Lecouturier J, Kelly Michael P, Sniehotta Falko F
Population Health Sciences Institute, Newcastle University, Newcastle, UK.
Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Public Health Pract (Oxf). 2024 Oct 25;8:100551. doi: 10.1016/j.puhip.2024.100551. eCollection 2024 Dec.
UK local authority public health teams (LAPHT) supported delivery of the Covid-19 vaccination programme, particularly to disadvantaged populations. We explored the challenges encountered and lessons learnt by LAPHTs in tackling low Covid-19 vaccine uptake. The aim of this study was to understand what works, and how, in addressing local inequalities in relation to uptake of the Covid-19 vaccination with a view to generalising insights to building back fairer after the pandemic and into the future.
Qualitative.
We conducted in-depth on-line interviews with Directors of Public Health or their representatives from 21 English local authorities covering a total population of over 8 million people. Data were analysed thematically.
Accessing the requisite (and accurate) data, engaging with communities, and working with National Health Service (NHS) organisations presented challenges in delivering initiatives to improve vaccine uptake, particularly for disadvantaged groups. LAPHT's assets beneficial to the programme - in-depth knowledge and experience of their communities and locality - were not considered in the national vaccination programme. Community engagement and relationships with local NHS featured heavily in the majority of LAPHTs responses to improving vaccine uptake rates.
Incorporating local public health infrastructure, expertise and existing relationships into national vaccination planning during epidemics or pandemics is crucial. Community engagement and good relationships with NHS staff help to reach and serve disadvantaged populations. How these can be developed and maintained in the longer term without future investment was a concern. Future research should explore the design and implementation of PH and NHS joint service delivery models to tackle health inequalities, informed by experiences of the Covid-19 vaccination programme and with input from community partners.
英国地方当局公共卫生团队（LAPHT）支持新冠疫苗接种计划的实施，尤其是针对弱势群体。我们探讨了LAPHT在应对新冠疫苗接种率低的问题时所遇到的挑战和吸取的经验教训。本研究的目的是了解在解决与新冠疫苗接种相关的地方不平等问题上，哪些措施有效以及如何有效，以期将相关见解推广至疫情后及未来构建更公平的社会。
定性研究。
我们对来自21个英格兰地方当局的公共卫生主任或其代表进行了深入的在线访谈，这些地方当局的总人口超过800万。对数据进行了主题分析。
获取必要（且准确）的数据、与社区互动以及与国民医疗服务体系（NHS）组织合作，在开展提高疫苗接种率的举措时面临挑战，尤其是对弱势群体而言。LAPHT对该计划有益的资产——对其社区和当地的深入了解及经验——在国家疫苗接种计划中未被考虑。社区参与以及与当地NHS的关系在大多数LAPHT提高疫苗接种率的应对措施中占据重要地位。
在流行病或大流行期间，将地方公共卫生基础设施、专业知识和现有关系纳入国家疫苗接种规划至关重要。社区参与以及与NHS工作人员的良好关系有助于覆盖和服务弱势群体。如何在没有未来投资的情况下长期发展和维持这些是一个令人担忧的问题。未来的研究应借鉴新冠疫苗接种计划的经验并结合社区合作伙伴的意见，探索公共卫生和NHS联合服务提供模式的设计与实施，以解决健康不平等问题。
