Improving Physician Vaccine Recommendation Using Social Norms, Trust, and Presumptive Language

NCT05957393 | Completed

• 1 other identifier: Pro00113696
• Study Type: interventional
• Target: 447
• Locations: 2 countries
• Sites: 3

Brief Summary

This research examines vaccination recommendation perceptions and behaviors of physicians and advanced practice providers.

Conditions

Healthy

Keywords

Physicians; Vaccination Recommendation; Social Norms; Trust; Presumptive Recommendation

Outcome Measures

Primary Outcomes (6)

• Change in proportion of patients that receive a vaccine recommendation

  Proportion of patients that receive a vaccine recommendation = multiplication of the answer to the following two items: (1) "I (will) check(ed) whether a patient has/had gotten all indicated vaccines", (2) "If I saw/see a patient had not gotten an indicated vaccine, I (will) discuss(ed) getting it." Both items are answered on a scale from 0% (never) to 100% (always).

  Day 1, Day 30, Day 60, Day 90

• Change in self-reported responsibility perception

  Self-reported responsibility perception = answer to the following item: (1) "Recommending indicated vaccines is within the scope of my professional responsibilities". This item is answered on a scale from 0% (completely disagree) to 100% (completely agree).

  Day 1, Day 30, Day 60, Day 90

• Change in self-reported assessment of patient recommendation acceptance

  Self-reported assessment of patient recommendation acceptance = answer to the following item: (1) "If I recommend(ed) an indicated vaccine, my patient (will) accept(ed) that recommendation.". This item is answered on a scale from 0% (never) to 100% (always).

  Day 1, Day 30, Day 60, Day 90

• Change in self-reported patient trust

  Self-reported patient trust = answer to the following item: (1) "Thinking about the last/next 30 days I provided care, I can say that my patients (will) trust(ed) me as their healthcare provider". This item is answered on a scale from 0% (completely disagree) to 100% (completely agree).

  Day 1, Day 30, Day 60, Day 90

• Change in self-reported utilization of AIMS

  Composite score of the following items: (1) "I used/will use direct, declarative language, like: "You're due for your flu shot. We'll do that at the end of this visit"; (2) "If the patient showed/shows hesitancy about getting vaccinated, I (will) ask(ed) about their concerns, and then use(d) active listening to understand their thoughts"; (3) "If the patient showed/shows hesitancy about getting vaccinated, I (will) listen(ed) to the patient's reasoning and then summarize(d) the patient's reasoning back to them to show that I understood/understand"; (4) "If the patient still has concerns, I did/will not continue efforts to convince them." Each item is answered on a scale from 0% (never) to 100% (always).

  Day 1, Day 30, Day 60, Day 90

• Change in self-reported rate of patient vaccine uptake

  Answer to the following item: "Estimate what percentage of your patients is/will be fully vaccinated against \[…\]" This item is answered on a scale from 0% to 100%. The question is being asked 8-10 times with the following name inserted for \[...\] in the above question: Flu COVID-19 Tetanus, Diphtheria, Pertussis HPV Hepatitis B Meningitis / Meningococcal Shingles Pneumococcal Other (which can be two other diseases that the respondent indicated)

  Day 1, Day 30, Day 60, Day 90

Secondary Outcomes (2)

• Change in belief about patient autonomy

  Day 1, Day 30, Day 60, Day 90

• Change in proportion of patients that accept a recommendation

  Day 1, Day 30, Day 60, Day 90

Study Arms (4)

Quantity (present) x Quality (present)

EXPERIMENTAL

Participants will receive a social norm-based message (for quantity) and will learn the AIMS method, a trust-building method using presumptive language (for quality).

Other: Quantity of vaccination recommendations; Other: Quality of vaccination recommendations

Quantity (present) x Quality (absent)

EXPERIMENTAL

Participants will receive a social norm-based message (for quantity).

Other: Quantity of vaccination recommendations

Quantity (absent) x Quality (present)

EXPERIMENTAL

Participants will learn the AIMS method, a trust-building method using presumptive language (for quality).

Other: Quality of vaccination recommendations

Quantity (absent) x Quality (absent)

EXPERIMENTAL

Control: Participants in this condition will receive general information about vaccines, including vaccine principles, uptake barriers, and guidelines. This information will come directly from the CDC's Advisory Committee on Immunization Practices (ACIP) website.

Other: Control

Interventions

Quantity of vaccination recommendations OTHER

The survey contains a messaging intervention using a 2x2 randomized factorial design, where the investigators attempt to increase the quantity and/or quality of physician and APP vaccination recommendations (Quantity (present vs. absent) x Quality (present vs. absent)).

Quantity (present) x Quality (absent); Quantity (present) x Quality (present)

Quality of vaccination recommendations OTHER

The survey contains a messaging intervention using a 2x2 randomized factorial design, where the investigators attempt to increase the quantity and/or quality of physician and APP vaccination recommendations (Quantity (present vs. absent) x Quality (present vs. absent)).

Quantity (absent) x Quality (present); Quantity (present) x Quality (present)

Control OTHER

The survey contains a messaging intervention using a 2x2 randomized factorial design, where the investigators attempt to increase the quantity and/or quality of physician and APP vaccination recommendations (Quantity (present vs. absent) x Quality (present vs. absent)).

Quantity (absent) x Quality (absent)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participants must be physicians, advanced practice providers, medical students, nurses/nurse practitioners, or medical fellows.
• Must be in a position to be authorized to recommend vaccines to patients in their official professional capacities/responsibilities.

Sponsors & Collaborators

• Duke University: lead

Study Sites (3)

(Any and all facilities) - The study team ask(s)/(ed) professional contacts, friends, and family members who are employed at various US Institutions to forward the recruitment announcement message via their respective networks

Durham, North Carolina, 27710, United States

Location

Duke University Health System (all locations)

Durham, North Carolina, 27710, United States

Location

(Any and all facilities) - Participants are recruited via market research company "Survey Healthcare Global"

Brasília, Brazil

Location

Study Officials

• Dan Ariely, PhD

  Duke University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: OTHER
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 14, 2023
• First Posted: July 24, 2023
• Study Start: September 21, 2023
• Primary Completion: April 24, 2024
• Study Completion: April 24, 2024
• Last Updated: May 1, 2024

Record last verified: 2023-10

Data Sharing

• IPD Sharing: Will share
• Shared Documents: SAP
• Time Frame: After data from the last participant is collected, we'll take 6 months for analysis before data becomes available. Data will be available indefinitely.
• Access Criteria: Disaggregated data will be uploaded to the Open Science Framework research portal.

Locations

US (2); BR (1)