MomsTalkShots, Tailored Educational App, Improves Vaccine Attitudes: A Randomized Controlled Trial
Affiliation
Johns Hopkins University Bloomberg School of Public Health (Dudley, Limaye, Church-Balin, Halsey, Salmon); Yale School of Medicine (Omer); Yale School of Public Health (Omer, Ellingson, Malik); University of Colorado Anschutz Medical Campus and Children's Hospital Colorado (O'Leary, Spina, Brewer); University of Colorado Anschutz Medical Campus (O'Leary, Brewer); present address: Merck & Co., Inc., (at Emory University and the University of Nevada - not Merck - when work was performed) (Limaye, Frew); Emory University (Bednarczyk, Chamberlain, Frew, Orenstein); University of Nevada (Frew); Weill Cornell Medicine (Riley); University of Kansas School of Medicine (Ault)
Date
Summary
"MomsTalkShots positively impacted pregnant women's and mothers' knowledge and perceptions of maternal and infant vaccines and the diseases they prevent."
Many pregnant women and parents have concerns about vaccines. In part, this hesitancy is due to the fact they do not receive adequate information about vaccines directly from their prenatal care providers, instead relying on internet searches and their social networks. This randomised controlled trial (RCT) examined the impact of MomsTalkShots, an individually tailored educational application ("app"), on vaccine attitudes of pregnant women and mothers in the United States (US), where only 55% of pregnant women received influenza vaccination during the 2020-2021 influenza season.
The MomsTalkShots app was designed as a website to be accessible via multiple internet browsers on smartphones, tablets, and computers. It features educational videos that are algorithmically responsive to its users' demographics, vaccine intentions, and knowledge, attitudes, and beliefs (KABs). The videos incorporate introductions and conclusions from obstetricians and paediatricians of different races/ethnicities with narrated animation to communicate messages in an interesting and engaging manner. For patients already intending to vaccinate, the videos take a presumptive approach; for patients with concerns, the videos establish empathy and then address concerns within the context of the risk of disease, the benefits of vaccination, and the ability to protect through vaccinating. Videos covered both maternal and infant vaccination.
MomsTalkShots was the patient-level component of a multi-level intervention to improve maternal and infant vaccine uptake that also included provider- and practice-level interventions. The impact of these interventions was studied using a two-by-two factorial design, randomising at both the patient- and the practice-level. Study staff recruited pregnant women from a diverse set of prenatal care practices in Colorado and Georgia, US, between June 2017 and July 2018. All participants (n = 2,087) received a baseline survey of maternal and infant vaccine intentions and attitudes, and 2 follow-up surveys at least 1 month and 1 year after their infant's birth, respectively. Half of participants (n = 1,041) were randomly assigned to receive educational videos through MomsTalkShots. Since the practice/provider intervention did not appear impactful, this analysis focused on MomsTalkShots (the patient-level intervention) regardless of the practice/provider intervention.
Selected findings:
Per the evaluators: "Evaluation of MomsTalkShots through a RCT has high internal validity and provides compelling efficacy data....Other similar interventions do not offer this potential combination of effectiveness and scalability. In-person training of providers to improve their vaccine communication with patients has been shown to be effective, but scale-up would be cost- and time-intensive..."
As of this writing, in response to these findings, the researchers are updating and expanding MomsTalkShots to become "LetsTalkShots", which will cover vaccines across the lifespan, including routine adolescent and adult vaccines. MomsTalkShots has also been adapted to improve COVID-19 vaccine knowledge and perceptions: LetsTalkCovidVaccines is free and accessible for all. The content, design, and distribution of LetsTalkShots and LetsTalkCovidVaccines will be regularly assessed and upgraded to reflect updates in science, incorporate new topics of concern, improve the user experience, and expand access, reach, and impact.
In conclusion: "MomsTalkShots offers a scalable tool to address vaccine hesitancy by disseminating easily accessible information tailored to individuals' demographics and concerns..."
Many pregnant women and parents have concerns about vaccines. In part, this hesitancy is due to the fact they do not receive adequate information about vaccines directly from their prenatal care providers, instead relying on internet searches and their social networks. This randomised controlled trial (RCT) examined the impact of MomsTalkShots, an individually tailored educational application ("app"), on vaccine attitudes of pregnant women and mothers in the United States (US), where only 55% of pregnant women received influenza vaccination during the 2020-2021 influenza season.
