Evaluating a web-based MMR decision aid to support informed decision-making by UK parents: A before-and-after feasibility study

Abstract

Objective:The objective of this feasibility study was to evaluate the acceptability and potential effectiveness of a web-based MMR decision aid in supporting informed decision-making for the MMR vaccine. Design: This was a prospective before-and-after evaluation. Setting: Thirty parents of children eligible for MMR vaccination were recruited from two childcare organizations in a moderately deprived community in a city in the north of England. Method: Parents completed postal questionnaires at recruitment, one week and three months after using the decision aid. Data on the acceptability of the decision aid, informed decision-making outcome measures and vaccine uptake were collected. Telephone interviews were conducted with five parents. Acceptability data were analysed using simple descriptive statistics. Repeated measures ANOVAs were undertaken for analysing the informed decision-making data. Content analysis of the qualitative data was undertaken. Results: Twenty six parents (87 per cent) completed all three study questionnaires. The decision aid was found to be acceptable to parents and was considered useful in supporting their informed decision-making. There was a statistically significant increase in parents' knowledge over time and statistically significant decrease in decisional conflict for the MMR decision. Most parents (88 per cent) reported vaccinating their child. Conclusions: We cannot extrapolate from our data to infer that the decision aid has changed decisionmaking outcomes or influenced vaccination uptake. However, findings suggest that it may increase knowledge about MMR and reduce decisional conflict to a level where parents can make an informed decision. A randomized controlled trial is now underway to expand on these findings.

Maximising the impact of qualitative research in feasibility studies for randomised controlled trials: guidance for researchers

“…Researchers commonly use qualitative research to address the acceptability and feasibility of the intervention [10, 21–24] or its perceived benefits [11, 22]. During our workshop, we identified four important questions that can be overlooked and are worth considering:

How do the intervention components and delivery processes work in the real world?

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“…When undertaking qualitative research in feasibility studies for trials, it is common for researchers to undertake a cross-sectional interview study with intervention deliverers and recipients and not to specify explicitly an approach or design [12, 21, 22, 24]. Although sometimes it may be important to mirror closely the expected approach of the planned full trial in terms of recruitment practices, it may be helpful for the research team to take a flexible approach to the qualitative research.…”

Ethics and Childhood Vaccination Policy in the United States

“…77, 78 The timing of information provision could also be fine-tuned, adding prenatal visits as an opportunity for families and providers to discuss childhood immunizations as well as to identify opportunities and resources for vaccine education well before an infant's first vaccines.…”

‘That’s just what’s expected of you … so you do it’: Mothers discussions around choice and the MMR vaccination

“…The primary assumption of such studies is that parental decisions are rooted in complex belief systems and that through gaining an understanding of these systems, beliefs can be modified leading to better uptake (Brown et al, 2010). Interventions aimed at 'assisting' parents to make a more 'informed choice' in relation to the MMR are being developed in line with this assumption (see for example, Gardner Davies, McAteer & Michie, 2010;Jackson Cheater, Peacock, Leask & Trevena, 2010).…”