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  1. Article ; Online: Clinician Communication to Address Vaccine Hesitancy.

    Opel, Douglas J

    Pediatric clinics of North America

    2022  Volume 70, Issue 2, Page(s) 309–319

    Abstract: There are several factors that influence childhood vaccine uptake. Pediatric clinicians play a particularly influential role in parent vaccine decision-making. It is critical therefore that pediatric clinicians have a "communication toolbox"--a set of ... ...

    Abstract There are several factors that influence childhood vaccine uptake. Pediatric clinicians play a particularly influential role in parent vaccine decision-making. It is critical therefore that pediatric clinicians have a "communication toolbox"--a set of effective, evidence-based communication strategies to facilitate uptake of childhood vaccines--that they can use in conversations with parents about vaccines. In this article, recent advances in our understanding of what constitutes effective clinician vaccine communication with parents are discussed.
    MeSH term(s) Humans ; Child ; Vaccination ; Vaccination Hesitancy ; Communication ; Vaccines ; Parents ; Health Knowledge, Attitudes, Practice ; Patient Acceptance of Health Care
    Chemical Substances Vaccines
    Language English
    Publishing date 2022-12-08
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 215711-1
    ISSN 1557-8240 ; 0031-3955
    ISSN (online) 1557-8240
    ISSN 0031-3955
    DOI 10.1016/j.pcl.2022.11.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Shared Decision-Making in Pediatrics.

    Sawyer, Kimberly E / Opel, Douglas J

    Pediatric clinics of North America

    2023  Volume 71, Issue 1, Page(s) 39–48

    Abstract: This article briefly reviews a 4-step process for implementing shared decision-making (SDM) in pediatrics. The authors address difficulties with determining whether SDM should occur and comment on how the SDM process relates to, and may be conflated with, ...

    Abstract This article briefly reviews a 4-step process for implementing shared decision-making (SDM) in pediatrics. The authors address difficulties with determining whether SDM should occur and comment on how the SDM process relates to, and may be conflated with, other decision-making models that leverage similar patient-centered and family-centered communication strategies.
    MeSH term(s) Child ; Humans ; Communication ; Decision Making ; Patient Participation ; Pediatrics
    Language English
    Publishing date 2023-09-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 215711-1
    ISSN 1557-8240 ; 0031-3955
    ISSN (online) 1557-8240
    ISSN 0031-3955
    DOI 10.1016/j.pcl.2023.08.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Vaccine Confidence and the Importance of an Interdisciplinary Approach.

    Opel, Douglas J / Larson, Heidi J

    The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics

    2022  Volume 49, Issue 4, Page(s) 596–598

    Abstract: Parental confidence in vaccines is waning. To sustain and improve childhood vaccine coverage rates, insights from multiple disciplines are needed to understand and address the socio-cultural factors contributing to decreased vaccine confidence and uptake. ...

    Abstract Parental confidence in vaccines is waning. To sustain and improve childhood vaccine coverage rates, insights from multiple disciplines are needed to understand and address the socio-cultural factors contributing to decreased vaccine confidence and uptake.
    MeSH term(s) Child ; Humans ; Parents ; Vaccination ; Vaccines
    Chemical Substances Vaccines
    Language English
    Publishing date 2022-01-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 1168812-9
    ISSN 1748-720X ; 1073-1105 ; 0277-8459
    ISSN (online) 1748-720X
    ISSN 1073-1105 ; 0277-8459
    DOI 10.1017/jme.2021.82
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  4. Article ; Online: AI as a Mental Health Therapist for Adolescents.

    Opel, Douglas J / Kious, Brent M / Cohen, I Glenn

    JAMA pediatrics

    2023  Volume 177, Issue 12, Page(s) 1253–1254

    MeSH term(s) Adolescent ; Humans ; Mental Health ; Artificial Intelligence
    Language English
    Publishing date 2023-10-16
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2701223-2
    ISSN 2168-6211 ; 2168-6203
    ISSN (online) 2168-6211
    ISSN 2168-6203
    DOI 10.1001/jamapediatrics.2023.4215
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  5. Article ; Online: The case against COVID-19 vaccine mandates in pediatric solid organ transplantation.

