Using the COM-B framework to elucidate facilitators and barriers to COVID-19 vaccine uptake in pregnant women: a qualitative study
Abstract Since April 2021, COVID-19 vaccines have been recommended for pregnant women. Despite this, COVID-19 vaccine uptake in this group is low compared to the non-pregnant population of childbearing age. Our aim was to understand barriers and facilitators to COVID-19 vaccine uptake among pregnant...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-09-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-023-05958-y |
| _version_ | 1797451115778801664 |
|---|---|
| author | Lynsey Patterson Emma Berry Carole Parsons Bronagh Clarke Alison Little Jillian Beggs Antony Chuter Tracy Jackson Yingfen Hsia Hannah McGrath Catherine Millman Siobhan Murphy Declan T. Bradley Sarah Milligan |
| author_facet | Lynsey Patterson Emma Berry Carole Parsons Bronagh Clarke Alison Little Jillian Beggs Antony Chuter Tracy Jackson Yingfen Hsia Hannah McGrath Catherine Millman Siobhan Murphy Declan T. Bradley Sarah Milligan |
| author_sort | Lynsey Patterson |
| collection | DOAJ |
| description | Abstract Since April 2021, COVID-19 vaccines have been recommended for pregnant women. Despite this, COVID-19 vaccine uptake in this group is low compared to the non-pregnant population of childbearing age. Our aim was to understand barriers and facilitators to COVID-19 vaccine uptake among pregnant women in Northern Ireland using the COM-B framework, and so to make recommendations for public health interventions. The COM-B proposes that human behaviour is influenced by the extent to which a person has the capability, opportunity, and motivation to enact that behaviour. Understanding the factors underpinning behaviour through this lens helps discern what needs to change to change behaviour, therefore supporting the development of targeted interventions. This study consisted of eight semi-structured interviews with new/expectant mothers who did not receive a COVID-19 vaccine dose while pregnant since April 2021, and a focus group with five participants who received at least one COVID-19 vaccine dose while pregnant. Interview and focus group data were analysed using semi-deductive reflexive thematic analysis framed by a subtle realist approach. The COM-B was used to categorise codes and subthemes were developed within each COM-B construct. Within Psychological Capability, subthemes captured the need for consistent and reliable COVID-19 vaccine information and access to balanced and jargon-free, risk–benefit information that is tailored to the pregnant individual. The behaviour/opinions of family, friends, and local healthcare providers had a powerful influence on COVID-19 vaccine decisions (Social Opportunity). Integrating the COVID-19 vaccine as part of routine antenatal pathways was believed to support access and sense of familiarity (Physical Opportunity). Participants valued health autonomy, however experienced internal conflict driven by concerns about long-term side effects for their baby (Reflective Motivation). Feelings of fear, lack of empathy from healthcare providers, and anticipated guilt commonly underpinned indecision as to whether to get the vaccine (Automatic Motivation). Our study highlighted that the choice to accept a vaccine during pregnancy generates internal conflict and worry. Several participants cited their concern was primarily around the safety for their baby. Healthcare professionals (HCPs) play a significant part when it comes to decision making about COVID-19 vaccines among pregnant women. HCPs and pregnant women should be involved in the development of interventions to improve the delivery and communication of information. |
| first_indexed | 2024-03-09T14:50:14Z |
| format | Article |
| id | doaj.art-4b19f37ded1d4b138bec690f17ecc1d9 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-09T14:50:14Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-4b19f37ded1d4b138bec690f17ecc1d92023-11-26T14:30:57ZengBMCBMC Pregnancy and Childbirth1471-23932023-09-0123111310.1186/s12884-023-05958-yUsing the COM-B framework to elucidate facilitators and barriers to COVID-19 vaccine uptake in pregnant women: a qualitative studyLynsey Patterson0Emma Berry1Carole Parsons2Bronagh Clarke3Alison Little4Jillian Beggs5Antony Chuter6Tracy Jackson7Yingfen Hsia8Hannah McGrath9Catherine Millman10Siobhan Murphy11Declan T. Bradley12Sarah Milligan13Public Health AgencySchool of Psychology, Queen’s University BelfastSchool of Pharmacy, Queen’s University BelfastPublic Health AgencyPublic Health AgencyPPI, Usher Institute, University of EdinburghPPI, Usher Institute, University of EdinburghPPI, Usher Institute, University of EdinburghSchool of Pharmacy, Queen’s University BelfastPublic Health AgencyPublic Health AgencyCentre for Public Health, Queen’s University BelfastPublic Health AgencyPublic Health AgencyAbstract Since April 2021, COVID-19 vaccines have been recommended for pregnant women. Despite this, COVID-19 vaccine uptake in this group is low compared to the non-pregnant population of childbearing age. Our aim was to understand barriers and facilitators to COVID-19 vaccine uptake among pregnant women in Northern Ireland using the COM-B framework, and so to make recommendations for public health interventions. The COM-B proposes that human behaviour is influenced by the extent to which a person has the capability, opportunity, and motivation