The MomsTalkShots app was designed as a website to be accessible via multiple internet browsers on smartphones, tablets, and computers. It features educational videos that are algorithmically responsive to its users' demographics, vaccine intentions, and knowledge, attitudes, and beliefs (KABs). The videos incorporate introductions and conclusions from obstetricians and paediatricians of different races/ethnicities with narrated animation to communicate messages in an interesting and engaging manner. For patients already intending to vaccinate, the videos take a presumptive approach; for patients with concerns, the videos establish empathy and then address concerns within the context of the risk of disease, the benefits of vaccination, and the ability to protect through vaccinating. Videos covered both maternal and infant vaccination.
MomsTalkShots was the patient-level component of a multi-level intervention to improve maternal and infant vaccine uptake that also included provider- and practice-level interventions. The impact of these interventions was studied using a two-by-two factorial design, randomising at both the patient- and the practice-level. Study staff recruited pregnant women from a diverse set of prenatal care practices in Colorado and Georgia, US, between June 2017 and July 2018. All participants (n = 2,087) received a baseline survey of maternal and infant vaccine intentions and attitudes, and 2 follow-up surveys at least 1 month and 1 year after their infant's birth, respectively. Half of participants (n = 1,041) were randomly assigned to receive educational videos through MomsTalkShots. Since the practice/provider intervention did not appear impactful, this analysis focused on MomsTalkShots (the patient-level intervention) regardless of the practice/provider intervention.
Selected findings:
- Among all participants, by 1 month post-birth, MomsTalkShots increased perceived risk of maternal influenza disease (61% among MomsTalkShots recipients vs 55% among controls; odds ratio (OR): 1.61, 95% confidence interval (CI): 1.23-2.09), confidence in influenza vaccine efficacy (73% vs 63%; OR: 1.97, 95%CI: 1.47-2.65), and perceived vaccine knowledge (55% vs 48%; OR: 1.39, 95%CI: 1.13-1.72). By 1 year post-birth, MomsTalkShots increased perceived vaccine knowledge (62% vs 50%; OR: 1.74, 95%CI: 1.36-2.24) and trust in vaccine information from obstetricians and paediatricians (64% vs 55%; OR: 1.53, 95%CI: 1.17-2.00).
- Among those intending not to vaccinate at baseline, MomsTalkShots increased perceived risk of maternal influenza disease (38% vs 32%; OR: 2.07, 95%CI: 1.15-3.71) and confidence in influenza vaccine efficacy (44% vs 28%; OR: 2.62, 95%CI: 1.46-4.69).
- Among those uncertain about vaccinating at baseline, MomsTalkShots increased perceived vaccine knowledge (47% vs 12%; OR: 6.89, 95%CI: 1.52-31.25) and reduced infant vaccine safety concerns (71% vs 91%; OR: 0.24, 95%CI: 0.06-0.98).
Per the evaluators: "Evaluation of MomsTalkShots through a RCT has high internal validity and provides compelling efficacy data....Other similar interventions do not offer this potential combination of effectiveness and scalability. In-person training of providers to improve their vaccine communication with patients has been shown to be effective, but scale-up would be cost- and time-intensive..."
As of this writing, in response to these findings, the researchers are updating and expanding MomsTalkShots to become "LetsTalkShots", which will cover vaccines across the lifespan, including routine adolescent and adult vaccines. MomsTalkShots has also been adapted to improve COVID-19 vaccine knowledge and perceptions: LetsTalkCovidVaccines is free and accessible for all. The content, design, and distribution of LetsTalkShots and LetsTalkCovidVaccines will be regularly assessed and upgraded to reflect updates in science, incorporate new topics of concern, improve the user experience, and expand access, reach, and impact.
In conclusion: "MomsTalkShots offers a scalable tool to address vaccine hesitancy by disseminating easily accessible information tailored to individuals' demographics and concerns..."
Source
BMC Public Health. 2022 Nov 21;22(1):2134. doi: 10.1186/s12889-022-14498-7. Image credit: Amina Filkins via Pexels (free to use)
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