Promoting vaccination in the province of Québec: the PromoVaQ randomized controlled trial protocol

Arnaud Gagneur, Caroline Quach, François D Boucher, Bruce Tapiero, Philippe De Wals, Anne Farrands, Thomas Lemaitre, Nicole Boulianne, Chantal Sauvageau, Manale Ouakki, Virginie Gosselin, Dominique Gagnon, Geneviève Petit, Marie-Claude Jacques, Ève Dubé, Arnaud Gagneur, Caroline Quach, François D Boucher, Bruce Tapiero, Philippe De Wals, Anne Farrands, Thomas Lemaitre, Nicole Boulianne, Chantal Sauvageau, Manale Ouakki, Virginie Gosselin, Dominique Gagnon, Geneviève Petit, Marie-Claude Jacques, Ève Dubé

Abstract

Background: Vaccination has a huge public health impact. Maintaining vaccine coverage is key to avoid the devastating consequences of resurgence. In the Province of Québec, vaccine coverage in young children are sub-optimal, mostly due to ambivalence toward vaccine safety and efficacy. We previously conducted a regional study in the Québec's Eastern Townships region, the PromoVac Study, to test a new educational intervention, based on motivational interviewing techniques, aimed at promoting infant vaccination. This first study evidenced that the intervention led to a marked increase in mothers' intention to vaccinate, and vaccine coverage in their infants. The current study protocol aims at scaling up these results at a provincial level using a randomized controlled trial design.

Methods: This pragmatic, randomized, controlled, parallel-group clinical trial will compare the effectiveness of the motivational interviewing to an educational intervention, including the distribution of an information flyer as standard of care on vaccination coverage in four maternity wards across the Province of Québec (PromovaQ). Adult mothers of children born in participating maternity wards were recruited between March 2014 and February 2015. Vaccination coverage will be assessed at 3-years of age, thus the trial is expected to be completed in March 2019. Statistical analyses will be conducted under the intention-to-treat principle. Vaccine coverage will be analyzed using Chi-squared distribution testing and logistic regression to identify determinant factors. Secondary outcomes will include vaccine hesitation and intention scores, mother's knowledge, attitudes and beliefs about immunization, and psychosocial determinants of intention to vaccinate.

Discussion: In the case results of this Provincial RCT be confirmed, serious consideration should then be given by Ministry of Health authorities to the possible implementation of MI-based strategies across provincial maternity wards. To ensure adequate input and secure implementation, study design and results will be reviewed with relevant stakeholders, including the children's families, and provincial and regional decision-makers. Results will be adapted and shared with all stakeholders.

Trial registration: ClinicalTrials.gov NCT02666872 (Retrospectively registered as January 28, 2016).

Keywords: Motivational interviewing; Province of Québec; RCT; Vaccination coverage.

Conflict of interest statement

Ethics approval and consent to participate

This trial was approved by the CHUS Research Ethics Board (number 13–074) and was conducted according to applicable laws and regulations. Written informed consent was obtained from each participant prior to starting study participation.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Prochaska’s Stages of Change
Fig. 2
Fig. 2
Intervention composite model