    Ross, Lainie Friedman / Opel, Douglas J

    Pediatric transplantation

    2022  Volume 26, Issue 7, Page(s) e14243

    Abstract: Background: The American Society of Transplantation in conjunction with the International Society for Heart and Lung Transplantation released a joint statement on August 13, 2021 in which they strongly recommend that solid organ transplant (SOT) ... ...

    Abstract Background: The American Society of Transplantation in conjunction with the International Society for Heart and Lung Transplantation released a joint statement on August 13, 2021 in which they strongly recommend that solid organ transplant (SOT) recipients and their eligible household members and close contacts be vaccinated against SARS-CoV-2 with an approved COVID-19 vaccine. Some SOT programs have gone further and will refuse to list or transplant candidates unless the candidate and their household are vaccinated against SARS-CoV-2.
    Methods: Two general pediatrician-ethicists use current best evidence and moral theory to argue why it is unethical to mandate COVID-19 vaccination for pediatric SOT candidates, their primary support person, and their households.
    Results: Pediatric vaccine mandates are most justifiable when they prevent the harm of a serious vaccine preventable disease (VPD) in children in settings where transmission is highly likely and there are no alternatives that are effective in preventing transmission that intrude less on individual freedom. An additional justification for a vaccine mandate in the SOT context is stewardship of a scarce resource if there is significant risk of graft loss from the VPD to an unvaccinated SOT candidate or recipient. Current evidence does not support fulfillment of these criteria in pediatric solid organ transplantation.
    Conclusions: Making SOT listing contingent on COVID-19 vaccination is problematic. Though there is some risk of harm to a pediatric SOT candidate in remaining unvaccinated, the risk of harm of not being listed and transplanted is greater and overriding.
    MeSH term(s) COVID-19/prevention & control ; COVID-19 Vaccines/therapeutic use ; Child ; Humans ; Organ Transplantation ; SARS-CoV-2 ; Transplant Recipients ; Vaccines
    Chemical Substances COVID-19 Vaccines ; Vaccines
    Language English
    Publishing date 2022-02-12
    Publishing country Denmark
    Document type Journal Article
    ZDB-ID 1390284-2
    ISSN 1399-3046 ; 1397-3142
    ISSN (online) 1399-3046
    ISSN 1397-3142
    DOI 10.1111/petr.14243
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Frequency of Perceived Conflict between Families and Clinicians at Time of Clinical Ethics Consultation in Hospitalized Children.

    Olszewski, Aleksandra E / Zhou, Chuan / Ugale, Jiana / Ramos, Jessica / Patneaude, Arika / Opel, Douglas J

    AJOB empirical bioethics

    2024  Volume 15, Issue 1, Page(s) 60–65

    Abstract: Background: Little is known about the frequency of conflict between clinicians and families at the time of pediatric clinical ethics consultation (CEC) and what factors are associated with the presence of conflict.: Methods: We conducted a ... ...

    Abstract Background: Little is known about the frequency of conflict between clinicians and families at the time of pediatric clinical ethics consultation (CEC) and what factors are associated with the presence of conflict.
    Methods: We conducted a retrospective cohort study at a single, tertiary urban US pediatric hospital that included all hospitalized patients between January 2008 and December 2019 who received CEC. Utilizing the hospital's CEC database that requires documentation of the presence of conflict by the consultant at the time of CEC, we determined the frequency and types of perceived conflict between families and clinicians. We also assessed the bivariable association between conflict and patient age, patient- or family-reported race/ethnicity, language for care, insurance status, clinical setting, and consultant involvement.
    Results: Perceived conflict between clinicians and families was present in 44% (91/209) of CEC. We observed a higher occurrence of clinician-family conflict within certain consult topics than others, in particular, informed consent/parental permission (69%), cultural considerations (67%), benefit/harm assessment (58%), and limitation of life-sustaining treatment (58%). We found no other significant associations between the presence of perceived conflict and patient sociodemographic factors or CEC factors.
    Conclusions: Conflict between healthcare teams and families appears common in CEC, particularly with certain consult topics. Further study is needed to better understand conflict types, causes of conflicts, management and mediation strategies, and outcomes.
    MeSH term(s) Humans ; Child ; Ethics Consultation ; Retrospective Studies ; Child, Hospitalized ; Ethics, Clinical ; Informed Consent
    Language English
    Publishing date 2024-01-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2763190-4
    ISSN 2329-4523 ; 2329-4515
    ISSN (online) 2329-4523
    ISSN 2329-4515
    DOI 10.1080/23294515.2023.2262958
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  7. Article ; Online: A 4-Step Framework for Shared Decision-making in Pediatrics.

