Building Trust: Helping Mothers Interpret the Data

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Building Trust Helping Mothers Interpret the
Data Make Sound Decisions

• Sharon G. Humiston, MD, MPH, FAAP
• Department of Emergency Medicine
• University of Rochester
• School of Medicine and Dentistry

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We cannot rise above our subjectivity

• So its important to know who you are

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Its all personal Vaccine protection from
Hemophilus influenza type b (Hib)
50 40 30 20 10 0
1987 1990 1993 1996
Estimated annual incidence of invasive Hib per
100,000 Children lt 5 years of age, 1987-1996
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Some of my failings when communicating

• I get tired
• I become judgmental
• Im often arrogantmotivated to seem smart, be
  right, win
• I can even be paternalistic, dogmatic, bossy
• I stop listening -- most important!

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Emotional Intelligence 5 basic emotional
social competencies

• Self-awareness - knowing what we feel
• Self-regulation - handling it, recovering
• Motivation - using our deepest preferences to
  guide us, take initiative, improve, persevere
• Empathy - taking anothers perspective
• Social skills - using skills to persuade
  negotiate for cooperation

Daniel Goleman (Bantam Books)
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We need help understanding

• Social trends, for example
• Culture of blame
• Mistrust of all authority (corporations, but also
  science, public health/govt)
• Poor science background
• Persuasion

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We need help understanding

• Social trends, for example
• Culture of blame
• Mistrust of all authority (corporations, but also
  science, public health/govt)
• Poor science background
• Persuasion

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A crowd always thinks with its sympathy, never
with its reason. William R. Alger (1823 - 1905)
US minister, writer In "Correct Quotes for DOS,"
WordStar International, 1991.
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We need help understanding

• Social trends, for example
• Culture of blame
• Mistrust of all authority (corporations, but also
  science, public health/govt)
• Poor science background
• Persuasion
• What parents think of vaccines

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Parents perceptions

• Think too many immunizations may weaken
  childrens immune system
• 25
• Believe children get more immunizations than
  necessary 23

Gellin BG et al. Pediatrics. 2000106(5)1097-1102
.
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Parents need help understanding

• The vaccine study cycle
• Waiting is a conscious choice to stay vulnerable
  to disease
• Everyone who is interested has an interest
  (including journalists)
• A little epidemiology

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Establishing cause requiresinformation in all
four boxes
Illness or Syndrome
95 of kids with ASD had MMR
Vaccination
5 of kids with ASD didnt get MMR
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Establishing cause requiresinformation in all
four boxes
Illness or Syndrome
95 of kids with ASD had MMR
95 of NT kids had MMR
Vaccination
5 of NT kids didnt get MMR
5 of kids with ASD didnt get MMR
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Systems Approach to Communication

• Written materials
• Provide VIS before vaccines are administered
  (see www.immunize.org)
• Use booklets contraindication screening sheets
  to streamline communication
• Messages Up-to-date and succinct
• Teamwork
• Agree on specific vaccine communication tasks for
  receptionist, nurse, physician
• Be ready

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Can We Fine-Tune Our Communication to Match the
Values and Communication Style of the Family?
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Audience Segmentation Regarding Vaccine
Communication

• Vaccine Believer (10)
• Relaxed (34)
• Cautious (23)
• Unconvinced (10)

Keane MT, Walter MV, Patel BI, et al.
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Great Immunization CommunicationTools
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CDC National Immunization Program

• Immunization hotline [phone]
• Email questions to nipinfo_at_cdc.gov
• www.cdc.gov/nip
• The Pink Book available free online
• Parents Guide

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Be sure to give the VIS

• Use up-to-date version
• Available in many languages
• www.immunize.org

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What do you think makes for a good website?
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Allied Vaccine Group www.vaccine.org

• Immunization Action Coalition (IAC)
• Parents of Kids with Infectious Diseases (PKIDs)
• National Network for Immunization Information
  (NNii)
• Vaccine Education Center of Childrens Hospital
  of Philadelphia (CHOP)
• American Academy of Pediatrics (AAP)

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Books

• Vaccinating your child - Questions and answers
  for the concerned parentHumiston Good
• Vaccines- What every parent should knowOffit
  Bell
• The Vaccine HandbookMarshall

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From a bumper sticker

• All truths go through three stages
• Ridiculed
• Violently opposed
• Accepted as self evident