Informed Decision-Making About COVID-19 Vaccination - Development and Feasibility of a Decision Support Intervention: A Mixed-Methods Study.

Abstract

Many people, particularly from vulnerable groups, experienced decisional conflict regarding COVID-19 vaccination. To support informed decision-making, we developed and pilot-tested a decision support intervention consisting of a patient decision aid and non-directive decision coaching led by a trained health professional. We developed a training program to prepare healthcare professionals to implement the intervention. To assess the decisional needs of unvaccinated individuals, a literature review and a focus group with community health workers were conducted. The results informed the development of the intervention and the associated training for health professionals, which were then tested regarding their comprehensibility, feasibility, and acceptance. Fourteen health professionals completed a 540-minute training and participated in guided focus groups. The decision support intervention was subsequently tested with laypeople through guided interviews. Data were analyzed via qualitative content analysis. The training was feasible and well accepted, and the competencies to provide decision coaching were acquired. The decision coaching offer was tested in two real and seven simulated sessions. The patient decision aid, comprising an evidence-based COVID-19 information sheet and a decision guidance, was comprehensible and highly accepted by all participants. While the intervention proved feasible, access to vulnerable groups and their willingness to participate remained low.