A1 Refereed original research article in a scientific journal

Implementing psychology-based empathetic refutational interview training to support vaccine confident conversations for health workers;




AuthorsHolford, Dawn; Anderson, Emma C.; Gould, Virginia C.; Weil, Leonora G.; Wilson, Joanne; Ahmed, Rehana; Karlsson, Linda C.; Lewandowsky, Stephan

PublisherElsevier BV

Publication year2026

Journal: Public Health

Article number106295

Volume256

ISSN0033-3506

eISSN1476-5616

DOIhttps://doi.org/10.1016/j.puhe.2026.106295

Publication's open availability at the time of reportingOpen Access

Publication channel's open availability Partially Open Access publication channel

Web address https://doi.org/10.1016/j.puhe.2026.106295

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/523723517

Self-archived copy's licenceCC BY

Self-archived copy's versionPublisher`s PDF


Abstract
Objective

It can be challenging for health workers to have conversations with the public about vaccination and address misinformation without evidence-based training. Our objective was to pilot and evaluate a programme to teach an evidence-based communication approach, the Empathetic Refutational Interview (ERI), developed to help health workers address vaccine misinformation while maintaining trust.

Study design

This mixed-methods study evaluated participants’ skills and confidence in the ERI before and after training and explored the feasibility of participants training others to use the ERI.

Methods

Ten in-person, two-day workshops were conducted for 106 trainees in London, UK between October 2023 and November 2024. Participants were supported to adapt training content and pass it on (e.g., onward ERI training). Participants completed assessment and feedback questionnaires before and after the workshop and were emailed follow-up questionnaires at one month and three months after the workshop.

Results

We received 101 before-and-after questionnaire responses, and 42 and 35 responses to the follow-ups. Participants' confidence, preparedness, and skills in using the ERI for vaccine conversations improved significantly. In their feedback, participants cited better understanding of patients’ psychological motivations and the structure provided by the ERI framework as useful elements for their practice. Eighteen participants reported passing on ERI knowledge to colleagues; most onward ERI training featured a shorter version of the content delivered during the workshop.

Conclusions

The training successfully equipped health workers with skills and confidence to approach vaccine conversations. However, few trainees were able to give in-depth ERI training to others without further support.


Downloadable publication

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Funding information in the publication
This project has received funding from the Horizon 2020 Research and Innovation Programme grant 964728 (JITSUVAX).
This work was supported by an ESRC (UKRI) Impact Acceleration Award (ES/X004392/1).
LK is supported by funding from the Turku Institute for Advanced Studies.
LW and JW were supported by funding from the NHSE London Legacy and Health Equity Partnership.


Last updated on 15/06/2026 12:06:43 PM