Staff and caregivers' perceptions of digital storytelling to increase influenza vaccine confidence in an urban safety-net healthcare system.

Background: Myriad risk factors contribute to pediatric influenza vaccination disparities. Digital stories are compelling accounts of lived experience that have been useful in health promotion, especially in minoritized communities. Little is known about how they are perceived as a behavioral intervention to improve influenza vaccination confidence in safety-net healthcare systems.

Objective: To explore staff and caregivers' perceptions of Digital Storytelling (DST) as a behavioral intervention to improve influenza vaccine confidence among caregivers of children.

Methods: This qualitative study was set in two federally qualified health centers in historically Black neighborhoods in Denver, Colorado, USA. Informal group discussions with clinic staff probed perceptions of vaccine disparities, clinic priorities, and DST. Individual interviews with key staff and caregivers of children 6 months to 5 years old explored perceptions of and preferences for DST to improve vaccine confidence. Interviews were recorded and transcribed verbatim. Three researchers analyzed transcripts via directed content analysis using a deductive approach based off the IM4Equity framework. Final themes were member-checked with clinic staff, pediatric providers, and community advisors.

Results: Approximately 70 staff attended informal group discussions; 13 staff and 12 caregivers participated in key informant interviews. Transcripts from group discussions (n = 6) and individual interviews (n = 23) were included in final analyses. Staff felt existing influenza vaccination strategies were inadequate, perceived digital stories meaningfully, and desired equitable implementation without responsibility for implementing them. Caregivers perceived DST as compelling, noted the importance of trusted storytellers, and suggested relatable stories from diverse caregivers could be sent via text messages in the winter to cue caregivers to action.

Conclusions: In this qualitative study, staff and caregivers perceived DST favorably, with preferences specific to DST implementation in a large, diverse health system. Work to develop and implement text-based DST for pediatric influenza vaccination in this context is warranted.