Service Trust Research Articles

Exploring implementation of intrapartum trial evidence: a qualitative study with clinicians and clinical academics

BackgroundImplementing research evidence into clinical practice is challenging. This study aim was to explore implementation of two intrapartum trials with compelling findings: BUMPES (position in second stage of labour in nulliparous women with epidural), and RESPITE (remifentanil intravenous patient-controlled analgesia). MethodsA qualitative interview study set in UK National Health Service Trusts and Universities. Purposively sampled investigators from RESPITE and BUMPES trials and clinicians providing intrapartum care: midwives, anaesthetists, and obstetricians, were recruited using existing networks and snowball sampling. Semi-structured virtual interviews were conducted. Thematic analysis was underpinned by Capability Opportunity Motivation Behaviour Change Framework.ResultsTwenty-nine interview participants across 19 maternity units: 11 clinical academics, 10 midwives, 4 obstetricians, 4 anaesthetists. Most (25/29) were aware of one or both trials. BUMPES had been implemented in 4/19 units (one original trial site) and RESPITE in 3/19 units (two trial sites). Access to sufficient resources, training, exposure to interventions, support from leaders, and post-trial dissemination and implementation activities all facilitated uptake of interventions. Some clinicians were opposed to the intervention or disagreed with trial conclusions. However competing priorities in terms of staff time and a plethora of initiatives in maternity care, emerged as a key barrier to implementation.ConclusionsCompelling trial findings were not implemented widely, and numerous barriers and facilitators were identified. Large-scale improvement programmes and evidence-based national guidelines may mean single trials have limited potential to change practice. There is a need to examine how intervention implementation is prioritised to optimise safety outcomes in the context of workforce restrictions, limited resources and large arrays of competing priorities including statutory requirements, that have increased in maternity care.

Joint Human and Animal Health Campaigns in Chad

Abstract Providing basic health services to nomadic populations is challenging mainly because of their mobility affecting geographical access to essential services but also due to their particular cultural habits and beliefs, influencing health intervention acceptance. The strategy of joint human and animal health campaigns applied in Chad for over 30 years has helped to improve coverage of childhood and livestock vaccination and increased access to disease prevention. The campaigns are organized by the Chadian ministries for public health and livestock, supported by the Swiss Tropical and Public Health Institute (Swiss TPH) and its local partners. The use of synergies across sectors intends to reduce costs compared to independent sectoral interventions. The gain lies not only in shared logistics but also in better trust in essential services by pastoralists. Planning of joint interventions should start with a careful assessment of the context through a transdisciplinary approach identifying possible access barriers. This allows multidisciplinary development of mitigation measures such as a locally adapted awareness strategy. The multi-disciplinary approach also provides information on the seasonal movements of the different pastoral groups, which is crucial for the timing and location of interventions. Administrative and technical preparation of the field visits needs concerted efforts by all ministries and partners involved to maximize the benefits. To facilitate the uptake and sustainability of joint campaigns in Chad, the involved partners together developed an implementation guide based on their long-standing experience. This case report draws on this guiding document and showcases it for other actors interested in implementing similar One Health strategies. Information © The Authors 2024

What Impact Does the Diagnosis of Mild Cognitive Impairment Have on the Wellbeing, Everyday Behavior, and Healthcare Utilization of People and Their Carers? A Systematic Review.

