The SKAI project: Sharing Knowledge About Immunisation

Supporting vaccination discussions between parents and health professionals

What is SKAI?

SKAI stands for Sharing Knowledge About Immunisation. SKAI is a three-year research project that is investigating vaccination communication and developing resources to share information about childhood immunisation.

Childhood immunisation has been one of the most successful measures to control serious childhood diseases and is generally accepted by many parents.  However some parents and carers have concerns about the safety of the vaccines particularly as the schedules get more complex. This leads to some parents and carers being hesitant or even declining vaccinations. 

Immunisation is important because it protects the individual, and also the wider community, from serious diseases. When a significant portion of the population is immunised and protected, an outbreak of disease is less likely to occur. This protection of the population is often known as herd immunity. It is important for those who cannot receive vaccinations, such as children who are too young to be vaccinated, people with immune system problems and those who are ill.

SKAI aims to work with all parents but particularly those who are hesitant or concerned about vaccination to give them access to reliable information and to have supportive conversations with healthcare providers.

What will the SKAI project do?

In consultation with parents and health professionals, the SKAI team is building a package of resources for health professionals and parents/carers of babies and young children, designed to support conversations about childhood vaccination. The resources for parents provide current, evidence-based information about vaccines and the diseases they prevent. The resources for health professionals will be designed to help them to present accurate vaccination information at the right time, in the right amount, and present it in the right way for each of their patients.

The SKAI resources are shaped by best practice in health communication and informed by parents and health professionals to ensure that they meet the needs of both groups.

What are the components of the SKAI system?

1. Resources for parents: Our first resources are a series of five fact sheets addressing the five concerns most commonly expressed by Australian parents. We chose these five concerns based on research conducted in Australia and overseas, and confirmed by our research investigating healthcare professionals’ experiences talking with parents about vaccination. These SKAI Q&A sheets are available from the Australian Government Department of Health Immunisation website.. Further resources for parents are in development.

2. Resources for health professionals: These will include tips to improve communication between healthcare providers and parents, conversation vignettes, and a referral option for parents who need a longer conversation with a specialist in childhood vaccination. Research with GPs and nurses has already provided rich insights into the challenges they encounter when discussing vaccination with parents in busy clinics and general practices. Feedback from health professionals will be sought regularly and used as the basis for continual improvement of the system.

3. Training for health professionals in using the system: We have been working closely with GPs, vaccinating nurses and experts in medical education to ensure that the system can be integrated seamlessly into established clinics. The development of the training package for health professionals is underway.

4. Digital platform to house the system: The digital implementation of the SKAI system and resources is currently in development. The next phase of the project, to begin in late-2017, is a study to determine how the SKAI system can best be integrated into primary health care settings.

Who is on the SKAI research team?

The SKAI Collaboration is a group of researchers with specific expertise in vaccination, each aligned with an independent research organisation. Some of us are medical doctors. Some of us are nurses. Some are social scientists. And some are health communicators. We are all parents. As advocates for child health, we support vaccination. As parents, we understand and respect the challenges of raising children. As health professionals, we understand the demands of busy clinics.

Our aim is to help parents and professionals together make the best decisions for children. We believe the best decisions are made when we approach one another with respect, value one another’s autonomy, aim for good health outcomes and, above all, avoid causing harm. These are the values that guide the work of the SKAI project.

Meet the SKAI team
  • Julie Leask, Nina Berry, Lyndal Trevena are researchers from the University of Sydney. Julie works in the Faculty of Nursing and Midwifery. Nina works in the School of Public Health and Lyndal is the Head of the Discipline of General Practice at the Sydney Medical School.
  • Margie Danchin is a researcher at the University of Melbourne and Murdoch Children’s Research Institute and a paediatrician at the Royal Children’s Hospital in Melbourne.
  • Kristine Macartney is a researcher at NCIRS and a paediatrician specialising in infectious diseases at The Children’s Hospital at Westmead.
  • Tom Snelling is a consultant paediatric and infectious diseases physician, Princess Margaret Hospital and a researcher at the Telethon Kids Institute.
  • Paul Kinnersley is a Clinical Communication researcher at Cardiff University in Wales.
  • Holly Witteman is a Human Factors Engineer at Laval University, Québec in Canada.
  • Penelope Robinson is the Project Manager based at the University of Sydney.

We are a diverse and truly interdisciplinary research team, bringing together expertise in Health Communication, Human Factors Engineering, Implementation Science, General Practice, Nursing, Medical Education, Vaccinology and Paediatrics.

We also consult with a wide network of experts. NCIRS provides technical advice on vaccinology. Jo Lander and Susan Randall are collaborating with us on data analysis. Annette Alafaci is our research assistant based in Melbourne. Hal Willaby at the University of Sydney was involved in early development of the SKAI concept. Maria Chow at the University of Sydney is translating the SKAI resources into Chinese characters. Melinda Hassall at James Cook University analysed our interviews with health professionals. Overseas, Cath Jackson, Francine Cheater, Helen Bedford and Nick Sevdalis were involved in early development, supported by a University of Sydney International Program Development Fund. We continue to consult with parents, health professionals and immunisation program managers.


SARAH stands for Support and Resources for Assisting Hesitant parents with vaccination decisions. SARAH was the original name of the research project, before we decided to use the brand name SKAI.

How is SKAI funded and administered?

We do not accept any funding from the pharmaceutical industry. The SKAI project is funded by the Australian Government Department of Health. It is a partnership between researchers from the University of Sydney, NCIRS, the University of Melbourne, Murdoch Children’s Research Institute, Telethon Kids Institute, Cardiff University and the University of East Anglia. Some of the early research that has informed the project was provided by the University of Sydney and the Sydney North Shore and Beaches Medicare Local (which has now been replaced with a Primary Health Network). Our current funding will enable us to develop effective communication tools and work out how best to integrate them into clinics and general practices. We expect to complete these tasks by 2018.

The SKAI Advisory Group provides advice on the scientific direction and governance of the project. The members of this group are:

  • Professor Terry Nolan, Melbourne School of Population and Global Health, University of Melbourne
  • Ms Karen Booth, President, Australian Primary Health Care Nurses Association (APNA)
  • Dr Greg Rowles, General practitioner
  • Dr Elizabeth Marles, Royal Australasian College of General Practitioners
  • Catherine Hughes, Light for Riley
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Last updated August 2017