Abstract
BackgroundImmunisation 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.MethodsAn 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.ResultsTen 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.ConclusionsCreating 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.
Highlights
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
Sample population & recruitment process This study presents the qualitative component of an intervention study that was undertaken of general practices from regions across New Zealand with low childhood immunisation coverage rates (Fig. 1)
This study indicated that issues were experienced with coordinating referrals to outreach immunisation services
Summary
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. In New Zealand, the National Immunisation Schedule (NIS) consists of publicly funded vaccination for all children at certain milestone ages [2]. The historically suboptimal childhood immunisation coverage rates and delayed immunisation timing has sparked the implementation of numerous strategies to improve uptake rates and reduce equity gaps [6]. Despite overall immunisation coverage rates improving nationally and disparity gaps closing, these rates vary considerably among general practices at the local level [5,6,7]
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