    Opel, Douglas J

    Pediatrics

    2018  Volume 142, Issue Suppl 3, Page(s) S149–S156

    Abstract: Shared decision-making (SDM) is a well-established component of patient-centered care, and yet, its application in pediatrics is poorly understood. Common features of pediatric decision-making are not completely addressed in current SDM models, such as ... ...

    Abstract Shared decision-making (SDM) is a well-established component of patient-centered care, and yet, its application in pediatrics is poorly understood. Common features of pediatric decision-making are not completely addressed in current SDM models, such as the fact that the principal SDM participant is the patient's surrogate, who, unlike competent adult patients deciding for themselves, has limitations on decision-making authority. To address this gap and improve the practice of SDM in pediatrics, a practical 4-step framework is presented. In step 1, physicians are posed the following question for any discrete decision: does the decision include >1 medically reasonable option? If the answer is no, SDM is not indicated. If the answer is yes, physicians proceed to step 2 and answer the following question: does 1 option have a favorable medical benefit-burden ratio compared with other options? If yes, physician-guided SDM is appropriate. If no, parent-guided SDM is appropriate. For each SDM approach, the physician proceeds to step 3 and answers the following question: how preference sensitive are the options? This helps to determine the specific SDM approach in step 4, which ranges from a strong or weak version of physician-guided SDM to a strong or weak version of parent-guided SDM. Several decisional characteristics, if present, can also help calibrate the version of SDM used. Additional analyses are needed to consider the inclusion of adolescents into this SDM framework.
    MeSH term(s) Child ; Decision Making ; Humans ; Parents ; Pediatrics/methods ; Physician-Patient Relations ; Physicians ; Practice Guidelines as Topic
    Language English
    Publishing date 2018-09-22
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2018-0516E
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  8. Article ; Online: Strategies for Improving Vaccine Communication and Uptake.

    O'Leary, Sean T / Opel, Douglas J / Cataldi, Jessica R / Hackell, Jesse M

    Pediatrics

    2024  Volume 153, Issue 3

    Abstract: Vaccines have led to a significant decrease in rates of vaccine-preventable diseases and have made a significant impact on the health of children. However, some parents express concerns about vaccine safety and the necessity of vaccines. The concerns of ... ...

    Abstract Vaccines have led to a significant decrease in rates of vaccine-preventable diseases and have made a significant impact on the health of children. However, some parents express concerns about vaccine safety and the necessity of vaccines. The concerns of parents range from hesitancy about some immunizations to refusal of all vaccines. This clinical report provides information about the scope and impact of the problem, the facts surrounding common vaccination concerns, and the latest evidence regarding effective communication techniques for the vaccine conversation. After reading this clinical report, readers can expect to: Understand concepts and underlying determinants of vaccine uptake and vaccine hesitancy.Understand the relationship between vaccine hesitancy and costs of preventable medical care.Recognize and address specific concerns (eg, vaccine safety) with caregivers when hesitancy is present.
    MeSH term(s) Child ; Humans ; Vaccines ; Biological Transport ; Vaccination ; Communication ; Immunization
    Chemical Substances Vaccines
    Language English
    Publishing date 2024-02-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2023-065483
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: A Push for Progress With Shared Decision-making in Pediatrics.

    Opel, Douglas J

    Pediatrics

    2017  Volume 139, Issue 2

    Language English
    Publishing date 2017
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2016-2526
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  10. Article ; Online: Mandatory Coronavirus Disease 2019 Vaccine for Children?-Reply.

    Opel, Douglas J / Diekema, Douglas S / Ross, Lainie Friedman

    JAMA pediatrics

    2021  Volume 175, Issue 5, Page(s) 534

    MeSH term(s) COVID-19 ; COVID-19 Vaccines ; Child ; Humans ; Mandatory Programs ; SARS-CoV-2 ; Vaccination
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2021-02-08
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2701223-2
    ISSN 2168-6211 ; 2168-6203
    ISSN (online) 2168-6211
    ISSN 2168-6203
    DOI 10.1001/jamapediatrics.2020.6013
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