to enact that behaviour. Understanding the factors underpinning behaviour through this lens helps discern what needs to change to change behaviour, therefore supporting the development of targeted interventions. This study consisted of eight semi-structured interviews with new/expectant mothers who did not receive a COVID-19 vaccine dose while pregnant since April 2021, and a focus group with five participants who received at least one COVID-19 vaccine dose while pregnant. Interview and focus group data were analysed using semi-deductive reflexive thematic analysis framed by a subtle realist approach. The COM-B was used to categorise codes and subthemes were developed within each COM-B construct. Within Psychological Capability, subthemes captured the need for consistent and reliable COVID-19 vaccine information and access to balanced and jargon-free, risk–benefit information that is tailored to the pregnant individual. The behaviour/opinions of family, friends, and local healthcare providers had a powerful influence on COVID-19 vaccine decisions (Social Opportunity). Integrating the COVID-19 vaccine as part of routine antenatal pathways was believed to support access and sense of familiarity (Physical Opportunity). Participants valued health autonomy, however experienced internal conflict driven by concerns about long-term side effects for their baby (Reflective Motivation). Feelings of fear, lack of empathy from healthcare providers, and anticipated guilt commonly underpinned indecision as to whether to get the vaccine (Automatic Motivation). Our study highlighted that the choice to accept a vaccine during pregnancy generates internal conflict and worry. Several participants cited their concern was primarily around the safety for their baby. Healthcare professionals (HCPs) play a significant part when it comes to decision making about COVID-19 vaccines among pregnant women. HCPs and pregnant women should be involved in the development of interventions to improve the delivery and communication of information.https://doi.org/10.1186/s12884-023-05958-yCOVID-19 vaccinationPregnancyQualitativeFacilitatorsBarriersCOM-B |
| spellingShingle | Lynsey Patterson Emma Berry Carole Parsons Bronagh Clarke Alison Little Jillian Beggs Antony Chuter Tracy Jackson Yingfen Hsia Hannah McGrath Catherine Millman Siobhan Murphy Declan T. Bradley Sarah Milligan Using the COM-B framework to elucidate facilitators and barriers to COVID-19 vaccine uptake in pregnant women: a qualitative study BMC Pregnancy and Childbirth COVID-19 vaccination Pregnancy Qualitative Facilitators Barriers COM-B |
| title | Using the COM-B framework to elucidate facilitators and barriers to COVID-19 vaccine uptake in pregnant women: a qualitative study |
| title_full | Using the COM-B framework to elucidate facilitators and barriers to COVID-19 vaccine uptake in pregnant women: a qualitative study |
| title_fullStr | Using the COM-B framework to elucidate facilitators and barriers to COVID-19 vaccine uptake in pregnant women: a qualitative study |
| title_full_unstemmed | Using the COM-B framework to elucidate facilitators and barriers to COVID-19 vaccine uptake in pregnant women: a qualitative study |
| title_short | Using the COM-B framework to elucidate facilitators and barriers to COVID-19 vaccine uptake in pregnant women: a qualitative study |
| title_sort | using the com b framework to elucidate facilitators and barriers to covid 19 vaccine uptake in pregnant women a qualitative study |
| topic | COVID-19 vaccination Pregnancy Qualitative Facilitators Barriers COM-B |
| url | https://doi.org/10.1186/s12884-023-05958-y |
| work_keys_str_mv | AT lynseypatterson usingthecombframeworktoelucidatefacilitatorsandbarrierstocovid19vaccineuptakeinpregnantwomenaqualitativestudy AT emmaberry usingthecombframeworktoelucidatefacilitatorsandbarrierstocovid19vaccineuptakeinpregnantwomenaqualitativestudy AT caroleparsons usingthecombframeworktoelucidatefacilitatorsandbarrierstocovid19vaccineuptakeinpregnantwomenaqualitativestudy AT bronaghclarke usingthecombframeworktoelucidatefacilitatorsandbarrierstocovid19vaccineuptakeinpregnantwomenaqualitativestudy AT alisonlittle usingthecombframeworktoelucidatefacilitatorsandbarrierstocovid19vaccineuptakeinpregnantwomenaqualitativestudy AT jillianbeggs usingthecombframeworktoelucidatefacilitatorsandbarrierstocovid19vaccineuptakeinpregnantwomenaqualitativestudy AT antonychuter usingthecombframeworktoelucidatefacilitatorsandbarrierstocovid19vaccineuptakeinpregnantwomenaqualitativestudy AT tracyjackson usingthecombframeworktoelucidatefacilitatorsandbarrierstocovid19vaccineuptakeinpregnantwomenaqualitativestudy AT yingfenhsia usingthecombframeworktoelucidatefacilitatorsandbarrierstocovid19vaccineuptakeinpregnantwomenaqualitativestudy AT hannahmcgrath usingthecombframeworktoelucidatefacilitatorsandbarrierstocovid19vaccineuptakeinpregnantwomenaqualitativestudy AT catherinemillman usingthecombframeworktoelucidatefacilitatorsandbarrierstocovid19vaccineuptakeinpregnantwomenaqualitativestudy AT siobhanmurphy usingthecombframeworktoelucidatefacilitatorsandbarrierstocovid19vaccineuptakeinpregnantwomenaqualitativestudy AT declantbradley usingthecombframeworktoelucidatefacilitatorsandbarrierstocovid19vaccineuptakeinpregnantwomenaqualitativestudy AT sarahmilligan usingthecombframeworktoelucidatefacilitatorsandbarrierstocovid19vaccineuptakeinpregnantwomenaqualitativestudy |