Impact of physician communication with vaccine-hesitant parents

Smith MJ. Promoting Vaccine Confidence. Infect Dis Clin North Am. 2015 Dec; 29(4): 759-69.

Vaccine hesitancy incorporates a wide range of parental attitudes and behaviors surrounding vaccines. Ironically, the very success of the immunization program has fueled vaccine concerns; because vaccine-preventable diseases are no longer prevalent, attention has shifted to the safety and necessity of vaccines themselves. This article reviews some of the underlying themes of vaccine hesitancy as well as specific vaccine safety concerns. Strategies for discussing vaccines with concerned parents are also discussed.

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Opel DJ, et al. The Influence of Provider Communication Behaviors on Parental Vaccine Acceptance and Visit Experience. Am J Public Health. 2015 Oct;105(10):1998-2004.

In the context of 2 general communication formats used by providers to initiate vaccine discussions, there appears to be an inverse relationship between parental acceptance of vaccines and visit experience. Further exploration of this inverse relationship in longitudinal studies is needed.

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Preventing gun injuries in children (with a focus on firearm storage)

Betz ME, Wintemute GJ. Physician counseling on firearm safety: a new kind of cultural competence. JAMA. 2015 Aug 4;314(5):449-50.

“The physician’s attitude is also important. Patients prefer that physicians provide nonjudgmental firearm safety information empathetically without explicit orders to do something, suggestions in line with principles of shared decision-making. Clinicians should respectfully educate patients about firearm safety, including known statistics about the risks of injury or death; written educational materials with resources may support this less judgmental approach. But to refine these educational approaches, physicians need to collaborate with a range of representatives from within the larger community of gun-owners to identify acceptable and effective strategies for incorporating firearm safety counseling into clinical care. Ideally, gun safety counseling could incorporate a range of safe storage options from which patients could choose the most acceptable and feasible option. For example, those who own only long guns for hunting may choose certain storage options (eg, a combination gun safe in the basement), whereas those who own handguns for personal protection may choose others (eg, a fingerprint-operated lock box in a bedside table).”

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Barton BK, Kologi SM. Why do you keep them there? A qualitative assessment of firearms storage practices. J Pediatr Nurs. 2015 Mar-Apr;30(2):285-93.

Thousands of children are killed or injured each year in the United States after gaining access to firearms. Storage methods are inconsistent and influenced by various contextual factors in the home. We explored reasons underlying parents’ choices of firearm storage. Thirty individuals were interviewed regarding firearm storage methods used in their homes and reasons for choosing those methods. Storage practices varied within and across households. Qualitative results suggested that storage practices were related to child presence and age, intended use of firearms, and perception of risk associated with potential access by unsafe individuals. Implications for injury prevention are discussed.

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