# Adapting Motivational Interviewing for Maternal Immunization (MI4MI)

> **NIH NIH R21** · UNIVERSITY OF COLORADO DENVER · 2020 · $198,923

## Abstract

Project Summary
Pertussis and influenza are the most poorly controlled vaccine preventable diseases in the United States.
Pregnant women have increased risk of severe disease from influenza and newborns have increased risk of
severe disease from influenza and pertussis. The Advisory Committee on Immunization Practices and
American College of Obstetricians and Gynecologists recommend women receive influenza and pertussis
(Tdap) vaccine during each pregnancy, yet only about half of pregnant women receive these vaccines. Among
identified barriers to maternal immunization are patient concerns about vaccine safety and effectiveness and
lack of evidence for how ob-gyn providers can best communicate vaccine recommendations. Interventions to
address these barriers and increase uptake of maternal immunizations are urgently needed. Motivational
interviewing (MI) is a communication technique that has proven effective for changing health behaviors
including increasing adolescent vaccination rates. MI is both time-effective and acceptable to providers. The
long-term goal of this project is to adapt MI to the ob-gyn setting to improve influenza and Tdap vaccine
uptake in pregnancy. There is evidence to support use of MI for childhood immunizations; however it is
unknown if MI is feasible and acceptable among ob-gyn providers and pregnant women. We propose a
pragmatic practice-based study in 5 Colorado ob-gyn practices to develop the MI for maternal immunizations
(MI4MI) intervention and assess acceptability, adoption and implementation among patients and providers.
Aim 1 will use an iterative process building upon existing knowledge of patient concerns about maternal
immunizations and our prior experience training providers in MI for childhood immunizations to develop the
MI4MI training. During development, we will conduct focus groups for provider input and [organizational
context. The MI4MI intervention will include a video-module, in-person training, provider reference sheets,
and practice study champions. Aim 2 will include intervention implementation and assessment of MI4MI
acceptability, adoption, and implementation. We will audio-record a sample of provider visits with patients
with vaccine concerns to assess fidelity of the intervention. Audio-elicitation interviews will be conducted to
assess acceptability of MI4MI among patients. This qualitative method uses a recorded interaction to guide a
semi-structured interview. We will conduct post-intervention provider focus groups to assess acceptability and
adoption of the MI training intervention. We will also conduct pre- and post-intervention surveys among
providers to assess time spent and self-efficacy in vaccine communication. Providers will receive Maintenance
of Certification or Continuing Medical/Nursing Education credit for participation. In Aim 2a, we will conduct
pre- and post-intervention chart reviews in study practices to evaluate the impact of MI4MI on influenza and
Tdap vaccine uptake in pr...

## Key facts

- **NIH application ID:** 9965728
- **Project number:** 5R21AI141822-02
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Sean T O'Leary
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $198,923
- **Award type:** 5
- **Project period:** 2019-07-01 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9965728

## Citation

> US National Institutes of Health, RePORTER application 9965728, Adapting Motivational Interviewing for Maternal Immunization (MI4MI) (5R21AI141822-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9965728. Licensed CC0.

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