Discussion
INFLUENZA
To the best of our knowledge, this is the first RCT that examined the efficacy of a video-based, HCD-driven intervention improving parental confidence in childhood vaccinations in the Philippines. We found that our HCD-driven intervention, the Salubong animated video, positively impacted caregiver attitudes and confidence toward childhood vaccinations. Our intervention also improved vaccine confidence among participants who previously delayed or refused a vaccine for their children. Our findings reaffirm the value of HCD as a meaning-making approach that influences attitudes and behavioural intent in generalOur results support the use of HCD to boost vaccine confidence along the vaccine hesitancy continuum. A number of research studies have used HCD when developing vaccine confidence interventions with promising results, for example, to design mobile Apps to inform parents about the vaccination status of their children in GermanySome studies also provide evidence of the effectiveness of different types of vaccine confidence interventions and highlight the importance of addressing vaccine confidence as a barrier to vaccine uptake. Prior successful interventions include text message reminders for influenza vaccine uptake in Australia,Our findings also provide concrete evidence of the opportunities of empathic-driven interventions, particularly for low-resource settings combating vaccine losses brought on by controversies.While our findings are generally encouraging, we note limitations. First, confidence and intent to vaccinate do not always translate into actual vaccination uptake. We invite future researchers to implement similar interventions that include actual vaccine uptake as an outcome measure. Second, certain concerns might be associated with this study being conducted online, especially regarding internet connectivity concerns and informed consent processes. However, we developed online data collection and standard operating procedures to allay these operational worries.