School of Medicine, University of Maryland School of Nursing, Baltimore, MD, USA.
School of Medicine, University of Louisville, Louisville, KY, USA.
Transl Behav Med. 2018 Nov 21;8(6):867-875. doi: 10.1093/tbm/iby069.
The current rate of immunizations for older adults does not meet the immunization goals for Healthy People 2020. Using a Social Ecological Model and Social Cognitive Theory, the purpose of this study was to disseminate and implement the Immunization Champions, Advocates and Mentors Program (ICAMP) into a variety of health care settings. This study used a single group pre-/post-test design. Champions were recruited nationally. Five geographically diverse face-to-face meetings were held to train health care providers to be ICAMP immunization champions. Dissemination and implementation of ICAMP was evaluated using the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) model. Participants were surveyed at baseline for descriptive information and were asked to gather immunization rates for at least one particular vaccine and provide follow-up data on progress toward goal achievement. A total of 212 champions from 82 settings participated in ICAMP. The majority were nurses (111/212, 52%). With regard to reach, we obtained 212 applications from individuals in a variety of settings interested in becoming champions. With regard to effectiveness, the majority of the champions (n = 178/212, 84%) used ICAMP material, 88% (n = 186/212) made changes related to immunization processes within their setting, and all reported that immunization practices improved. The majority used the toolkit materials up through 60 days following ICAMP. Sustained use of materials after the 60-day follow-up was less evident. ICAMP was implemented as intended and was effective in changing processes around immunizations. Ongoing work is needed to determine whether ICAMP improves immunization rates.
当前老年人的免疫接种率未达到 2020 年健康人免疫目标。本研究采用社会生态学模型和社会认知理论,旨在将免疫拥护者、倡导者和导师计划(ICAMP)推广到各种医疗保健环境中。本研究采用了单组前后测试设计。在全国范围内招募拥护者。举办了五次地理上多样化的面对面会议,培训医疗保健提供者成为 ICAMP 免疫拥护者。使用扩展、有效性/效果、采用、实施和维持(RE-AIM)模型评估 ICAMP 的传播和实施情况。参与者在基线时接受了描述性信息调查,并被要求收集至少一种特定疫苗的免疫接种率,并提供实现目标进展的后续数据。共有 212 名来自 82 个环境的拥护者参加了 ICAMP。大多数是护士(111/212,52%)。在覆盖范围方面,我们从各种有兴趣成为拥护者的环境中收到了 212 份个人申请。在有效性方面,大多数拥护者(n=178/212,84%)使用了 ICAMP 材料,88%(n=186/212)在其环境中对免疫程序做出了改变,并且都报告称免疫实践得到了改善。大多数人在参加 ICAMP 后的 60 天内使用工具包材料。在 60 天的随访之后,持续使用材料的情况就不那么明显了。ICAMP 按预期实施,并且在改变免疫接种流程方面是有效的。需要开展进一步的工作,以确定 ICAMP 是否能够提高免疫接种率。