Dementia is a major cause of disability and dependency globally. Mild cognitive impairment (MCI) is considered an early indicator of developing dementia. There are growing efforts to detect and diagnose MCI earlier; consequently, we need to understand the perspectives of individuals and carers regarding the implications of an MCI diagnosis. To systematically review qualitative literature to understand the impact of a MCI diagnosis on both the individual and their carers, focusing on wellbeing, everyday behaviors, and healthcare utilization. Key search terms were input into five databases. Studies were included if they were peer-reviewed qualitative research published in English that obtained perspectives of community-dwellers with MCI or carers and focused on either their wellbeing, everyday behaviors and/or healthcare utilization. The protocol was pre-registered on PROSPERO (CRD42021291995). Data was synthesized narratively. Key findings from 15 eligible articles highlighted the negative impact of an MCI diagnosis on the wellbeing of both individuals and carers, due to stigma and limited understanding regarding diagnosis/prognosis. Changes in everyday behavior varied, particularly regarding motivation to engage with physical activity, hobbies and social opportunities. Both individuals and carers were sometimes dissatisfied with healthcare services; ineffective communication during clinical consolations highlighted as a reason for lack of trust in clinicians. Results indicate that an MCI diagnosis impacts both people with MCI and their carers across key facets of life. There is a critical need to effectively communicate the diagnosis and prognosis of MCI to support wellbeing and everyday activities and ensure trust in healthcare services.

Faktor-Faktor Yang Mempengaruhi Kepuasan Jamaah Umroh Dan Haji Dengan Persepsi Kesehatan Sebagai Variabel Moderating

Background – Indonesia is the country with the largest Muslim population in the world. This creates a lot of interest and demand for Hajj and Umrah in Indonesia. Hajj and Umrah are worship activities carried out by visiting Mecca and Medina and carried out in accordance with religious law. Since the city of Mecca reopened for Umrah pilgrims after Covid-19, thousands of people have visited various travel services that provide Umrah services. Various types of travel offers ranging from cheap prices, good aircraft facilities, and hotels close to the Kaaba. This offering strategy is carried out to get the attention of prospective Umrah pilgrims. Aim – In this study, the purpose of the study is to test whether service quality, price perception, trust, empathy and health perception influence customer satisfaction and whether health perception is able to moderate all these factors. Design / methodology / approach – This type of research is quantitative research, namely analyzing data in the form of numbers. The data used in this research is primary data which is data directly obtained from the first data source. Data was obtained from the results of a questionnaire distributed to respondents, namely Hikmah Travel pilgrims and Umrah pilgrims. The method used is multiple linear regression analysis with moderator effects. Findings – The results of this research are that the service quality variable (X1) has no effect on consumer satisfaction (Y), the price perception variable (X2) has no effect on consumer satisfaction (Y), the trust variable (X3) has no effect on consumer satisfaction (Y), the empathy variable (X4) has a significant effect on consumer satisfaction (Y), healthy perception (Z) moderates the influence of service quality (X1) on consumer satisfaction (Y), healthy perception (Z) is unable to moderate the influence of price (X2) on consumer satisfaction (Y), healthy perception (Z) is able to moderate the influence of trust (X3) on consumer satisfaction (Y), healthy perception (Z) is unable to moderate the influence of empathy (X4) on consumer satisfaction (Y). Conclusion - The ability of health perception to moderate consumer satisfaction is seen from the quality of service, price perception, trust is good, so this needs to be a concern for hajj and umrah services. However, the absence of health perception will actually result in compromised customer satisfaction. Research implication – Empathy has a significant effect on consumer satisfaction, so travel agencies should pay attention to the empathy factor so that it can increase consumer satisfaction and can be used to attract Hajj pilgrims to use their travel services. Apart from the empathy factor, healthy perceptions are able to moderate the factors of service quality and trust in customer satisfaction, so travel agencies must also pay attention to these factors to get potential customers. Limitations – The population in this research is Hajj and Umrah travel services in East Java, while the sample from this research is Umrah and Hajj pilgrims at Hikmah Travel.

Nurses’ experiences and sense making of COVID-19 redeployment and the impact on well-being, performance, and turnover intentions: A longitudinal multimethod study.

