CPHA Canvax

Québec Ministry of Health and Social Services

Project Title:  Implantation d’une stratégie éducative de promotion de la vaccination basée sur les techniques de l’entretien motivationnel dans des maternités au Québec (Promovac)
Funding Recipient:  Centre Intégré Universitaire de Santé et Services de l’Estrie – Centre hospitalier universitaire de Sherbrooke (CIUSSS de l’Estrie – CHUS)
Project Contact:  Dr. Danielle Auger, Medical Coordinator (danielle.auger@msss.gouv.qc.ca) 
Project Period:  April 1st, 2017 – March 31st, 2019


About the Project

Currently in Québec, vaccination coverage rates are below the national targets, and the province would like to increase 18-month vaccination coverage rates by five to ten percent.  To do this, health care providers (HCP) in Québec maternity wards will receive specialized training in motivational interviewing (MI) techniques to enable them to better communicate the benefits of vaccination and address the concerns of vaccine hesitant parents. The proposed intervention is a standardized information session on infant vaccination, based on the MI techniques delivered to parents of newborns. The intervention will be performed by HCPs during the postpartum stay of mothers for an approximate duration of 20 minutes. The initiative has previously achieved positive results in two pilot implementations of maternity services in Québec.

Goal 

The purpose of this project is to implement the intervention in the maternity wards of Québec, to evaluate the issues and the barriers "in real situations" and to confirm its effectiveness under these conditions. This project will ultimately determine implementation in the province-wide strategy as part of a public health practice of immunization promotion and a standard of practice in terms of organization of services.

Objectives

Implementation

  • Implement intervention in maternity wards with more than 2,500 annual deliveries in Québec 

Assessment of implementation 

  • Identify obstacles, barriers and facilitators to the implementation of the intervention 
  • Reducing the hesitancy to vaccination among the parents encountered following the intervention received in the maternity wards
  • Increase vaccination coverage rates in Québec children following the implementation of the immunization promotion program
     

Outcomes 

Short Term

  • This project is recruiting and training HCPs and improve their skills in using MI techniques in their parent promotion intervention. 
  • The maternity intervention will allow parents to question their position regarding vaccination and discuss their concerns with the HCP. 
  • This collaborative, parent-centered exchange will enable parents to raise their own advantages and disadvantages of vaccination and the HCP can motivate them to accept more immunization without playing a role of expert. 
  • The expected results are a reduction in the parents' hesitancy score following the intervention in each participating maternity unit.

Intermediate

  • This project will make it possible to extend the strategy to all 65 maternity wards in Québec in order to implement it permanently. The strategy could also be implemented in other provinces of Canada to improve the vaccination coverage rates of Canadian children.

Long Term

  • This project will not only allow children whose parents have been vaccinated to be adequately protected from vaccine-preventable diseases, but also indirectly protect unvaccinated children. Ultimately, this could achieve the goal of vaccinating 95% of children to reduce the incidence of vaccine-preventable diseases in Québec.

The challenge that the project addresses

Vaccination has reduced mortality and morbidity by controlling many vaccine-preventable diseases. However, in most countries, the vaccination coverage rates of young children remain suboptimal. In fact, according to data from the Québec vaccination coverage rates survey in 2014, 80% of 1-year-olds and 71% of 2-year-olds had a complete vaccination coverage rates for their age. This is due in part to an increasing proportion of parents who are ambivalent about the safety and effectiveness of vaccines. One-third of parents would now be hesitant about vaccination. High vaccination coverage rates must be maintained in the population in order to avoid resurgence of diseases, as was the case during the measles outbreaks in Canada or Europe in recent years.

About the Québec Ministry of Health and Social Services

The mission of the Ministère de la Santé et des Services Sociaux du Québec (MSSS) is to maintain, improve and restore the health and well-being of Québecers by making available integrated and quality health and social services, thus contributing to the social and economic development of Québec. The Direction de la Protection de la Santé Publique (DPSP) is a directorate responsible for the Québec Immunization Program (QIP). It provides planning, implementation, financing and evaluation. The DPSP is responsible for developing departmental immunization guidelines and their application throughout Québec. It is supported by the public health directorates in all regions of Québec, which ensure the regional implementation of ministerial orientations.

 

Last Reviewed: October 16, 2018