two segments, though, is a distrust of healthcare professionals as the most credible source of healthcare information. These two segments are very independent-minded and self-reliant. For these segments, vaccinations may be something done to them, not for them, by the medical community.
So what does a healthcare provider say to these parent-patients to break down these barriers and, as Patsy Stinchfield suggests, “go the long way toward building trust”? The catch is that there is no one-size-fits-all message that will work for everyone. However, each psychographic segment has its own motivations and preferred messages, so tailoring one’s approach to the patient type can improve the likelihood of success.