Supporting Informed Vaccine Decision-Making and Communication in Pregnancy Through the Vaccines in Pregnancy Canada Intervention - Multimethod Co-Design Study

Sep 28, 2026

Vaccination in pregnancy protects pregnant individuals and newborns, yet uptake remains suboptimal. Pregnant people face distinctive decision-making challenges, making communication with healthcare providers crucial for vaccine uptake. While barriers to vaccination in pregnancy are well documented, evidence-based behavior change interventions co-designed with end users are limited. This study co-designed and developed a multicomponent intervention to support informed decision-making and vaccine communication during pregnancy in Canada.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages18

Reading Time45 min

AccessFree to download

Abstract

Background

Objective

Methods

Results

Conclusions

Introduction

Vaccination in pregnancy and uptake challenges

JOURNAL OF MEDICAL INTERNET RESEARCH Castillo et al Original Paper Supporting Informed Vaccine Decision-Making and Communication in Pregnancy Through the Vaccines in Pregnancy Canada Intervention: Multimethod Co-Design Study | Eliana Castillo1,2,3, MHSc, MD; Andrea M Patey4, PhD; Medea Myers-Stewart1, MPH; Monica Santosh Surti1, MPH; Maria Castrellon Pardo 1, BPsych; Marcia Bruce 1, BCom; Zaileen Jamal1, MPH; Madison Kennedy 1, MPH; Julie ABettinger5,6, PhD; Jessica Kaufman7,8, PhD; Margie Danchin7,8,9, MBBS, PhD; Maoliosa Donald10, PhD | | --- | | 1Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
2Department of Obstetrics and Gynaecology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada 3Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
4Department of Medicine, Quality and Safety, IWK Health, Halifax, NS, Canada
5Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada 6Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
7Department of Paediatrics, The University of Melbourne, Melbourne, Australia
8Vaccine Uptake Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia 9Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
10Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
Corresponding Author:
Eliana Castillo, MHSc, MD
Department of Medicine, Cumming School of Medicine University of Calgary
3330 Hospital Drive NW Calgary, AB, T2N 4N1 Canada
Phone: 1 403 220 8867
Email: castillo@ucalg[ary.ca](ary.ca)
Abstract | Background: Vaccination in pregnancy (VIP) protects pregnant individuals and their newborns; yet, uptake remains suboptimal. Pregnant individuals face unique decision-making challenges, and communication with their health care provider (HCP) is crucial for uptake. While there is extensive data on barriers to VIP, interventions applying evidence-based behavior change strategies and co-designed with end users are scarce. Our prior work indicated that a new Canadian intervention was needed. Objective: This study aimed to co-design a multicomponent intervention to support informed decision-making and vaccine communication in pregnancy. Methods: Our multimethod study followed the Double Diamond phases (ie, Discover, Define, Develop, and Deliver) and partnered with a diverse patient advisory council and a multidisciplinary team of HCPs. During the Discover and Define phases, our previous work, we explored gaps and barriers to VIP in Canada and defined the behavior change strategies to address those needs. During the Develop phase, we co-designed and conducted iterative prototyping of four intervention components: (1) a pregnancy-specific communication approach,(2) a skills course for HCPs,(3) a practice change plan, and (4) a website with evidence-based resources for patients and HCPs. We used online and in-person participatory co-design sessions and peer-to-peer, patient-oriented online focus groups and semistructured in-depth interviews. During the Deliver phase, we refined the intervention components through functionality and usability testing. Results: The Vaccines in Pregnancy Canada (VIP Canada) intervention consists of four integrated components: (1) DECIDE (Determine, Elicit, Consent, Interactive discussion, Deliver, and Empower): a patient-centered, pregnancy-specific communication approach for providers to deliver a clear vaccine recommendation while respecting autonomy. (2) Skills course for HCPs: 4 self-paced, online modules to learn the rationale for VIP and the DECIDE communication approach and 2 group sessions. Providers found the skills course clear, practical, and applicable across diverse clinical roles and settings.

FAQs

Why is communication with healthcare providers important for vaccination in pregnancy?

Pregnant individuals face unique decision-making challenges, and provider communication is crucial to support informed vaccine decision-making and improve uptake.

What was the main objective of the study?

To co-design a multicomponent intervention that supports informed decision-making and vaccine communication in pregnancy.

What components make up the Vaccines in Pregnancy Canada (VIP Canada) intervention?

VIP Canada includes four integrated components: the DECIDE communication approach, an HCP skills course, a practice change plan, and a patient- and provider-focused website with evidence-based resources.

Sep 28, 2026

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