From Trust to Choice: A Cross-Sectional Survey of How Patient Trust in Pharmacists Shapes Willingness and Vaccination Decision Control Preferences

Oluchukwu M. Ezeala, Nicholas P. McCormick, Lotanna Ezeja, Sara K. Jaradat, Spencer H. Durham and Salisa C. Westrick ()
Additional contact information
Oluchukwu M. Ezeala: Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA
Nicholas P. McCormick: Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA
Lotanna Ezeja: Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA
Sara K. Jaradat: Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA
Spencer H. Durham: Department of Pharmacy Practice, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA
Salisa C. Westrick: Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA

IJERPH, 2025, vol. 22, issue 10, 1-21

Abstract: Background/Objectives: The U.S. Centers for Disease Control and Prevention recommends some vaccinations using shared clinical decision-making (SCDM). SCDM recommendations are made when not every individual within a given age or risk group would benefit from vaccination, requiring collaborative discussions between patients and providers to assess risks and benefits. Pharmacists play a key role in implementing this recommendation and have frequent opportunities to engage with patients who may be eligible for SCDM-based vaccines. Because SCDM requires provider discussions to assess each patient’s eligibility for the vaccines under SCDM, trust may play a central role in the process. Trust has been suggested to affect patient’s participation in their care and their decision making preferences; however, the nature of this relationship in the context of SCDM vaccines and willingness to engage with pharmacists has yet to be investigated. As the CDC continues to expand the SCDM vaccine category, there is need to assess these. This study aimed to examine relationships between patient characteristics, trust in pharmacists, willingness to engage in SCDM, and vaccination decision control preference. Methods: Using quota sampling, cross-sectional data were collected from Alabama residents aged 18+ between February and March 2024 via a validated online questionnaire. Bivariate and multivariable logistic regression analyses were used to determine the association between trust, patient characteristics and willingness. Structural equation modeling was used to assess the direct and indirect relationships between trust, willingness and vaccination decision control preference. Statistical significance was set at p < 0.05. Results: A substantial portion (45.8%) of participants were unaware that certain vaccinations were based on SCDM. Multivariable logistic regression showed that race (Black vs. White, p = 0.001), age (25–34 vs. 18–24, p = 0.029), highest degree obtained (high school diploma or graduate equivalency degree vs. less than high school, p = 0.001; associate degree or vocational certificate vs. less than high school, p = 0.000; bachelor’s degree or higher vs. less than high school, p = 0.001), political affiliation (Democrat vs. Republican, p = 0.002), confidence in understanding health-related information (high vs. low, p =.029); moderate vs. low, p = 0.002), and patients’ trust in community pharmacists’ communication skills ( p = 0.045) and benevolence ( p = 0.001) towards their patients were significantly associated with patients’ willingness to engage in SCDM. Trust had a significant direct ( p = 0.001) and indirect relationship ( p = 0.000) with decision control preference through the willingness variable. Conclusions: Educational interventions are recommended to improve awareness and knowledge of SCDM vaccines among patients. Given their trusted role, pharmacists should actively build and maintain trust with patients, as this may help foster collaborative environments for discussion, encourage patient engagement in SCDM, and support more informed vaccination choices.

Keywords: SCDM; vaccinations; ACIP; trust; preference; willingness (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
References: Add references at CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/22/10/1525/pdf (application/pdf)
https://www.mdpi.com/1660-4601/22/10/1525/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:22:y:2025:i:10:p:1525-:d:1765239

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().