Motivational Interviewing Training to Promote COVID-19 and Influenza Vaccination (MI-VAX): What Providers Need and Patients Want

PROJECT SUMMARY/ABSTRACT Declared a top ten threat to global health by the World Health Organization in 2019, vaccine hesitancy continues to be a major problem, as highlighted by the ongoing COVID-19 pandemic. COVID-19 and influenza are both respiratory viral illnesses that result in a substantial number of vaccine-preventable illnesses, hospitalizations, and deaths due to suboptimal vaccine uptake in the United States (US). There are major disparities in COVID-19 and influenza vaccine uptake according to race/ethnicity and socioeconomic status. These disparities contribute to the disproportionately high burden of COVID-19 and influenza illness among these vulnerable populations, with higher rates of COVID-19 and influenza related hospitalizations and deaths among individuals of racial/ethnic minorities, non-US born populations, and low socioeconomic status. Effective strategies are urgently needed to increase COVID-19 and influenza vaccine uptake among vulnerable populations. The overall goal of this proposal is to test the impact of a highly promising approach, motivational interviewing, on COVID-19 and influenza vaccine hesitancy among vulnerable adults. Building on experience training providers in MI and ongoing work supporting PCPs in addressing COVID-19 vaccine hesitancy, we will develop, implement, and evaluate an innovative motivational interviewing training program specific to COVID- 19 and influenza vaccination for PCPs who care for adult patients in and near Worcester, MA. The training program will include: (1) a video module introducing providers to key principles of MI and presumptive recommendations for vaccination; (2) opportunities to practice MI skills and receive feedback using an innovative Video-based Communication Assessment (VCA) platform; and (3) provider reference sheets with suggested responses to common concerns. We will implement and evaluate the intervention at three clinical systems via a large pragmatic clinical trial. The clinical systems include UMass Memorial Health Care (UMMHC) and two Federally Qualified Health Centers (FQHCs) which collectively serve large populations of racial/ethnic minority groups, non-US born individuals, and socioeconomically disadvantaged patients. Our specific aims are: (1) To develop a motivational interviewing training program for PCPs to address COVID-19 and influenza vaccine hesitancy among adult patients; (2) To implement and assess the impact of the MI training on COVID-19 and influenza vaccine uptake through a large, pragmatic cluster randomized trial; and (3) To evaluate the intervention according to the RE-AIM framework, incorporating the perspectives of patients and primary care providers. This research will generate urgently needed evidence for training PCPs to communicate effectively with vaccine hesitant adult patients. By developing an efficient and scalable platform for training PCPs in MI, this research will also catalyze the use of MI to promote a range of health-related behavior changes.