Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599-7440, USA.
UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7295,USA.
Transl Behav Med. 2024 Nov 25;14(12):722-731. doi: 10.1093/tbm/ibae054.
Implementation science research identifies clinical champions as instrumental in aligning healthcare professionals' (HCPs) behavior with practice guidelines for delivering health services, including vaccinations. However, we know relatively little about identifying or supporting champions. To characterize who vaccine champions are, what they do, and how to support their work in pediatric primary care. In 2022, we interviewed a purposive sample of peer-nominated or self-identified vaccine champions (n=20) and HCPs who worked with vaccine champions (n=4). We thematically analyzed qualitative data. Vaccine champions' defining characteristics were firsthand primary care experience, whether as providers or nursing staff, and a strong belief in vaccinations as uniquely effective tools for primary prevention. Participants noted these beliefs were "part of the DNA" of specialties like pediatrics and infectious disease, where they perceived champions as especially common. Being "insatiable in their quest for knowledge," champions primarily conceptualized their role as understanding and sharing complex information and performance metric data related to vaccine administration. Champions' role in leading other implementation strategies, such as communication training, was more peripheral. Champions reported that dedicated time and staff support helped them "go above and beyond" to improve vaccination rates. Our findings suggest that vaccine champions can be found among providers and nursing staff with deep clinical experience and commitment to primary prevention through vaccination, including through providing vaccine education to colleagues. Healthcare systems can allocate resources to support champions as educators, while exploring opportunities to extend their role in other implementation strategies to improve vaccination rates.
实施科学研究发现，临床拥护者在使医疗保健专业人员（HCPs）的行为与提供卫生服务（包括疫苗接种）的实践指南保持一致方面发挥了重要作用。然而，我们对识别或支持拥护者的了解相对较少。为了描述疫苗拥护者是谁、他们做什么以及如何支持他们在儿科初级保健中的工作，我们于 2022 年采访了具有代表性的、由同行提名或自我认定的疫苗拥护者（n=20）和与疫苗拥护者合作的 HCPs（n=4）。我们对定性数据进行了主题分析。疫苗拥护者的特征是具有第一手的初级保健经验，无论是作为提供者还是护理人员，并且坚信疫苗接种是初级预防的独特有效工具。参与者指出，这些信念“是儿科和传染病等专业的 DNA 一部分”，他们认为这些专业的拥护者尤其常见。拥护者“对知识的追求永无止境”，他们主要将自己的角色视为理解和分享与疫苗接种管理相关的复杂信息和绩效指标数据。他们在领导其他实施策略（如沟通培训）方面的作用较为次要。拥护者报告说，专门的时间和员工支持有助于他们“超越自我”，提高疫苗接种率。我们的研究结果表明，疫苗拥护者可以在具有深厚临床经验和通过疫苗接种实现初级预防承诺的提供者和护理人员中找到，包括为同事提供疫苗教育。医疗保健系统可以分配资源来支持拥护者作为教育者，同时探索机会扩大他们在提高疫苗接种率的其他实施策略中的作用。
