Qualitative focus groups with stakeholders identify new potential outcomes related to vaccination communication

Introduction
Communication interventions are widely used to promote childhood vaccination and sustain vaccine acceptance, but communication’s role in changing people’s beliefs and behaviours is not well understood. To determine why these interventions work or where they fail, evaluations must measure a range of outcomes in addition to vaccination uptake. As part of a larger project to develop a preliminary Core Outcome Set for vaccination communication, we conducted a qualitative focus group study exploring how parents and health professionals perceive and experience communication encounters and what outcomes are relevant to them.
Methods
Focus group participants included parents and health professionals involved in vaccination communication (healthcare providers, researchers and policymakers). Participants discussed their experiences with communication for childhood vaccination, and what made the communication ‘successful’ or 'unsuccessful.'
Our analysis involved two stages: first, we thematically analysed the discussions, identifying key parent and professional themes. In stage two, we used an interpretive analysis approach to translate the themes and quotes into measurable outcomes. We compared these outcomes with outcomes measured in vaccination communication trials (previously identified and mapped).
Results
We held three focus groups with parents (n = 12) and four with professionals (n = 19). In stage one, we identified six parent themes (primarily related to decision-making) and five professional themes (primarily related to intervention planning, delivery and evaluation).
In stage two, we translated 47 outcomes from parents and 73 from professionals (91 total, de-duplicated). All stakeholders discussed attitudes or beliefs and decision-making outcomes most frequently. Most (66%) of the focus group-generated outcomes were not measured in vaccination communication trials.
Conclusion
Consulting with stakeholders through focus groups allowed us to explore how parents and professionals experienced vaccination communication, identify those aspects of the experience that were important to them, and translate these into outcomes that can be prioritised into a Core Outcome Set and measured in intervention evaluations.

研究背景
沟通干预措施（communication interventions）被广泛用于推广儿童疫苗接种并维持疫苗接种认可度，但目前学界对沟通在改变人们观念与行为方面的作用仍缺乏充分认知。为明确此类干预措施的起效原因或失败症结，相关评估除需测量疫苗接种率外，还需对一系列结局指标进行考量。本研究作为开发疫苗接种沟通初步核心结局集（Core Outcome Set）的大型项目的一部分，开展了一项定性焦点小组研究，旨在探究家长与卫生专业人员如何感知和体验疫苗接种沟通场景，以及哪些结局指标与他们相关。

研究方法
焦点小组的参与者涵盖参与疫苗接种沟通工作的家长与卫生专业人员，包括医疗服务提供者、研究人员及政策制定者。参与者围绕儿童疫苗接种沟通的相关经历，以及何为“成功”或“失败”的沟通展开讨论。

本研究的分析分为两个阶段：第一阶段，我们对讨论内容进行主题分析，提炼出针对家长群体与专业群体的核心主题；第二阶段，我们采用解释性分析方法，将这些主题与访谈语录转化为可测量的结局指标，并将其与此前已识别并梳理的疫苗接种沟通试验中所采用的结局指标进行比对。

研究结果
我们共开展了3场针对家长的焦点小组讨论（n=12）以及4场针对专业人员的焦点小组讨论（n=19）。第一阶段，我们提炼出6个与家长相关的核心主题（主要涉及决策制定），以及5个与专业人员相关的核心主题（主要涉及干预措施的规划、实施与评估）。

第二阶段，我们从家长的讨论中提炼出47项结局指标，从专业人员的讨论中提炼出73项（共计91项，已去重）。所有利益相关方均最为频繁地提及态度/观念与决策制定类结局指标。焦点小组所生成的结局指标中，有66%未在现有疫苗接种沟通试验中得到测量。

研究结论
通过焦点小组与利益相关方开展咨询，使我们得以深入探究家长与专业人员对疫苗接种沟通的体验，明确他们所重视的沟通体验维度，并将其转化为可纳入核心结局集（Core Outcome Set）优先排序、且可在干预措施评估中进行测量的结局指标。