29 - Perspectives of Clinicians and Parents on an Intervention to Increase Parental Confidence in Respiratory Syncytial Virus Immunoprophylaxis in the Well Newborn Unit

Publication Number: 2026.29

Paul L. Aronson, Yale School of Medicine, New Haven, CT, United States; Jaspreet Loyal, Yale School of Medicine, New Haven, CT, United States; Cristina Del valle, Yale-New Haven Children's Hospital, Shelton, CT, United States; Varshini Batti, Yale-New Haven Children's Hospital, New Haven, CT, United States; Rakesh D. Mistry, Yale School of Medicine, New Haven, CT, United States; Elena Aragona, Yale School of Medicine, New Haven, CT, United States

Background: Newborn respiratory syncytial virus (RSV) immunoprophylaxis is efficacious in reducing hospitalizations, yet uptake is low in comparison with other recommended newborn interventions. The well newborn unit is ideal for implementation of an intervention to increase parental confidence in RSV immunoprophylaxis.

Objective: We aimed to identify barriers to and enablers of implementation of an intervention in the well newborn unit to increase parental confidence in newborn RSV immunoprophylaxis.

Design/Methods: We conducted individual, semi-structured interviews of purposively sampled clinicians and parents at an urban, quaternary care hospital well newborn unit between 8/13/2025-10/22/2025. Interviews elicited clinicians' and parents' perceptions of RSV immunoprophylaxis, the process for counseling, barriers and facilitators, and their perspectives on the design and implementation of a potential intervention to increase parental confidence. Interview questions were guided by the Consolidated Framework for Implementation Research. Using both deductive and inductive approaches, we applied codes to iteratively categorize text into themes. Four investigators independently coded the first 2 transcripts in each stakeholder group. Two investigators then applied codes to the remaining transcripts, resolving discrepancies by consensus.

Results: We interviewed 18 clinicians (5 hospitalists, 3 general pediatricians, 3 obstetricians, 7 nurses/nurse managers) and 24 parents, with codes applied to all clinician transcripts and 18 parent transcripts to date. Clinicians were universally supportive of RSV immunoprophylaxis in the well newborn unit, while the majority of parents would or did accept RSV immunoprophylaxis when recommended by a physician. We identified several themes related to implementation of an intervention to increase parental confidence: 1) trust and mistrust of information; 2) differentiation of RSV immunoprophylaxis from a vaccine; 3) value of providing both data and personal experiences; 4) support for a tool to augment, but not replace, clinician counseling; 5) use of visuals in a tool; 6) need for a tool to be accessible for parents of varying health literacy and languages; and 7) importance of timing (Table 1; representative quotations).

Conclusion(s): Clinicians and parents were supportive of an intervention to facilitate counseling about RSV immunoprophylaxis and identified several themes related to implementation. After completion of interviews and analysis, we will focus on the design, development, and implementation of an intervention which centers the key themes identified in this study.

Table 1. Representative Quotations