Motivational Interview

Definition: Vaccine hesitancy refers to the delay in acceptance or refusal of vaccines despite the availability of vaccination services.
Historical Context: Vaccine hesitancy has been a persistent issue since the inception of vaccines and has recently escalated due to perceived risks associated with vaccine-preventable diseases.

Perceived Risks: When risks of vaccine-preventable diseases are perceived as low, vaccine uptake may decline.
Convenience: Factors such as availability, affordability, and access to vaccines influence the decision to get vaccinated.
Confidence: Trust in the effectiveness and safety of vaccines, as well as confidence in the healthcare system and vaccine manufacturing processes, affects vaccine acceptance.
- Key Components:
  - Perceived effectiveness of vaccines
  - Trust in healthcare professionals
  - Understanding of vaccine development and approval processes

Impact of SDR: Pharmacists must recognize and be sensitive to social determinants of health and potential health literacy gaps experienced by individuals exhibiting vaccine hesitancy.

Overview: This model outlines stages that individuals go through when changing a health behavior, from pre-contemplation to maintenance.

Purpose: MI is a collaborative conversation style aimed at enhancing a person's motivation to change.
Approaches in MI: Not a one-size-fits-all approach; MI strategies can be flexibly applied depending on the patient's circumstances.
Key Principles: Remembered by the acronym REDS:
- Rolling with Resistance: Avoid arguing with patients; instead, respond to resistance constructively.
- Expressing Empathy: Develop a collaborative relationship by validating patients' feelings and concerns.
- Developing Discrepancy: Help patients recognize the gap between their current behaviors and their goals, encouraging self-reflection.
- Supporting Self-Efficacy: Empower patients by facilitating their belief in their capability to make changes.

Reflective Listening: Acknowledge what the patient says to demonstrate understanding and build empathy.
Open-Ended Questions: Encourage patients to express their thoughts and feelings, helping to explore their concerns and knowledge bases.
Affirmations: Use positive reinforcement to build confidence in patients for making changes, regardless of their size.
Summarizing: At key points in the conversation, summarize what has been discussed to clarify and reinforce the patient's perspective.

Examples of Open-Ended Questions:
- "What are your thoughts about getting vaccinated?"
- "Can you share with me your concerns regarding vaccines?"
Addressing Barriers: Engage patients in discussing challenges that may prevent them from receiving the vaccine, such as transportation or scheduling issues.
Planning: Encourage patients to make actionable plans to receive their vaccines, enhancing their self-efficacy and commitment.

Evidence of Efficacy: Clinical trials demonstrate that MI effectively encourages patients to adopt healthier behaviors, including improving vaccine acceptance.