Factors that influence vaccination communication during pregnancy: provider and patient perspectives using the theoretical domains framework.

INTRODUCTION Vaccination during pregnancy is recommended but uptake is low and evidence on the topic is limited. AIMS This study aimed to identify the drivers of current behavior and barriers to change for health care practitioners (HCPs) and pregnant patients in Canada. METHODS This study is an in-depth qualitative investigation of the factors influencing HCPs' vaccination communication during pregnancy, as well as factors influencing pregnant patients' vaccination uptake in Canada using the Theoretical Domains Framework. Three data sources were used: (1) perinatal HCP interviews before COVID-19; (2) perinatal HCP interviews regarding vaccine communication after COVID-19; and (3) survey of pregnant or lactating women after COVID-19. RESULTS Forty-seven interviews and 169 participant responses were included. Perinatal HCPs reported limited information on vaccine communication or difficulty keeping up-to-date (Environmental context and resources; Knowledge; Beliefs about capabilities). HCPs lacked confidence and struggled with lack of training to address vaccine hesitancy without alienating patients (Beliefs about capabilities; Skills). Pregnant or lactating women struggled with the amount of information they felt was imposed on them, had concerns about the perceived negative consequences of vaccination, and felt pressure to understand what was best for them and their babies (Knowledge; Beliefs about consequences; Social influences). CONCLUSIONS Our study provides a theory-based approach to identify influencing factors that can be mapped to theory-based intervention components, improving the likelihood of intervention effectiveness. The study is the first step in adapting an existing intervention to improve vaccine communication during pregnancy, ultimately, increasing vaccination uptake. SPANISH ABSTRACT http://links.lww.com/IJEBH/A260.