BackgroundDuring Covid-19 nurses were redeployed to new teams and specialties at a level never previously experienced. Little is known about how nurses made sense of and coped with this situation and what we can learn from this for future redeployment approaches. ObjectivesWe sought to understand how nurses made sense of ongoing redeployment during the COVID-19 pandemic and how this related to their psychological distress, burnout, turnover intentions, and perceived performance DesignA longitudinal multi-method design. (ISRCTN: 18,172,749). Setting(s)Three acute National Health Service (NHS) Trusts in England, selected for diversity in geographical location and ethnicity, with different COVID-19 contexts. ParticipantsSixty-two nurses (90 % female; 83 % white) who experienced different types of redeployment during the pandemic, with an average of 17 year's post-registration experience (mean age 41 years). MethodsWe gathered both interview and survey data from 62 nurses across two or three time points in 2020–2021 and sought to find commonalities and differences in patterns of experience using Pen Portrait analysis. ResultsThe pandemic redeployment process was life-changing for all nurses, personally and professionally. The research uncovered an intertwined pattern of identity and sensemaking as nurses coped with COVID-19 redeployment. Three sensemaking ‘journeys’ were evident, involving professional identity as a nurse and identification with one's organisation. Nurses in journey one: ‘Organisational Identification and Professional Identity Maintained’ (n = 28) had the best outcomes for wellbeing, burnout, performance, and retention. Those experiencing the ‘Devaluation of Organisational Identification But Maintenance of Professional Identity’ journey (n = 24) maintained their professional identity, but their organisational identification deteriorated. Journey three nurses: ‘Devaluation of both Organisational Identification and Professional Identity’ (n = 10) had the worst outcomes for wellbeing, burnout, performance, and retention. A salient nurse identity triggered stoicism and resilient behaviours while external cues of control, support and contextual awareness affected organisational identification. ConclusionsNurses made sense of their experiences of redeployment during Covid-19 differently which, in turn affected their outcomes. Given the stark differences in how nurses perceived their psychological distress, burnout, turnover intentions and performance across the journeys, the importance of understanding the cues (e.g. having autonomy) associated with each journey is apparent. Thus, our research provides clear guidance for managers to help them support nurses during redeployment.

Raising the barcode: improving medication safety behaviours through a behavioural science-informed feedback intervention. A quality improvement project and difference-in-difference analysis

Barcode medication administration (BCMA) technology can improve patient safety by using scanning technology to ensure the right drug and dose are given to the right patient. Implementation can be challenging,...

Application of SERVQUAL Model to Gauge Relationship between Service Commitment, Trust, and Price Fairness to Customers Loyalty: Empirical Evidence of Telecommunication Users in Nepal

Background: The service sector, a significant contributor to global GDP, is increasingly focused on innovation, particularly in the telecom industry. Despite its importance, research on how service commitment, service trust, and price fairness affect customer loyalty within Nepal’s telecommunications sector remains limited. Objective: This study aims to investigate the impact of service commitment, service trust, and price fairness on customer loyalty in the mobile telecom sector in Kathmandu Valley. It seeks to apply the SERVQUAL model to assess how these factors influence customer retention and satisfaction. Method: An explanatory research design was employed using a quantitative approach. Data were collected through a structured questionnaire from 404 telecom users selected via purposive sampling. The analysis was conducted using structural equation modeling (SEM) with confirmatory factor analysis and path analysis, employing software tools such as KOBO Toolbox and AMOS to examine the relationships among variables. Result: The findings indicate that service commitment, service trust, and price fairness significantly impact customer loyalty. Service trust and price fairness were found to have a positive and significant effect on loyalty, with price fairness exhibiting a partial mediating role between service commitment and customer loyalty. The study also highlights that telecom firms’ ability to enhance customer satisfaction is closely linked to their service innovation and commitment. Conclusion: The research underscores the importance of service commitment, trust, and price fairness in fostering customer loyalty within Nepal’s telecom sector. Telecom service providers are encouraged to focus on these areas to improve service quality and customer retention. The study offers valuable insights for enhancing customer satisfaction and achieving long-term loyalty in the telecommunications industry. Paper Types: Research Paper Keywords: Telecommunication Service; Commitment; Service Trust; Price Fairness; Customer Loyalty; SERVQUAL model; Structure Equation Model. JEL Classification: D12, L86, L96, M31

Acute Health System-Level Interventions for Identification and Management of Domestic Abuse: Preliminary Interrupted Time Series Evaluation.

