The empathetic refutational interview to tackle vaccine misconceptions: Four randomized experiments.

Abstract

Objective: We introduce and report early stage testing of a novel, multicomponent intervention that can be used by healthcare professionals (HCPs) to address false or misleading antivaccination arguments while maintaining empathy for and understanding of people's motivations to believe misinformation: the "Empathetic Refutational Interview" (ERI). Method: We conducted four experiments in 2022 with participants who were predominantly negative or on the fence about vaccination (total n = 2,545) to test four steps for tailoring an HCP's response to a vaccine-hesitant individual: (a) elicit their concerns, (b) affirm their values and beliefs to the extent possible, (c) refute the misinformed beliefs in their reasoning in a way that is tailored to their psychological motivations, and (d) provide factual information about vaccines. Each of the steps was tested against active control conditions, with participants randomized to conditions. Results: Overall, compared to controls, we found that observing steps of the ERI produced small effects on increasing vaccine acceptance and lowering support for antivaccination arguments. Critically, an HCP who affirmed participants' concerns generated significantly more support for their refutations and subsequent information, with large effects compared to controls. In addition, participants found tailored refutations (compared to control responses) more compelling, and displayed more trust and openness toward the HCP giving them. Conclusions: The ERI can potentially be leveraged and tested further as a tailored communication tool for HCPs to refute antivaccination misconceptions while maintaining trust and rapport with patients. Public Significance StatementTo effectively address misinformed beliefs about vaccination, communicators must go beyond simply refuting these and show an understanding of people's underlying motivations for their beliefs. We developed a new approach toward such conversations, taking into account individuals' possible psychological motivations and responding with empathy even while correcting their misconceptions. Our approach is based on past work in healthcare communication and misinformation correction and provides a guide for more productive vaccine conversations.

Proneness to false memory generation predicts pseudoscientific belief endorsement

“…Additionally, and following Larrick ( 2004 ) with regard to the necessity to complement “training in bias” (i.e., educating regarding the existence of specific cognitive biases) with “training in rules” (i.e., providing strategies to overcome them or guidance on how to optimally make decisions), a successful intervention might also need to include the presentation of clear information about the efficacy of the products and/or treatments, which should serve as a basis to modify beliefs established resulting from erroneous memories. In this sense, we strongly recommend the implementation of empirically supported methods to address pseudoscientific beliefs, such as the motivational interview (Gagneur, 2020 ) or the empathetic motivational interview (Holford et al, 2024 ), which emphasize the use of respectful and empathetic approaches to avoid backfire effects.…”

Identifying the underlying psychological constructs from self-expressed anti-vaccination argumentation

“…There is a growing body of evidence supporting the effectiveness of tailoring communication to address people's attitude roots. Unvaccinated individuals reported greater trust in medical professionals discussing vaccines when those professionals first expressed their shared religiosity (Chu et al, 2021), or affirmed the validity of the individual's attitude root (Holford et al, 2024), compared to when they did not. An Australian community campaign that positioned vaccination as congruent with the values of alternative lifestyle communities-engaging with their ideology and identity-also reported positive impact on vaccination views for three quarters of their targeted population (Attwell & Freeman, 2015).…”

“…Understanding how attitude roots are expressed is therefore useful to permit responding effectively to individuals who express anti-vaccination beliefs by tailoring communication towards the attitude root(s) (Holford et al, 2024).…”

“…The identification of individuals' psychological motivations are critical when implementing interventions to address vaccine hesitancy, as it enables healthcare professionals to build trust with hesitant patients through demonstrating empathy for their motivations (Gagneur, 2020;Paterson et al, 2016). In line with this, the "empathetic refutational interview" was recently proposed as a psychologically-informed framework to guide conversations when patients express concern about being vaccinated (Holford et al, 2024). In this framework, healthcare professionals are advised to tailor their responses and any rebuttals of misinformation to the attitude roots from the same theoretical framework that guided our analyses in this study (Fasce et al, 2023) 8 .…”