The HRC and Ministry of Health Immunisation Research Strategy partnership funded research was carried out by a Massey University and Whanganui Community team, led by Associate Professor Margie Comrie, and managed by Dr Niki Murray from Massey University’s School of Communication, Journalism and Marketing, who share a long-standing interest in literacy issues.
Dr Murray says an earlier literacy project exposed links between low levels of health and low levels of literacy.
The Whanganui PHO were interested in developing better communication of immunisation information so the team worked to develop a communication tool using extensive input from community end-users and health professionals.
Associate Professor Comrie says that as communicators they thought visual communication and simplicity was really important, but the first step was to work with the community and find out more about people’s decisionmaking around whether or not they chose to immunise their children.
Dr Murray says they set up focus groups involving participants from a range of social support organisations, including Māori, Pacific People and mainstream providers. “We talked to decision-makers and asked them what sort of information they received about immunisation and what they thought about that information. Then we asked them what would be a preferred means of getting information about immunisation and what sorts of things they would like to know,” she says.
“We also showed them some pictures and asked them whether that form of showing them illustrations would help them to remember messages. They were quite adamant that they needed real-life photos and real-life people they could relate to.”
Associate Professor Comrie says they also wanted bright colours, simple words, and bullet points. Almost everyone they spoke to wanted to receive information as part of a discussion. “They also told us that they didn’t want a lot of information all at once but they wanted to know how to get more information if they wanted to.”
From these focus groups they developed a simple illustrated flip chart as a communication tool for the lead maternity carer to use when having a discussion with the mother or family.
It takes them through what immunisation is for, how vaccines work, what are the diseases it can protect against and shows a simplified version of the immunisation chart. It also talks about the immunisation register, where immunisation information is recorded and goes through what happens when they go to the doctor and what happens afterwards.
They also developed an A5 sized fridge magnet which has the key immunisation messages, as well as information on when the injections are due and important contact information.
Associate Professor Comrie says they also tested how much of a difference the pictures made using two groups of 31 mothers who were about 28 weeks pregnant. An intervention group received the information with illustrations while a control group received the same information but without illustrations.
A follow-up phone interview six weeks later found the ones who received information with the accompanying illustrations recalled more information, were more confident in their recall and also felt more confident about making immunisation decisions.
Associate Professor Comrie says they have been talking to midwifery groups and various health boards about further testing and development with a view to finding out how the resources could be most effectively used.
Information: Associate Professor Margie Comrie, Massey University, Palmerston North.