This preliminary interrupted time series analysis evaluated different interventions to improve identification of victim-survivors of domestic abuse in one U.K. National Health Service trust, focusing on emergency department, sexual health services and HIV care, and obstetrics and gynecology. This analysis demonstrated that while system-level interventions can improve identification of domestic abuse in clinical contexts, the exact nature of interventions most likely to be effective may vary in different clinical contexts. For example, none of the modeled interventions generated significant impacts in emergency department contexts, and estimates were close to the null in all cases, but routine inquiry demonstrated effectiveness in sexual health services, while implementation generated improved effectiveness in the obstetrics and gynecology setting.

Beyond service: commercial friendship's impact on trust and student loyalty

ABSTRACT Grounded in social cognitive theory, this study aims to explore how service quality and commercial friendship contribute to enhancing student loyalty and facilitating long-term positive relationships between universities and their students. It also examines the mediating role of trust in management policies and practices, as well as in faculty and staff within this framework. Structural equation modeling is used to test the hypotheses using the survey data collected from students in higher education institutions within Pakistan. The research reveals that service quality has a significant impact on students’ loyalty to their university, with trust serving as a crucial mediator in this relationship. Conversely, commercial friendship does not directly influence student loyalty. However, trust in management policies and practices effectively bridges the gap between commercial friendship and student loyalty. These findings are pivotal for crafting effective student retention strategies. This study makes a unique contribution by identifying the pathways to student loyalty through service quality, commercial friendship, and trust in management and faculty. It represents the first empirical investigation into the role of individual-organizational factors in the context of educational services marketing, offering valuable insights for enhancing student retention efforts.

The sustainability of exercise following colorectal surgery: A qualitative study of participants in the PREPARE-ABC trial

Objective This study aimed to explore perceptions regarding the sustainability of exercise following participation in a pre- and post-colorectal surgery exercise intervention trial (PREPARE-ABC). Design Qualitative interview study. Data were analysed using framework analysis and independently coded by two researchers. Setting Six United Kingdom National Health Service Trusts. Participants Eighteen interviews (hospital-based exercise n = 9, home-based exercise n = 3, standard care n = 6) were conducted with patients 12–15 months after being randomised in the trial, after their 12 month appointment. Intervention Individuals who participated in one of two exercise intervention groups (hospital-supervised or home-supported exercise) or a standard care control group of the PREPARE-ABC trial were invited to interview. Results The exercise interventions were reported to influence participants’ recovery and future sustainability of exercise behaviour change. Several participants continued to engage in exercise over a year after their surgery. Reasons for this included being engaged with exercise prior to diagnosis, psychological benefits of exercise and wanting to be engaged with something to help recovery. Perceptions about the sustainability of active lifestyles were influenced by confidence to engage in structured exercise or physical activity and beliefs about its potential to promote future wellness. Conclusions Sustainability varies among individuals and early assessment of physical activity engagement could be beneficial. Physical activity interventions immediately following surgery may be important for future engagement.

The Influence of Service Quality and Trust on User Loyalty through User Satisfaction DANA in Jakarta

The Influence of Service Quality and Trust on User Loyalty through User Satisfaction DANA in Jakarta

Tour and Travel Services Company Website Design with Enhanced Awareness of Transportation Safety

