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The challenges and opportunities of translating best practice immunisation strategies among low performing general practices to reduce equity gaps in childhood immunisation coverage in New Zealand.
BMC Nursing ( IF 3.1 ) Pub Date : 2017-06-16 , DOI: 10.1186/s12912-017-0226-2
Nikki M Turner 1 , Nadia A Charania 2 , Angela Chong 1 , Joanna Stewart 3 , Lynn Taylor 1
Affiliation  

BACKGROUND Immunisation coverage rates vary considerably at the local level across New Zealand and challenges remain with effectively translating best available research evidence into public health practice. This study aimed to translate best practices from high performing general practices into strategies to improve childhood immunisation coverage among low performing practices. METHODS An intervention study was undertaken of general practices with low immunisation coverage rates and a high percentage of the enrolled population being of Māori ethnicity. Intervention groups received customised action plans and support for a 12 month period while control groups received 'business as usual' support. Structured interviews were conducted with key informants from all participating practices to understand current aspects related to childhood immunisation delivery and surveys were conducted to understand how the intervention worked. Collected data were thematically analysed. RESULTS Ten sites were randomised to either intervention (n = 6) or control group (n = 4). Positive aspects of childhood immunisation delivery included high prioritisation at the practice and staff being pro-immunisation and knowledgeable. Key challenges experienced included inaccurate family contact information and discrepancies with referral processes to other providers. Other challenges noted were building rapport with families and vaccine hesitancy. The action plans included various strategies aimed to improve processes at the practice, contact and engagement with parents, and partnership development with local service providers. CONCLUSIONS Creating customised action plans and providing support to providers were considered as helpful approaches when attempting to improve childhood immunisation coverage rates. Our study supports the notion that one strategy will not solely by itself improve childhood immunisation rates and highlights the importance of having a toolkit of strategies from which to draw from.

中文翻译:

在表现不佳的常规做法之间转换最佳实践免疫策略以减少新西兰儿童免疫覆盖率方面的公平性差距所面临的挑战和机遇。

背景技术新西兰各地的免疫覆盖率差异很大,将有效的最佳研究证据有效地转化为公共卫生实践仍面临挑战。这项研究旨在将最佳实践从高绩效的常规实践转化为提高低绩效实践中儿童免疫接种覆盖率的策略。方法进行了一项针对一般实践的干预研究,这些实践的免疫覆盖率低,并且在册的毛利人中有较高的比例。干预小组获得了为期12个月的定制行动计划和支持,而对照组则获得了“照常营业”的支持。与来自所有参与实践的主要信息提供者进行了结构化访谈,以了解与儿童免疫接种提供有关的当前方面,并进行了调查以了解干预措施的工作方式。对收集到的数据进行了主题分析。结果将十个部位随机分为干预组(n = 6)或对照组(n = 4)。儿童免疫接种的积极方面包括在实践中高度重视优先事项,并且工作人员应积极进行免疫接种并且知识渊博。遇到的主要挑战包括不正确的家庭联系信息以及与其他服务提供商的转诊流程之间的差异。注意到的其他挑战是与家庭建立融洽的关系以及疫苗犹豫。行动计划包括旨在改善实践过程的各种策略,与父母的联系和互动,以及与当地服务提供商的合作伙伴关系的发展。结论制定定制的行动计划并向提供者提供支持被认为是试图提高儿童免疫接种率的有用方法。我们的研究支持以下观点:一种策略不仅可以独自提高儿童的免疫接种率,而且强调了拥有可以借鉴的策略工具包的重要性。
更新日期:2019-11-01
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