A qualitative analysis of vaccine decision makers' conceptualization and fostering of 'community engagement' in India.
A qualitative analysis of vaccine decision makers' conceptualization and fostering of 'community engagement' in India.
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DOI：
10.1186/s12939-020-01290-5
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发表时间：
2020-10-20
影响因子：
4.8
通讯作者：
Nicholson-Crotty J
中科院分区：
文献类型：
--
作者：
Dutta T;Meyerson BE;Agley J;Barnes PA;Sherwood-Laughlin C;Nicholson-Crotty J
在全球范围内和印度，研究强调了社区参与实现国家疫苗接种目标和促进健康公平的重要性。然而，社区参与没有得到明确界定，仍然是一种利用不足的办法。关于社区参与在实现疫苗接种结果方面的有效性的文献也很少。为了解决这一差距，本研究采访了印度疫苗接种决策者，以获得对社区参与不断演变的概念化的共同理解，以及在印度疫苗十年（2010-2020年）期间如何促进社区参与。对印度25名有目的抽样的国家级疫苗决策者进行了半结构化访谈，包括政策制定者，免疫计划负责人和疫苗技术委员会负责人。参与者是根据他们在印度疫苗接种领域决策者中的“精英”地位来确定的。舒茨的社会现象学理论指导了一个源于社会生态模型的先验框架的发展。该框架有助于组织参与者对社区、社区参与和相关主题的概念化。评分员间的可靠性计算的编码采访的子样本，并在为期一天的成员签到会议与研究参与者和团队的结果进行了验证。访谈成功地阐明了参与者对关键术语（“社区”）的理解以及疫苗决策者宣传的社区参与方法。参与者将“社区”概念化为符合疫苗接种条件的儿童，他们的父母，一线医护人员和疫苗接种影响者。与这些社区的接触被理解为意味着疫苗推广、保健工作者的能力建设和信息传播。然而，与会者表示，尽管认识到社区参与是复杂的，而且研究不足，但既没有明确的政策准则界定社区参与，也没有相关的评价指标。社区参与的不同方法的例子包括强制接种疫苗和授权社区疫苗接种决策。最后，与会者提出了社区参与的可操作定义，并讨论了与执行该定义有关的关切问题，尽管决策者对社区的构成以及社区参与应如何发挥最佳作用有不同的看法，但联合小组阐明了社区参与对确保疫苗接种公平的重要性，并重申需要有协调一致的政治意愿，与社区建立信任。与此同时，在研究社区参与以及制定适当的执行和成果衡量标准方面，仍有工作要做。
Globally, and in India, research has highlighted the importance of community engagement in achieving national vaccination goals and in promoting health equity. However, community engagement is not well-defined and remains an underutilized approach. There is also paucity of literature on community engagement’s effectiveness in achieving vaccination outcomes. To address that gap, this study interviewed Indian vaccination decision makers to derive a shared understanding of the evolving conceptualization of community engagement, and how it has been fostered during India’s Decade of Vaccines (2010-2020). Semi-structured interviews were conducted with 25 purposefully sampled national-level vaccine decision makers in India, including policymakers, immunization program heads, and vaccine technical committee leads. Participants were identified by their ‘elite’ status among decisionmakers in the Indian vaccination space. Schutz’ Social Phenomenological Theory guided development of an a priori framework derived from the Social Ecological Model. The framework helped organize participants’ conceptualizations of communities, community engagement, and related themes. Inter-rater reliability was computed for a subsample of coded interviews, and findings were validated in a one-day member check-in meeting with study participants and teams. The interviews successfully elucidated participants’ understanding of key terminology (“community”) and approaches to community engagement propagated by the vaccine decision makers. Participants conceptualized ‘communities’ as vaccine-eligible children, their parents, frontline healthcare workers, and vaccination influencers. Engagement with those communities was understood to mean vaccine outreach, capacity-building of healthcare workers, and information dissemination. However, participants indicated that there were neither explicit policy guidelines defining community engagement nor pertinent evaluation metrics, despite awareness that community engagement is complex and under-researched. Examples of different approaches to community engagement ranged from vaccine imposition to empowered community vaccination decision-making. Finally, participants proposed an operational definition of community engagement and discussed concerns related to implementing it. Although decision makers had different perceptions about what constitutes a community, and how community engagement should optimally function, the combined group articulated its importance to ensure vaccination equity and reiterated the need for concerted political will to build trust with communities. At the same time, work remains to be done both in terms of research on community engagement as well as development of appropriate implementation and outcome metrics.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
影响因子：
3
作者：
Adhikari B;James N;Newby G;von Seidlein L;White NJ;Day NP;Dondorp AM;Pell C;Cheah PY
通讯作者：
Cheah PY
影响因子：
1.2
作者：
Head, Brian W.
通讯作者：
Head, Brian W.
影响因子：
9.7
作者：
Chang, Angela Y.;Riumallo-Herl, Carlos;Verguet, Stephane
通讯作者：
Verguet, Stephane
影响因子：
3.8
作者：
Elo, Satu;Kyngaes, Helvi
通讯作者：
Kyngaes, Helvi