<p><em>Transportation safety is a critical aspect of the tour and travel industry. With increased focus on passenger safety and comfort, tour and travel companies must adopt information technology to enhance safety aspects. This article discusses the design and development of a tour and travel company website that is more safety-conscious, integrating important features such as NIK usage, passenger tracking, real-time notifications, and customer awareness education regarding safety. The design process employs the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) methodology. In summary, the new features added to the booking system have greatly improved user satisfaction and operational efficiency for the company. The safety-conscious website has positively impacted passenger safety and comfort. Technologies like NIK integration, real-time tracking, and automatic notifications have made the service more reliable and user-friendly. However, there's still a need for better education on safety requirements for drivers and vehicles, as many users admit to lacking understanding in this area. Continued efforts to educate users transparently can enhance trust and safety in transportation services.</em></p>

Principal–agent trust and adoption of digital financial services: Evidence from India

AbstractThe high reliance on cash is a lifestyle for many people, and their low proficiency with smartphone usage acts as an inertial barrier to using digital financial services (DFS). Given low financial or digital literacy, online banking transactions have to be promoted and mediated by DFS agents. This study examines the role of digital platforms, intermediaries such as banks, mobile money agents, payment banks, post offices, and the government's increasing use of digital technologies. This usage of digital platforms is based on the trust relationship between the principals, who are owners of their bank accounts, and agents of DFS, who are intermediaries. A linear probabilistic model is employed to determine the determinants behind the low adoption of DFS between the necessity and nonnecessity groups. We observe that demand‐side factors like education level, identity proof (documentation), and level of smartphone use proficiency increase the probability of a principal's involvement in a digital mode of payment. At the same time, supply‐side factors like digital infrastructure and trust deficit due to unviable commission incentives to DFS agents decrease the principal's likelihood of using digital platforms.

A Study on Effectiveness of Customer Retention Strategies Factors in Banking Sector

Competition among banks is fierce, and non-banks and other financial firms are also majorrivals. The problem is that it's really simple to replicate a financial product, and in the end, they allessentially do the same thing. Customer retention is a wide and complicated notion, and it is possible thatmany factors contribute to it. This paper study Customer service quality, customer happiness, switchingcosts, customer relationships, trust, and bank pricing were among the few determinants of customerretention that were examined in this study. India has a highly competitive banking sector thanks to theexistence of public, private, and international institutions. banks, faced with an increasingly competitivemarket, are implementing strategies to keep as many of their current clients as possible. Keeping currentcustomers happy is crucial in today's cutthroat business climate. The bank has to go above and beyondits basic functions to provide its clients a satisfying banking experience.

Audit of the Acute Management of Renal Colic in District Hospitals Within a National Health Service Trust.

Renal colic is a prevalent acute urological emergency caused by urinary stones and commonly manifests as severe loin pain. This audit assesses the management of acute renal colic at a National Health Service (NHS) Trust in the West Midlands, England, comparing practices against theNational Institute for Clinical Excellence (NICE) and the British Association of Urological Surgeons (BAUS) guidelines. This retrospective audit reviewed 417 patients with suspected renal colic over a month. Data collected included patients' demographics, time to complete CT scan, laboratory investigations requested and management modalities. Patients assessed were either admitted through the Emergency Department, Surgical Assessment Unit, or previously admitted for other conditions on the wards. The audit benchmarked against NICE and BAUS guidelines, focusing on diagnostic timeliness and management, including essential blood investigations. Data analysis performed using SPSS (IBM Corp., Armonk, NY, USA) included descriptive statistics and Chi-square tests, with significance set at p < 0.05. A total of 417 patients met the inclusion criteria. The average age of patients was 47.4 years with slightly higher male population (51.1%). The diagnostic rate for renal or ureteric stones using computed tomography of the kidneys, ureters, and bladder (CT-KUB) was 41.2%. The positive detection rate was significantly higher in males (54%) compared to females (27.5%) while females have more alternate diagnosis than males (13.7% vs 6.1%). The average completion time of CT-KUB was nine hours with 7.7% of patients having their CT-KUB beyond the 24-hour benchmark. Most patients (48%) were managed conservatively with analgesia, 32% received tamsulosin as medical expulsive therapy and others had interventions like ureteric stent insertion (9.3%), nephrostomy (6.4%) or primary ureteroscopy (4.1%). The audit of renal colic management at our centre revealed a 41.2% diagnostic rate for renal or ureteric stones via CT-KUB, with a significantly higher rate in males than females. Diagnostic delays were minimal, with only 7.7% of scans exceeding 24 hours. Conservative management was common, however non-steroidal anti-inflammatory drugs (NSAIDs) were underutilized despite guideline recommendations. There was a notable gender disparity in diagnostic and alternate findings rates. The results showed the need for adherence to pain management protocols and highlight the effectiveness of existing renal colic protocol, while also pointing to potential areas for improvement in treatment uniformity and guideline adherence.

