(1148) MOTIVE: Integration of Motivational Interviewing-based Decision Tools on Vaccine Hesitancy in Community Pharmacies

Objectives: The objective of this study is to determine the impact of community pharmacists on vaccine hesitancy after completing motivational interviewing (MI) training and using MOTIVE (MOtivational interviewing Tool to Improve Vaccine adherencE) tools. The campaign against vaccine hesitancy, defined as the interruption or refusal of vaccination services despite accessibility, has solidified the role of the pharmacist in improving community health. Pharmacists, as trusted, front-line healthcare providers, must be equipped to answer patients’ questions and alleviate concerns to transition vaccine hesitancy into vaccine confidence. When evidence-based knowledge is combined with skills such as those presented in the communication approach of MI, pharmacists can confidently serve their patients and increase vaccine acceptance among members of their communities.

Methods: A mixed-methods approach was used for this study. Pharmacists practicing in community pharmacies or ambulatory care sites were recruited through the Ohio Pharmacists Association and through professional networking. Participants completed four educational modules and knowledge assessments designed by the study team to provide baseline knowledge of MI, vaccine hesitancy, and the MOTIVE tools. Each site received copies of the MOTIVE tools, which contained evidence-based responses to common questions about pediatric vaccines, the COVID-19 vaccines, the flu vaccines, and the shingles vaccine. (These tools were developed and piloted in prior research.) For each patient encounter in which the tools were utilized, a brief paper-based or online survey in REDCap was completed by the pharmacist to assess the outcomes of the interaction between the patient and the pharmacist. Survey items included non-identifiable patient characteristics, reasons for hesitancy, the MOTIVE tool utilized, and the patient’s post-encounter intent to receive the vaccine. At the end of the study period, participants completed a semi-structured interview to determine their perceptions of the educational modules and the MOTIVE tools. Descriptive statistics were performed in SPSS v 28.0, and qualitative data were analyzed using grounded theory in NVivo 14.

Results: A total of 349 pharmacist encounters with patients expressing vaccine hesitancy were recorded across 8 community pharmacy and ambulatory care sites. Most patients expressing initial hesitancy were white (88%), and ≥50 years of age (83.4%). Common vaccines discussed were: influenza, COVID-19, shingles, tetanus-diphtheria-acellular pertussis, hepatitis A and B, and pneumonia. The most common reason for initial hesitancy was safety (38.1%), followed by coordination of care (32.7%), and efficacy (30.4%). Religious/ethical considerations were expressed rarely (0.9%). After applying the MOTIVE tools, 36.4% of patients received a vaccine, with an additional 26.9% preparing or planning to receive a vaccine. The remaining patients expressed that they might consider in the future (23.8%) or were not interested (12.9%). Several themes emerged from the qualitative analysis. Pharmacists felt that the tools and training enhanced their communication with patients about vaccines. Another theme was that the tools aided in identifying questions or concerns that patients had and provided helpful resources/answers to common questions or concerns.

Conclusions: After engaging with an MI-trained pharmacist and the MOTIVE educational tools, over half the patients involved in the encounters either received a vaccine or planned to receive a vaccine. Although intention-to-vaccinate was lower overall in this study compared to similar trials, it should be noted that this intervention was utilized only when a patient expressed vaccine hesitancy. These results support the importance of in-person interactions with patients and parents to improve vaccine literacy and uptake. Equipping pharmacists for conversations with vaccine-hesitant patients increases comfortability and confidence for the pharmacist and the patient alike. Further studies evaluating validated communication and vaccine education tools among different healthcare professions are needed.