How do general practitioners persuade parents to vaccinate their children? A study using standardised scenarios.

Abstract

To understand how general practitioners (GPs) address parental concerns about childhood immunisation using standardised scenarios. A combination of typical case and intensity sampling was used to recruit GPs. Interviews began with role-play vignettes of four different scenarios, exemplifying concerns about immunisation and the parents who have them. They ended with GPs' reflections on these encounters. Transcripts were analysed with the focus on describing and evaluating typical persuasive strategies. Eleven GPs were interviewed from a range of demographic areas. In the role plays, GPs acknowledged the mother's concerns, tailored their discussion to her individual circumstances, and conveyed the notion of choice. Theoretical frameworks guided some in their responses. Less successful strategies were to enter into games of scientific 'ping pong'; to discredit a mother's source of information; or to ask confronting hypothetical questions. Attempts to negotiate with a mother refusing all vaccines for her children proved to be the most challenging role play. GPs tended to adopt the role of persuader rather than informer. Communication frameworks such as shared decision-making may help them to better balance these roles.