A study comparing the practice of Australian maternity care providers in relation to maternal immunisation

Krishnaswamy, Sushena; Wallace, Euan; Buttery, Jim; Giles, Michelle

doi:10.1111/ajo.12888

Cited by 6 publications

(4 citation statements)

References 25 publications

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“…19 Our study suggests the need for further research into the integration of immunisation training into contemporary educational contexts in Australia, as current educational approaches may not adequately prepare midwives for this aspect of their role. 19 Other recent Australian research also supports this contention, finding almost all surveyed midwives wanted more education on some aspect of maternal immunisation including information about evidence for maternal influenza vaccine (80.7%) and dTpa vaccine (81.9%); information on implications for the foetus/newborn (78.3%); and information on the roles and expectations of health care professionals regarding maternal immunisation (74.3%). 14 Our research indicates that this issue is not restricted to the maternal context and may reflect a need for additional education in both maternal and childhood immunisation.…”

Section: Discussionmentioning

confidence: 86%

Midwives’ knowledge, attitudes and confidence in discussing maternal and childhood immunisation with parents: A national study

Frawley

McKenzie

Sinclair

et al. 2020

Vaccine

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IntroductionDespite the enormous benefits of childhood and maternal immunisation to individual and population health, the uptake of maternal vaccines during pregnancy remains suboptimal. Midwives are a trusted information source for parents and play an important role in the provision of immunisation information. Understanding midwives' attitudes and vaccine knowledge, along with their confidence to discuss maternal and childhood immunisation with parents, is key to reducing parental decisional conflict and achieving immunisation goals. MethodsAn online study was conducted to investigate midwives' knowledge and attitudes towards maternal and childhood vaccination along with their confidence to answer parents' vaccine-related questions.Midwives were recruited by email via the midwifery peek body, the Australian College of Midwives. ResultsA total of 359 midwives completed the online survey. The majority of midwives supported maternal (influenza 83%, pertussis 90.5%) and childhood immunisation (85.8%); however, 69.4% of respondents wanted further training about immunisation. Midwives who felt their midwifery education adequately covered immunisation were more confident advising parents about maternal (p=0.007) and childhood immunisation (p<0.001). Similarly, Midwives were significantly more likely to confidently advise parents about maternal (p<0.001) and childhood immunisations (p<0.001) if they had completed a specific immunisation training course outside of their midwifery course. ConclusionMost midwives working in Australia support vaccination. However, access to contemporary, culturally appropriate education that enables midwives to engage confidently with parents about immunisation is lacking. Education based on a women-centred approach within the pre-registration curriculum along with continuing professional development programs could enable midwives to reduce the evidence to practice gap by increasing vaccine uptake.

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Section: Discussionmentioning

confidence: 86%

Midwives’ knowledge, attitudes and confidence in discussing maternal and childhood immunisation with parents: A national study

Frawley

McKenzie

Sinclair

et al. 2020

Vaccine

View full text Add to dashboard Cite

show abstract

“…Japanese providers aware of Guillain–Barre syndrome cases associated with U.S. influenza vaccination were less likely to recommend the vaccine during the 2009 H1N1 pandemic [ 112 ]. Providers with higher confidence in their knowledge elected to receive influenza vaccine more frequently [ 106 ] and recommended vaccination for influenza 1.3–3.5 times [ 55 , 106 , 114 , 115 ] and pertussis 6.8 times more often [ 114 ]. Reasons for not suggesting vaccines included not being confident in offering counseling [ 81 ] and inadequate vaccine training [ 82 ].…”

Section: Resultsmentioning

confidence: 99%

“…Lack of clear or official recommendation deterred suggesting [ 63 , 95 , 100 ] or administering vaccines [ 131 ]. HCPs who followed, consulted, or were aware of guidelines were more likely to advocate for vaccines (PR/OR = 1.3–3.6) [ 49 , 55 , 68 , 80 , 92 , 105 , 114 , 125 ], up to 22 times more for the diphtheria–tetanus–acellular pertussis (dTpa) vaccine during pregnancy [ 114 ] and over 6 times more for influenza vaccines to diabetic adults [ 65 ]. HCPs who distrusted authorities were less likely to encourage vaccination [ 53 ], and those who trusted information from institutional sources had lower hesitancy [ 62 ] and recommended more frequently [ 56 ] (OR = 1.40) [ 64 ].…”

