Title : Improving maternal vaccination uptake through team based education in a midwifery clinic setting
Abstract:
Maternal vaccination is a critical strategy for reducing morbidity and mortality among pregnant persons and newborns. Despite national recommendations from professional organizations such as the American College of Obstetricians and Gynecologists (ACOG), the American College of Nurse-Midwives (ACNM), and the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN), uptake of influenza, Tdap, and RSV vaccines during pregnancy remains suboptimal. This project, conducted as part of a Doctor of Nursing Practice (DNP) scholarly project, aimed to address maternal vaccination hesitancy and improve uptake rates through an evidence-based, team-centered educational intervention at a midwifery clinic in Oregon, USA.
A needs assessment identified gaps in workflow and messaging: medical assistants and non-physician staff deferred vaccination discussions exclusively to providers, resulting in inconsistent screening, counseling, and missed opportunities. Using the Knowledge-to-Action Process Framework and principles of behavior change theory, a tailored educational module was developed and delivered to all clinic staff, including midwives, nurses, medical assistants, and front-desk personnel. The module emphasized motivational interviewing, addressing misconceptions, consistent messaging, and the critical role of every team member in fostering a vaccine-positive environment.
Implementation included pre- and post-education surveys to assess knowledge, attitudes, and confidence in discussing maternal vaccines. As this project is in process, early outcomes are not yet available. Upon completion in early 2026, expected outcomes include increased staff awareness of their role in vaccine promotion, improved consistency in messaging, and enhanced confidence in addressing patient concerns. This work underscores the importance of team-based approaches to maternal immunization; highlights barriers encountered in community clinic implementation and offers recommendations for sustaining improvements in vaccine uptake.
