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      The comprehensive ‘Communicate to Vaccinate’ taxonomy of communication interventions for childhood vaccination in routine and campaign contexts

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          Abstract

          Background

          Communication can be used to generate demand for vaccination or address vaccine hesitancy, and is crucial to successful childhood vaccination programmes. Research efforts have primarily focused on communication for routine vaccination. However, vaccination campaigns, particularly in low- or middle-income countries (LMICs), also use communication in diverse ways.

          Without a comprehensive framework integrating communication interventions from routine and campaign contexts, it is not possible to conceptualise the full range of possible vaccination communication interventions. Therefore, vaccine programme managers may be unaware of potential communication options and researchers may not focus on building evidence for interventions used in practice.

          In this paper, we broaden the scope of our existing taxonomy of communication interventions for routine vaccination to include communication used in campaigns, and integrate these into a comprehensive taxonomy of vaccination communication interventions.

          Methods

          Building on our taxonomy of communication for routine vaccination, we identified communication interventions used in vaccination campaigns through a targeted literature search; observation of vaccination activities in Cameroon, Mozambique and Nigeria; and stakeholder consultations. We added these interventions to descriptions of routine vaccination communication and categorised the interventions according to their intended purposes, building from an earlier taxonomy of communication related to routine vaccination.

          Results

          The comprehensive taxonomy groups communication used in campaigns and routine childhood vaccination into seven purpose categories: ‘Inform or Educate’; ‘Remind or Recall’; ‘Enhance Community Ownership’; ‘Teach Skills’; ‘Provide Support’; ‘Facilitate Decision Making’ and ‘Enable Communication’. Consultations with LMIC stakeholders and experts informed the taxonomy’s definitions and structure and established its potential uses.

          Conclusions

          This taxonomy provides a standardised way to think and speak about vaccination communication. It is categorised by purpose to help conceptualise communication interventions as potential solutions to address needs or problems.

          It can be utilised by programme planners, implementers, researchers and funders to see the range of communication interventions used in practice, facilitate evidence synthesis and identify evidence gaps.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12889-017-4320-x) contains supplementary material, which is available to authorized users.

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          Most cited references30

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          Health communication and vaccine hesitancy.

          Health communication is an evolving field. There is evidence that communication can be an effective tool, if utilized in a carefully planned and integrated strategy, to influence the behaviours of populations on a number of health issues, including vaccine hesitancy. Experience has shown that key points to take into account in devising and implementing a communication plan include: (i) it is necessary to be proactive; (ii) communication is a two-way process; (iii) knowledge is important but not enough to change behaviour; and (iv) communication tools are available and can be selected and used creatively to promote vaccine uptake. A communication strategy, incorporating an appropriate selection of the available communication tools, should be an integral part of every immunization programme, addressing the specific factors that influence hesitancy in the target populations.
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            GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction.

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              Evidence-based discussion increases childhood vaccination uptake: a randomised cluster controlled trial of knowledge translation in Pakistan

              Background Childhood vaccination rates are low in Lasbela, one of the poorest districts in Pakistan's Balochistan province. This randomised cluster controlled trial tested the effect on uptake of informed discussion of vaccination costs and benefits, without relying on improved health services. Methods Following a baseline survey of randomly selected representative census enumeration areas, a computer generated random number sequence assigned 18 intervention and 14 control clusters. The intervention comprised three structured discussions separately with male and female groups in each cluster. The first discussion shared findings about vaccine uptake from the baseline study; the second focussed on the costs and benefits of childhood vaccination; the third focussed on local action plans. Field teams encouraged the group participants to spread the dialogue to households in their communities. Both intervention and control clusters received a district-wide health promotion programme emphasizing household hygiene. Interviewers in the household surveys were blind of intervention status of different clusters. A follow-up survey after one year measured impact of the intervention on uptake of measles and full DPT vaccinations of children aged 12-23 months, as reported by the mother or caregiver. Results In the follow-up survey, measles and DPT vaccination uptake among children aged 12-23 months (536 in intervention clusters, 422 in control clusters) was significantly higher in intervention than in control clusters, where uptake fell over the intervention period. Adjusting for baseline differences between intervention and control clusters with generalized estimating equations, the intervention doubled the odds of measles vaccination in the intervention communities (OR 2.20, 95% CI 1.24-3.88). It trebled the odds of full DPT vaccination (OR 3.36, 95% CI 2.03-5.56). Conclusion The relatively low cost knowledge translation intervention significantly increased vaccine uptake, without relying on improved services, in a poor district with limited access to services. This could have wide relevance in increasing coverage in developing countries. Trial registration ISRCTN12421731.
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                Author and article information

                Contributors
                j.kaufman@latrobe.edu.au
                heather.melanie.ames@gmail.com
                x.bosch@unibas.ch
                ycartier@iuhpe.org
                julie.cliff@gmail.com
                Claire.Glenton@fhi.no
                Simon.Lewin@fhi.no
                muloliwa@yahoo.com.br
                afyokuene@gmail.com
                oyo_ita@yahoo.com
                radagabriel@gmail.com
                Sophie.hill@latrobe.edu.au
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                10 May 2017
                10 May 2017
                2017
                : 17
                : 423
                Affiliations
                [1 ]ISNI 0000 0001 2342 0938, GRID grid.1018.8, School of Psychology and Public Health, , La Trobe University, ; Melbourne, Australia
                [2 ]ISNI 0000 0001 1541 4204, GRID grid.418193.6, , Norwegian Institute of Public Health, ; Oslo, Norway
                [3 ]ISNI 0000 0004 0587 0574, GRID grid.416786.a, , Swiss Tropical and Public Health Institute, ; Basel, Switzerland
                [4 ]ISNI 0000 0004 1937 0642, GRID grid.6612.3, , University of Basel, ; Basel, Switzerland
                [5 ]International Union for Health Promotion and Education, Saint-Maurice Cedex, France
                [6 ]GRID grid.8295.6, , Eduardo Mondlane University, ; Maputo, Mozambique
                [7 ]ISNI 0000 0001 1541 4204, GRID grid.418193.6, , Norwegian Institute of Public Health, ; Oslo, Norway
                [8 ]ISNI 0000 0000 9155 0024, GRID grid.415021.3, , South African Medical Research Council, ; Cape Town, South Africa
                [9 ]Provincial Directorate of Health, Nampula, Mozambique
                [10 ]ISNI 0000 0001 0291 6387, GRID grid.413097.8, , University of Calabar, ; Calabar, Nigeria
                [11 ]ISNI 0000 0001 2157 0406, GRID grid.7870.8, , Pontifical Catholic University of Chile, ; Santiago, Chile
                Author information
                http://orcid.org/0000-0001-5139-4183
                Article
                4320
                10.1186/s12889-017-4320-x
                5424416
                28486956
                daf97d03-79b1-470e-b846-5a916d3c7bd1
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 18 August 2016
                : 26 April 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100005416, Norges Forskningsråd;
                Award ID: 220873
                Award ID: 244676
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100001322, South African Medical Research Council;
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Public health
                communication,childhood vaccination,immunisation,taxonomy,interventions,campaigns
                Public health
                communication, childhood vaccination, immunisation, taxonomy, interventions, campaigns

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