Section: Resultsmentioning

confidence: 99%

Healthcare Providers’ Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review

et al. 2021

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Despite vaccines’ effectiveness in reducing the rate of preventable diseases, vaccine hesitancy has threatened public health and economies worldwide. Healthcare providers’ (HCP) communications and behavior strongly influence patient receptivity and uptake. The goal of this review was to examine HCP vaccine perceptions, knowledge, and reservations and how these attitudes affect their recommendations and vaccination practices. Primary research studies published by 16 September 2020 were searched in PubMed, Web of Science, Embase, CINAHL, and PsycINFO. A 14-item scale was developed for survey study and risk of bias appraisal (SSRBA). In total, 96 papers from 34 countries were included, covering 17 vaccines (HPV and influenza vaccines the most studied). Recommendation was positively associated with provider knowledge and experience, beliefs about disease risk, and perceptions of vaccine safety, necessity, and efficacy. HCP vaccination attitudes and practices varied across specialties, vaccines, and countries; demographic impact was inconclusive. Barriers included anticipation of patient/parental concerns or refusal, lacking clear guidelines, time constraints, and cost. For HPV, vaccines were more often recommended to older, female adolescents and by physicians who discussed sexual health. HCPs are vital advocates for patients and the public, but studies indicated a prevalence of provider hesitancy pertaining to inadequate knowledge, low vaccine confidence, and suboptimal uptake themselves. Improving HCP knowledge and assuring their access to information they deem trustworthy are essential to supporting HCPs‘ role as “trusted messengers” to promote vaccine acceptance.

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“…While health care professional (HCP) recommendation and/or endorsement of safety encourages uptake [12,18,19,23,27], sometimes antenatal care providers do not inform people about MVs [12,13,19], with some providers lacking confidence and/or knowledge [21,22,[28][29][30]. Specific training about MVs to health professionals increases their confidence to give appropriate advice to pregnant women [31,32].…”

Section: Introductionmentioning

confidence: 99%

Influences on Pregnant Women’s and Health Care Professionals’ Behaviour Regarding Maternal Vaccinations: A Qualitative Interview Study

Gauld

Martin²,

Sinclair

et al. 2022

Vaccines

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The uptake of maternal influenza and pertussis vaccinations is often suboptimal. This study explores the factors influencing pregnant women’s and health care professionals’ (HCPs) behaviour regarding maternal vaccinations (MVs). Pregnant/recently pregnant women, midwives, pharmacists and general practice staff in Waikato, New Zealand, were interviewed. The analysis used the behaviour change wheel model. Interviews of 18 women and 35 HCPs revealed knowledge about MVs varied with knowledge deficiencies hindering the uptake, particularly for influenza vaccination. HCPs, especially midwives, were key in raising women’s awareness of MVs. Experience with vaccinating, hospital work (for midwives) and training increased HCPs’ knowledge and proactivity about MVs. A “woman’s choice” philosophy saw midwives typically encouraging women to seek information and make their own decision. Women’s decisions were generally based on knowledge, beliefs, HCPs’ emphasis and their perceived risk, with little apparent influence from friends, family, or online or promotional material. General practice’s concentration on children’s vaccination and minimal antenatal contact limited proactivity with MVs. Busyness and prioritisation appeared to affect HCPs’ proactivity. Multi-pronged interventions targeting HCPs and pregnant women and increasing MV access are needed. All HCPs seeing pregnant women should be well-informed about MVs, including how to identify and address women’s questions or concerns about MVs to optimise uptake.

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A study comparing the practice of Australian maternity care providers in relation to maternal immunisation

Cited by 6 publications

References 25 publications

Midwives’ knowledge, attitudes and confidence in discussing maternal and childhood immunisation with parents: A national study

Midwives’ knowledge, attitudes and confidence in discussing maternal and childhood immunisation with parents: A national study

Healthcare Providers’ Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review

Influences on Pregnant Women’s and Health Care Professionals’ Behaviour Regarding Maternal Vaccinations: A Qualitative Interview Study

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