Navigating the data economy : Key considerations for decision makers in banking

The European Commission (EC) is advancing the data economy through a series of regulatory reforms aimed at giving customers control of their data and fostering innovation in third-party contexts. While the costs of developing existing banking infrastructures and creating open application programming interfaces have largely fallen on banks, third-party service providers have benefitted from new revenue streams and increased customer relevance. As a result, banks risk disintermediation with some customer segments. The impending Financial Data Access (FiDA) regulation is set to expand these dynamics by extending the range of financial data made accessible for third parties. Simultaneously, the entry into force of the Electronic Identification Authentication and Trust Services 2.0 (eIDAS2) introduces a digital wallet that allows consumers and businesses to share their identity credentials in online customer journeys, offering banks the potential to engage more effectively in the data economy. The key question is whether the new reforms will encourage banks to seek opportunities beyond compliance; more so than with the Revised Payment Services Directive (PSD2) and open banking. This paper analyses the opportunities arising from FiDA, eIDAS2 and the Data Acts, providing strategic considerations for banks navigating the data economy. It emphasises that banks are ideally positioned to become data custodians by offering customers tools for the secure and reliable exchange of data-driven digital transactions across all sectors. Ultimately, this approach will unlock new value and enhance the relevance of banks in the data economy.

Unveiling the Impact of Perceived Benefits on Digital Banking Readoption in Malaysia

Malaysia's banking sector has undergone significant transformation driven by digital technologies, revolutionizing traditional banking operations and customer engagement strategies. The introduction of digital banking products has redefined the financial landscape, providing unparalleled convenience, accessibility, and financial control to consumers and businesses. Key advantages such as operational efficiency, cost savings, 24/7 accessibility, and real-time financial management have been crucial in driving the adoption and readoption of digital banking services across various demographic segments in Malaysia. The study leverages theoretical frameworks like the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) to understand user acceptance and behavior towards digital banking readoption. These models highlight constructs such as performance expectancy, effort expectancy, social influence, and facilitating conditions as essential factors influencing technology adoption. Recent research emphasizes the importance of service quality in mobile banking applications as a determinant of customer satisfaction and loyalty, reflecting the advanced expectations of tech-savvy Malaysian consumers. a rigorous methodological approach, the study examines the factors influencing the readoption of digital banking products among Malaysian consumers. Utilizing Smart Partial Least Squares Structural Equation Modelling (Smart PLS-SEM), the study validates the relationships between perceived benefits and digital banking readoption decisions. The findings reveal that effort expectancy, rather than performance expectancy, is a critical factor influencing readoption, underscoring the importance of usability and convenience. The model explains 66.4% of the variance in readoption behavior, highlighting the complexity of consumer decision-making in digital banking. This study concludes that banking institutions must continuously enhance digital platform functionality and security while prioritizing superior user experiences. Trust, perceived security, and customer service quality remain pivotal in shaping consumer attitudes towards digital banking adoption and readoption, reflecting the dynamic and evolving preferences within Malaysia's digital banking ecosystem.

The use of locum doctors in the NHS: understanding and improving the quality and safety of care.

