A Vaccine Communication Training Intervention for Pediatric Inpatient Clinicians

Official title

Presumptively Initiating Vaccines and Optimizing Talk for Inpatients (PIVOT-IN): A Vaccine Communication Training Intervention for Pediatric Inpatient Clinicians

Overview

This study will examine a novel stakeholder-informed intervention to identify vaccine-eligible children and promote evidence-based clinician vaccine communication with families with the goal of increasing vaccine uptake during hospitalization.

Detailed description

This study aims to examine a novel stakeholder-informed intervention to improve routine vaccination of hospitalized children. Inpatient clinicians at Seattle Children's Hospital, including nurses, advanced practice providers, and physicians, will be trained using the 'Presumptively Initiating Vaccines and Optimizing Talk for Inpatients (PIVOT-IN)' curriculum. During this training, inpatient clinicians will learn, practice, and use a presumptive format to initiate their vaccine recommendations and motivational interviewing techniques in their vaccine conversations with hospitalized patients and families.

Specific aims are to (1) evaluate the impact of the intervention relative to baseline on routine vaccine administration to vaccine-eligible hospitalized children, and (2) to examine the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) of the intervention using mixed methods.

Interventions

• Behavioral PIVOT-IN
  Inpatient clinicians at Seattle Children's Hospital, including nurses, advanced practice providers, and physicians, will be trained using the 'Presumptively Initiating Vaccines and Optimizing Talk for Inpatients (PIVOT-IN)' curriculum. During this training, inpatient clinicians will learn, practice, and use a presumptive format to initiate their vaccine recommendations and motivational interviewing techniques in their vaccine conversations with hospitalized patients and families.
• Other Standardized Vaccine Eligibility Screening
  An electronic health record prompt to identify patients due or overdue for vaccines was activated by the hospital in September.

Primary outcome measures

• Percentage of vaccine-eligible hospitalized patients who receive routine childhood vaccines during hospitalization [Time frame: Hospital admission to discharge (up to 7 months or the intervention end date, whichever comes first)]

Secondary outcome measures (7)

• Number of clinicians who complete the PIVOT-IN vaccine communication curriculum [Time frame: Up to 8 months after the intervention start date]
• Change in clinicians' perceived self-efficacy in discussing vaccines [Time frame: At Baseline and Post-Intervention (up to 10 months after the intervention start date)]
• Change in clinicians' reported use of a presumptive approach to initiate their vaccine recommendation [Time frame: At Baseline and Post-Intervention (up to 10 months after the intervention start date)]
• Perceived feasibility of the PIVOT-IN vaccine communication curriculum [Time frame: Up to 2 months after the intervention end date]
• Perceived acceptability of the PIVOT-IN vaccine communication curriculum [Time frame: Up to 2 months after the intervention start date]
• Perceived appropriateness of the vaccine communication curriculum [Time frame: Up to 2 months after intervention end date]
• Percentage of clinicians who intend to use the vaccine communication strategies presented in the PIVOT-IN curriculum [Time frame: Up to 2 months after the intervention end date]

Eligibility criteria

Patient Inclusion Criteria:

• Hospitalized on medical or surgical unit (non-critical care) at Seattle Children's
• Age 0-17 years during hospitalization
• Eligible for vaccination during hospitalization

Patient Exclusion Criteria:

• Medical contraindication to vaccination
• Died during hospitalization
• Discharged from intensive care unit
• Discharged to hospice care

Clinician Inclusion Criteria:

• Nurse, physician, or advanced practice provider (APP)
• Cares for patients hospitalized on medical or surgical unit (non-critical care) at Seattle Children's
• Practices on general medicine, general surgery, pulmonology, or ENT service (physician, APP)

Clinician Exclusion Criteria:

• Works only night shifts or on short-term contract (i.e., travel nurse)
• Will complete residency training during intervention period

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Non-randomized

Model

Sequential

Masking

Open label

Primary purpose

Health services research

Study locations

United States · 1 center

• Seattle Children's Research Institute — Seattle

Publications

• Opel DJ, Robinson JD, Zhou C, Colborn K, Spielvogle H, Furniss A, Spina C, Perreira C, O'Leary ST. Tiered Clinician Vaccine Communication Strategy to Improve Childhood Vaccine Uptake: A Cluster Randomized Clinical Trial. JAMA Netw Open. 2025 Apr 1;8(4):e257814. doi: 10.1001/jamanetworkopen.2025.7814. PMID 40305020
• O'Leary ST, Spina CI, Spielvogle H, Robinson JD, Garrett K, Perreira C, Pahud B, Dempsey AF, Opel DJ. Development of PIVOT with MI: A motivational Interviewing-Based vaccine communication training for pediatric clinicians. Vaccine. 2023 Mar 3;41(10):1760-1767. doi: 10.1016/j.vaccine.2023.02.010. Epub 2023 Feb 10. PMID 36775776

Identifiers

NCT: NCT07552857 · STUDY00005086 · R21HD113971

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