Centre for Public Health and Wellbeing, University of the West of England, Coldharbour Lane, Bristol BS16 1QY UK.
Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
J Public Health (Oxf). 2021 Dec 10;43(4):e675-e683. doi: 10.1093/pubmed/fdaa100.
Gypsies, Roma and Travellers are at risk of low uptake of routine immunizations. Interventions to improve uptake in these communities are seldom evaluated. As part of a qualitative study exploring barriers and facilitators to immunization uptake in Travellers, we report service provider (SP) perspectives.
We interviewed immunization SPs working with six Traveller communities across four UK cities. Participants included frontline staff and those with strategic or commissioning roles. Semi-structured interviews explored perceived attitudes of Travellers to vaccinations, local service delivery, and opportunities and challenges to improving uptake. Audio-recordings were transcribed, analyzed thematically and mapped to a socio-ecological model of health.
39 SPs participated. Four overarching themes were identified: building trusting relationships between SPs and Travellers; facilitating attendance at appointments; improving record keeping and monitoring and responding to local and national policy change. Travellers were perceived as largely supportive of immunizations, though system and organizational processes were recognized barriers to accessing services.
Findings were broadly consistent across Traveller groups and settings. The barriers identified could often be addressed within existing infrastructure, though require system or policy change. Development of a culturally competent system appears important to enable equity in access to immunizations for Travellers.
吉普赛人、罗姆人和游民接种常规疫苗的比例较低。这些群体中很少有干预措施来提高接种率。作为探索影响游民接种疫苗的因素的定性研究的一部分，我们报告了服务提供者（SP）的观点。
我们采访了在英国四个城市的六个游民社区工作的免疫服务提供者。参与者包括一线工作人员和具有战略或委托角色的人员。半结构化访谈探讨了服务提供者对游民接种疫苗的态度、当地服务提供以及提高接种率的机会和挑战。录音被转录、主题分析，并映射到健康的社会生态模式。
39 名服务提供者参与了研究。确定了四个总体主题：在服务提供者和游民之间建立信任关系；促进预约出席；改善记录保存和监测，并对当地和国家政策变化做出反应。游民普遍支持免疫接种，但系统和组织流程被认为是获得服务的障碍。
研究结果在不同的游民群体和环境中基本一致。确定的障碍通常可以在现有基础设施内解决，但需要系统或政策变革。发展一个文化上有能力的系统对于确保游民平等获得免疫接种似乎很重要。
