Implementation of a quality improvement programme using the Active Patient Link call and recall system to improve timeliness and equity of childhood vaccinations: protocol for a mixed-methods evaluation.
Implementation of a quality improvement programme using the Active Patient Link call and recall system to improve timeliness and equity of childhood vaccinations: protocol for a mixed-methods evaluation.
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DOI：
10.1136/bmjopen-2022-064364
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发表时间：
2023-01-20
期刊：
影响因子：
2.9
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中科院分区：
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呼叫和召回系统提供可操作的情报，以提高儿童疫苗接种的公平性和及时性，这在COVID-19大流行期间受到干扰。我们将评估在初级保健中提供的数据支持的质量改进计划的有效性，保真度和可持续性，该计划使用主动患者链接免疫接种（APL-Imms）呼叫和召回系统，以提高多种族弱势城市人口的及时性和公平性。我们将使用定性方法来评估方案的交付，重点是吸收和使用，实施障碍和临床和非临床初级保健工作人员的服务改进，其保真度和可持续性。这是一项混合方法的观察性研究，在北东伦敦（NEL）的284个一般做法。目标人群将是有资格接受白喉、破伤风和百日咳（DTaP）或麻疹、腮腺炎和风疹（MMR）疫苗接种并在NEL全科诊所登记的学龄前儿童。干预措施包括实践中的电话和召回工具、便利和培训以及经济激励。定量评价将包括间断时间序列分析和不平等斜率指数。主要结局将是接受至少一剂含DTAP或MMR疫苗接种的儿童比例，分别定义为在6周龄至6个月或12至18个月之间接种。定性评价将采用“大声思考”的方法，并对利益攸关方进行半结构化访谈，以评估杀伤人员地雷-移民管理系统工具的影响、忠实性和可持续性，以及促进者实施工作的忠实性。研究团队已获得参与实践的数据控制者的许可，可以将去识别数据用于审计目的。由于研究结果将针对当地情况，因此不需要研究伦理批准。研究结果将在同行评审期刊上公布，并分发给利益攸关方，包括家长、保健提供者和专员。
Call and recall systems provide actionable intelligence to improve equity and timeliness of childhood vaccinations, which have been disrupted during the COVID-19 pandemic. We will evaluate the effectiveness, fidelity and sustainability of a data-enabled quality improvement programme delivered in primary care using an Active Patient Link Immunisation (APL-Imms) call and recall system to improve timeliness and equity of uptake in a multiethnic disadvantaged urban population. We will use qualitative methods to evaluate programme delivery, focusing on uptake and use, implementation barriers and service improvements for clinical and non-clinical primary care staff, its fidelity and sustainability. This is a mixed-methods observational study in 284 general practices in north east London (NEL). The target population will be preschool-aged children eligible to receive diphtheria, tetanus and pertussis (DTaP) or measles, mumps and rubella (MMR) vaccinations and registered with an NEL general practice. The intervention comprises an in-practice call and recall tool, facilitation and training, and financial incentives. The quantitative evaluation will include interrupted time Series analyses and Slope Index of Inequality. The primary outcomes will be the proportion of children receiving at least one dose of a DTaP-containing or MMR vaccination defined, respectively, as administered between age 6 weeks and 6 months or between 12 and 18 months of age. The qualitative evaluation will involve a ‘Think Aloud’ method and semistructured interviews of stakeholders to assess impact, fidelity and sustainability of the APL-Imms tool, and fidelity of the implementation by facilitators. The research team has been granted permission from data controllers in participating practices to use deidentified data for audit purposes. As findings will be specific to the local context, research ethics approval is not required. Results will be disseminated in a peer-reviewed journal and to stakeholders, including parents, health providers and commissioners.
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