References

    1. Comité consultatif national sur l'immunisation. Guide canadien d'immunisation. 7e ed. Ottawa: Ottawa: Agence de la santé publique du Canada 2006. p. 410.
    1. Boulianne N, Audet D, Ouakki M, Dubé È, De Serres G, Duay M. Enquête sur la couverture vaccinale des enfants de 1 an et 2 ans au Québec en 2014. Institut national de santé publique du Québec; 2015.
    1. De Serres G, Boulianne N, Defay F, Brousseau N, Benoit M, Lacoursiere S, et al. Higher risk of measles when the first dose of a 2-dose schedule of measles vaccine is given at 12-14 months versus 15 months of age. Clin Infect Dis. 2012;55(3):394–402. doi: 10.1093/cid/cis439.
    1. Boulianne N, Audet D, Ouakki M, Guay M, Duval B, De Serres G. Enquête sur la couverture vaccinale des enfants québécois en 2006. Institut national de santé publique du Québec. 2007. p. 104.
    1. D'Aragon F, Fradette V, Francoeur C, Pichette F, Toulouse K, Dufort J, et al. Retards de vaccination des nourrissons - qui en est responsable? Can J Infec Dis Med Microb. 2006;17:359.
    1. Boulianne N, Duval B, De Serres G, Audet D, Ouakki M. Couverture vaccinale des enfants québécois en 2006. 1es journées annuelles de santé publique, Montréal.2007.
    1. Landry M. Évaluation préliminaire des retards dans le calendrier de vaccination au Québec. Rapport préparé pour le Groupe provincial sur les retards en immunisation; 2005.
    1. Boulianne N, Hemon YA, Mawhinney T, Strong D, Gemmill I, Dobson S, et al. National eligible, due, and overdue guidelines for immunization registries: draft recommendations from the Canadian immunization registry network, data standards task group. Can Commun Dis Rep. 2004;30(6):53–59.
    1. Boulianne N, Kielou M, Sauvageau C. Avis du groupe scientifique en immunisation sur les indicateurs des retards vaccinaux au Québec. Institut national de santé publique du Québec; 2011. p. 31.
    1. Boulianne N, Bradet R, Audet D, Deceuninck G. Enquête sur la couverture vaccinale des enfants de 1 an et 2 ans au Québec en 2008. Institut national de santé publique du Québec; 2009. p. 205.
    1. Boulianne N, Bradet R, Audet D, Ouakki M, Guay M, De Serres G. Enquête sur la couverture vaccinale des enfants québécois en 2010. Institut national de santé publique du Québec; 2011. p. 149.
    1. Hilton S, Petticrew M, Hunt K. 'Combined vaccines are like a sudden onslaught to the body's immune system': parental concerns about vaccine 'overload' and 'immune-vulnerability'. Vaccine. 2006;24(20):4321–4327. doi: 10.1016/j.vaccine.2006.03.003.
    1. Moreco LB. Silence, on vaccine. Radio-Canada and France. 2008:5.
    1. Ritvo P, Wilson K, Willms D, Upshur R, Goldman A, Kelvin D, et al. Vaccines in the public eye. Nat Med. 2005;11(4 Suppl):S20–S24. doi: 10.1038/nm1220.
    1. Lagarde F. Summary of public opinion on immunization in Canada. Public Health Agency of Canada; 2005. p. 19.
    1. Sauvageau C, Duval B, Gilca V, Lavoie F, Ouakki M. Human papilloma virus vaccine and cervical cancer screening acceptability among adults in Quebec, Canada. BMC Public Health. 2007;7:304. doi: 10.1186/1471-2458-7-304.
    1. Smith A, Yarwood J, Salisbury DM. Tracking mothers' attitudes to MMR immunisation 1996-2006. Vaccine. 2007;25(20):3996–4002. doi: 10.1016/j.vaccine.2007.02.071.
    1. Zimet GD, Liddon N, Rosenthal SL, Lazcano-Ponce E, Allen B. Psychosocial aspects of vaccine acceptability. Vaccine. 24S3: Elsevier; 2006.
    1. Fabry P, Gagneur A, Pasquier JC. Determinants of a (H1N1) vaccination: cross-sectional study in a population of pregnant women in Quebec. Vaccine. 2011;29(9):1824–1829. doi: 10.1016/j.vaccine.2010.12.109.
    1. Vrdelja M, Kraigher A, Vercic D, Kropivnik S. The growing vaccine hesitancy: exploring the influence of the internet. Eur J Pub Health. 2018.
