This is part a continuing series of recommendations put out by CoVaRR-Net. These recommendations are directed to the federal Deputy Minister of Health, local and provincial Medical Health Officers, the Urban Public Health Network, the Variants of Concern Expert Panel, and public health officials.
Summary
Vaccine hesitancy has been identified by the World Health Organization as one of the top 10 threats to public health. It poses a direct challenge to the success of COVID-19 vaccination programs. By lowering vaccination coverage within the population, vaccine hesitancy threatens to increase the spread of disease and to prevent broad ‘herd immunity.’
Researchers and public health officials suggest vaccine hesitancy requires inter-disciplinary interventions because it stems from multiple sources, including social norms, religious beliefs, economic or political factors, trust in government and healthcare providers, and personal perceptions of vaccinations. Under these circumstances, interventions informed by behavior change theories, based on evidence-based principles, may offer the best prospect for convincing those who are reluctant to accept vaccination.
Motivational interviewing (MI) is a promising technique used by healthcare providers to induce health behavior changes amongst their clients and is being taught in some university curricula across Canada. Existing research has shown that MI, applied on a one-to-one basis by trained healthcare professionals can be effective at reducing vaccine hesitancy and increasing confidence with regard to COVID-19 vaccination. While MI has demonstrated its effectiveness as a single intervention, it should be incorporated in a multi-variate package of existing public health and individual interventions.
CoVaRR-Net Recommendations
At the federal level
- Continue to fund MI research and explore the efficacy of the approach for COVID-19 vaccination, specifically in a multi-site study across Canada, as well as the efficacy of scalable digital interventions utilizing MI dialogues.
- Such studies should include older and younger adults, as well as marginalized populations for more generalizable results.
- Funded research should also explore the effectiveness of MI in conjunction with other vaccine hesitancy interventions.
At the provincial/territorial levels
- Provide opportunities to train current healthcare providers and public health staff in MI techniques and encourage them to use these skills with clients. Utilize evidence-based evaluation techniques to assess healthcare competencies.
- Ensure that equity, diversity, and inclusion training, as well as culturally relevant vaccine hesitancy factors, are part of the curriculum.
- Integrate and add the MI approach into a package of existing vaccine hesitancy interventions.
At the local/regional levels
- Train local community “vaccination ambassadors” through programs in MI techniques.
- All healthcare workers with direct patient interactions, including allied health providers such as physiotherapy, occupational therapy, dietetics, and social work programs, along with nursing, midwifery, physician, and physician assistant programs, should be provided training in the practice of MI with their patients.