The use of locum doctors in the National Health Service is widely believed to have increased, and there have been widespread and sustained concerns among policy-makers, healthcare providers, professional associations and professional regulators about the quality/safety, cost and effective use of locum doctors. To provide evidence on the extent, quality and safety of medical locum practice and the implications of medical locum working for health service organisation and delivery in primary and secondary care in the English National Health Service, to support policy and practice. Four interlinked work packages involving surveys of National Health Service trusts and of general practices in England; semistructured interviews and focus groups across 11 healthcare organisations in England; analysis of existing routine data sets on the medical workforce in primary care and in National Health Service trusts in England from National Health Service Digital and National Health Service Improvement; and analysis of data from the Clinical Practice Research Datalink in primary care and of electronic patient record data from two National Health Service hospitals in secondary care. In primary care, about 6% of general practice medical consultations were undertaken by locums in 2010 and this had risen slightly to about 7.1% in 2021. In National Health Service trusts (mostly secondary care and mental health), about 4.4% of medical staff full-time equivalent was provided by locum doctors. But those overall national rates of locum use hide a great deal of variation. In primary care, we found the National Health Service Digital workforce returns showed the rate of locum use by Clinical Commissioning Group varied from 1% to almost 31%. Among National Health Service trusts, the reported rate of locum use varied from < 1% to almost 16%. We found that there was poor awareness of and adherence to national guidance on locum working arrangements produced by National Health Service England. Our research showed that locum working can have adverse consequences for the quality and safety of care, but that such consequences were probably more likely to result from the organisational setting and the working arrangements than they were from the locum doctors themselves and their competence, clinical practice or behaviours. Our research was hampered in some respects by the COVID pandemic which both resulted in some delays and other challenges. Our efforts to use electronic patient record data in secondary care to explore locum doctor working were stymied by the problems of data access and quality. Locum doctors are a key component of the medical workforce in the National Health Service, and provide necessary flexibility and additional capacity for healthcare organisations and services. We found that the extent of reliance on locum doctors varied considerably, but that an over-reliance on locums for service provision was undesirable. Some differences in practice and performance between locum and permanent doctors were found, but these seemed often to arise from organisational characteristics. We found that patients were more concerned with the clinical expertise and skills of the doctor they saw than whether they were a locum or not. Organisational arrangements for locum working could be improved in many respects. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128349) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 37. See the NIHR Funding and Awards website for further award information.

Addressing Vaccination Gaps through Student-Led Initiatives: A Study of Stanford Vax Crew's Impact

Background: Although vaccines are critical to disease prevention, substantial gaps persist in adult vaccination coverage in the United States due, in part, to material and social barriers. Farmworkers face unique challenges to accessing vaccination services, such as migratory residence, immigration status, low levels of insurance, and geographic distance from clinics, many of which were exacerbated during the coronavirus disease 2019 (COVID-19) pandemic. Student-driven, community-focused programs offer a potential mechanism to enhance vaccine equity. Stanford Vax Crew is a student-led organization that partners with community organizations to host pop-up vaccine clinics, which aim to (1) address the material barriers that impact vaccination status, (2) establish trust in vaccine services, and (3) equip future medical professionals with skills to engage in community health initiatives. Methods: This paper describes the strategies used by the organization to reach surrounding communities with vaccines, especially agricultural workers. It assesses the reach of the program through analysis of demographic data collected at pop-up clinics. Results: From August 2021 to March 2023, the majority of COVID-19 vaccine recipients were middle-aged adults (61%) of Hispanic ethnicity (82%) working in the agricultural, forestry, or fishing industries (58%). In total, 1377 COVID-19 vaccines were administered by Stanford Vax Crew. Conclusions: Findings suggest that Stanford Vax Crew's partnerships with diverse institutions helped facilitate access and build trust, thereby enhancing vaccine uptake. Partnership with agricultural employers and community-based organizations targeted farmworkers, which enabled the group to host clinics on farms immediately before and after work hours, which proved especially effective for reaching agricultural workers.

An empirical exploration of the drivers of trust in consumer financial services

An empirical exploration of the drivers of trust in consumer financial services