502 - Addressing COVID-19 vaccine hesitancy in an emergency department using motivational interviewing

Poster Number: 502
Publication Number: 502.325

Robert Palumbo, Mount Sinai Beth Israel, New York, NY, United States; Czer Anthoney E. Lim, Mount Sinai Health System, New York, NY, United States; Yvette Calderon, Mount Sinai Beth Israel ABEM, New York, NY, United States

Background: Vaccination is key to reducing the transmission of COVID-19. Emergency departments, frequently serve vulnerable populations that may be vaccine-hesitant due to multifactorial causes. Motivational interviewing is a patient-centered approach that has been used in healthcare as a tool to change patient behavior.

Objective: We aim to determine the impact of motivational interviewing to change attitudes regarding the COVID-19 vaccine for vaccine-hesitant patients in an emergency department setting.

Design/Methods: Patients were engaged for motivational interviewing intervention if they were unvaccinated, declined a vaccine appointment, and communicated concern(s) about the vaccine. Motivational interviews and surveys were conducted by two Emergency Department Patient Liaisons that received two weeks of training.  Key elements of motivational interviews used during discussions were open-ended questions, affirmations, reflective listening, and summary reflections. Age, gender, race, and ethnicity data were collected. Post-intervention change in attitude towards COVID-19 vaccination was measured using a 5-point Likert scale in response to the question “Has our talk improved your opinion about getting the COVID-19 vaccine?” Responses were dichotomized to one group responding “very unlikely” and “unlikely” and a second group including the remaining available responses.

Results: In this prospective convenience sample quality improvement initiative, data was collected from August to December 2021 in the ED of an urban, academic, community hospital.  Of 273 patients engaged, 130 (47.6%) patients consented to discuss the vaccine.  Mean age was 36.7 (SD of 16.0).  Participants were 71% female; 42% identified their race as African American, 9% as White, and 38% as Other; 38% self-identified as Latinx. The post-intervention survey demonstrated a significant difference between negative and positive attitudes regarding vaccination (14% vs 86%, p< 0.001). Conclusion(s): The use of a motivational interviewing approach was effective in influencing a positive change in attitude towards the COVID-19 vaccine for vaccine-hesitant ED patients. If implemented by EDs, motivational interviewing can serve as a valuable asset to reduce vaccine hesitancy during the COVID-19 pandemic.