# P-1887. Improving Vaccine Communication and Decision Making in Pregnancy: A Co-Designed Canadian Intervention

## TL;DR

This paper describes a co-designed Canadian intervention to improve vaccine communication and decision-making during pregnancy, involving healthcare providers and patients.

## Contribution

The novel contribution is a co-designed, four-component intervention to enhance vaccine communication and decision-making in pregnancy using behavioral and implementation science.

## Key findings

- The intervention includes a communication approach, skills course, practice change plan, and website with decision aids.
- A feasibility study showed the intervention supports healthcare providers in shared decision-making in busy practices.
- The approach bridges theoretical frameworks with real-world relevance through patient and HCP collaboration.

## Abstract

Vaccination in pregnancy (VIP) protects pregnant individuals and their newborns, yet vaccine uptake remains suboptimal. Pregnant individuals face unique decision-making challenges, and communication with their healthcare provider (HCP) is crucial for uptake. We aimed to co-design an intervention to support informed decision-making and vaccine communication in pregnancy.Figure 1Four components of the Intervention:(1) Pregnancy-specific Communication Approach - helps HCPs deliver a clear vaccine recommendation while supporting shared decision-making(2) VIP Skills Course for HCPs - uses evidence-based behavior change and adult learning techniques to improve HCPs skills and confidence(3) Practice Change Plan - supports HCPs in developing and executing a plan to normalize vaccine communication in their practice(4) VIP Website & Decision Aids - provides evidence-based resources for patients and HCPs

Four components of the Intervention:

(1) Pregnancy-specific Communication Approach - helps HCPs deliver a clear vaccine recommendation while supporting shared decision-making

(2) VIP Skills Course for HCPs - uses evidence-based behavior change and adult learning techniques to improve HCPs skills and confidence

(3) Practice Change Plan - supports HCPs in developing and executing a plan to normalize vaccine communication in their practice

(4) VIP Website & Decision Aids - provides evidence-based resources for patients and HCPs

A multi-method study following the Double Diamond Framework: Discover, Define, Develop, and Deliver. Discover: Partnering with a diverse patient council and a multidisciplinary team of HCPs and intermediaries, we identified barriers and enablers to VIP in Canada through a scoping review, and multi-method inquiry. Define: We defined behavioral change techniques to address barriers and enablers through mapping, rapid review and key informant interviews. Develop: We co-designed and iteratively prototyped intervention components. Deliver: We delivered the intervention following usability and heuristic testing through a feasibility study.

A co-designed intervention that includes four components: (1) pregnancy-specific communication approach to help HCPs deliver a clear vaccine recommendation while supporting shared decision-making (2) VIP skills course for HCPs that uses evidence-based behavior change and adult learning techniques to improve HCPs skills and confidence (3) Practice change plan that supports HCPs in creating a plan to normalize vaccine communication in their practice (4) VIP website with evidence-based resources & decision aids for patients and HCPs. This intervention takes into consideration that Canadian HCPs reported a lack of training and practical tools to improve their vaccine communication skills and that patients reported feeling overwhelmed by vaccine uncertainty. A pre-post feasibility study in one urban outpatient clinic found the VIPC intervention to effectively support HCPs engaging in shared decision-making in a busy practice.

Our innovative co-design approach combined a rigorous problem-understanding inquiry informed by behavioral and implementation sciences with a co-design process grounded on our patient partners and HCPs' perspectives and lived experiences to bridge theoretical frameworks with real world relevance.

Eliana Castillo, MD FRCPC MHSc, Pfizer Canada: Grant/Research Support|Sanofi: Honoraria