    1. World Health Organization. http://wwwwhoint/immunization/programmes_systems/vaccine_hesitancy/en/. Access September 2018.
    1. MacDonald NE, SWGoV H. Vaccine hesitancy: definition, scope and determinants. Vaccine. 2015;33(34):4161–4164. doi: 10.1016/j.vaccine.2015.04.036.
    1. Briss PA, Rodewald LE, Hinman AR, Shefer AM, Strikas RA, Bernier RR, et al. Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults. The task force on community preventive services. Am J Prev Med. 2000;18(1 Suppl):97–140. doi: 10.1016/S0749-3797(99)00118-X.
    1. Ames HM, Glenton C, Lewin S. Parents' and informal caregivers' views and experiences of communication about routine childhood vaccination: a synthesis of qualitative evidence. Cochrane Database Syst Rev. 2017;2:CD011787.
    1. Lee WW, Choi KC, Yum RW, Yu DS, Chair SY. Effectiveness of motivational interviewing on lifestyle modification and health outcomes of clients at risk or diagnosed with cardiovascular diseases: a systematic review. Int J Nurs Stud. 2016;53:331–341. doi: 10.1016/j.ijnurstu.2015.09.010.
    1. Lindson-Hawley N, Thompson TP, Begh R. Motivational interviewing for smoking cessation. Cochrane Database Syst Rev. 2015(3):CD006936.
    1. O'Halloran PD, Blackstock F, Shields N, Holland A, Iles R, Kingsley M, et al. Motivational interviewing to increase physical activity in people with chronic health conditions: a systematic review and meta-analysis. Clin Rehabil. 2014;28(12):1159–1171. doi: 10.1177/0269215514536210.
    1. VanBuskirk KA, Wetherell JL. Motivational interviewing with primary care populations: a systematic review and meta-analysis. J Behav Med. 2014;37(4):768–780. doi: 10.1007/s10865-013-9527-4.
    1. Miller WR, Rollnick S. Motivational interviewing: helping people change. 3rd edition ed, vol. 482. New York: Guilford Press2012.
    1. Gagneur A, Lemaitre T, Gosselin V, Farrands A, Carrier N, Petit G, et al. A postpartum vaccination promotion intervention using motivational interviewing techniques improves short-term vaccine coverage: PromoVac study. BMC Public Health. 2018;18(1):811. doi: 10.1186/s12889-018-5724-y.
    1. Gagneur A, Lemaître T, Gosselin V, Farrands A, Carrier N, Petit G, Valiquette L, De Wals P. Promoting vaccination at birth using motivational interviewing techniques improves vaccine intention. Journal of Infectious Diseases and Therapy. 2018:6. 10.4172/2332-0877.1000379.
    1. Gagneur A, Petit G, Valiquette L, de Wals P. Une promotion novatrice de la vaccination en maternité peut-elle améliorer les couvertures vaccinales des nourrissons. Rapport de l’étude Promovac en Estrie. . Bibliothèque et archives nationales du Canada. ISBN :978-2-9813830-0-6 (printed version), 978–2–9813830-1-3 (pdf version); 2013. p. 112.
    1. Naissance selon l’accoucheur . Institut de la statistique du Québec. 2007. Québec, (1997-2007)
    1. Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51(3):390–395. doi: 10.1037/0022-006X.51.3.390.
    1. Mauriello LM, Johnson SS, Prochaska JM. Meeting patients where they are at: using a stage approach to facilitate engagement. In: Springer C, editor. Practical Strategies and Tools to Promote Treatment Engagement 2017. p. 25–44.
    1. Protocole d'immunisation du Québec. Ministère de la Santé et des Services sociaux; 2009. p. 447.
    1. Gold R. Les Vaccins. Avoir la piqûre pour son enfant 2006.
    1. Rosenstock IM. Historical origins of the health belief model. Health Educ Behav. 1974;2(4).
    1. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211. doi: 10.1016/0749-5978(91)90020-T.
    1. Boulianne NBR, Audet D, Ouakki M, De Serres G, Guay M. Enquête sur la couverture vaccinale des enfants de 1 an et 2 ans au Québec en 2012. Institut National de la Santé Publique. 2013; .

Source: PubMed

3
購読する