Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
Prev Med. 2024 Oct;187:108104. doi: 10.1016/j.ypmed.2024.108104. Epub 2024 Aug 17.
Clinical champions are healthcare professionals who help their colleagues improve the delivery of evidence-based care. Because little is known about champions working in the context of adolescent vaccination, we sought to identify vaccine champion roles among primary care health professionals (PCHPs).
In 2022, we surveyed 2527 US PCHPs who serve adolescents. The survey assessed the extent to which respondents identified as vaccine champions and the activities they performed. Guided by the Consolidated Framework for Implementation Research, we used these data to categorize PCHPs as: champions who led projects to increase vaccination rates ("implementation leaders"); facilitating champions who more generally shared vaccination data, information, and encouragement ("facilitators"); or non-champions. We used multinomial logistic regression to identify correlates of being a leader or facilitator as opposed to a non-champion.
About one-fifth (21%) of PCHPs were implementation leaders, one-quarter (25%) were facilitators, and the remainder (54%) were non-champions. Leaders were more common among PCHPs with medium or high versus low practice experience (31% and 36% versus 20%, both p < .01) and adolescent patient volume (29% and 39% versus 17%, both p < .01). Being a facilitator was also associated with higher practice experience and patient volume. Leaders and facilitators reported a similar number of barriers to their work (mean = 1.8 and 1.9, respectively), with time and competing quality metrics being most common.
Our findings suggest that both implementation leaders and facilitators are common vaccine champions in adolescent primary care. These champions are more often found among PCHPs with higher experience and patient volume.
临床冠军是帮助同事提高循证护理水平的医疗保健专业人员。由于对在青少年疫苗接种背景下工作的冠军知之甚少,我们试图确定初级保健医疗专业人员(PCHP)中的疫苗冠军角色。
2022 年,我们调查了 2527 名为青少年服务的美国 PCHP。该调查评估了受访者作为疫苗冠军的程度以及他们所进行的活动。我们根据实施研究综合框架,使用这些数据将 PCHP 分为:领导项目以提高疫苗接种率的冠军(“实施领导者”);更普遍地共享疫苗接种数据、信息和鼓励的促进者(“促进者”);或非冠军。我们使用多项逻辑回归来确定成为领导者或促进者而不是非冠军的相关性。
约五分之一(21%)的 PCHP 是实施领导者,四分之一(25%)是促进者,其余(54%)是非冠军。在具有中等到高实践经验(31%和 36%,均 p < 0.01)和青少年患者量(29%和 39%,均 p < 0.01)的 PCHP 中,领导者更为常见。作为促进者也与更高的实践经验和患者量相关。领导者和促进者报告的工作障碍数量相似(平均值分别为 1.8 和 1.9),时间和竞争质量指标最为常见。
我们的研究结果表明,实施领导者和促进者都是青少年初级保健中的常见疫苗冠军。这些冠军更常见于经验和患者量更高的 PCHP 中。