Addressing COVID 19 Vaccine Hesitancy in Rural Community Pharmacies Reducing Disparities Through an Implementation Science Approach

解决农村社区药房对 COVID 19 疫苗的犹豫，通过实施科学方法减少差异

• 批准号: 10708869
• 负责人: GEOFFREY M CURRAN
• 金额: $ 64.68万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-22 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10708869
• 关键词: Address; Adoption; Agreement; Ally; Automobile Driving; Budgets; COVID-19 complications; COVID-19 impact; COVID-19 pandemic; COVID-19 susceptibility; COVID-19 vaccination; COVID-19 vaccine; Cessation of life; Charge; Communities; Community Pharmacy; Complex; Cost Analysis; Counseling; Country; Data; Data Collection; Dissemination and Implementation; Effectiveness; Effectiveness of Interventions; Evidence based practice; Feedback; Goals; Health; Health Professional; Healthcare; High Prevalence; Hospitals; Hour; Human Papilloma Virus Vaccination; Human Papillomavirus; Individual; Infrastructure; Intervention; Modeling; Monitor; Patients; Pharmaceutical Preparations; Pharmacists; Pharmacy facility; Politics; Positioning Attribute; Primary Care; Research; Resources; Risk; Rural; Rural Community; Rural Population; SARS-CoV-2 variant; Safety; Sampling; Services; Social Distance; Source; System; Telephone; Testing; Time; Training; Travel; Trust; Update; Urban Population; Vaccination; Vaccines; Walking; comorbidity; cost effective; disparity reduction; effectiveness evaluation; evidence base; flu; health care availability; health professional shortage areas; implementation facilitation; implementation fidelity; implementation outcomes; implementation science; improved; pandemic disease; practice-based research network; primary care provider; primary outcome; rural area; rural counties; rural patients; rural underserved; secondary outcome; severe COVID-19; support tools; vaccine acceptance; vaccine hesitancy; video coaching; virtual

PROJECT SUMMARY The COVID-19 pandemic has disproportionally impacted rural communities, which are often health professional shortage areas that lack health care infrastructure, including hospitals1-3. When compared to urban populations, individuals living in rural areas are more vaccine hesitant8,9, have a higher prevalence of comorbid health conditions that increase their risk for severe COVID-19 complications12, and are at greater risk from SARS-CoV-2 variants due to lower vaccination rates and fewer vaccination mandates33,40. Thus, interventions to increase vaccine uptake in rural areas are greatly needed. As the most accessible healthcare professional in rural areas4,5 and one of the most trusted sources of medication information16, community pharmacists are well-positioned to address vaccine hesitancy with underserved, rural populations. Because vaccination conversations are sensitive and often politically charged, pharmacists need implementation support, including training and ongoing guidance to deliver evidence-based vaccine hesitancy counseling interventions18. Implementation facilitation, in which trained facilitators coach and troubleshoot problems with professionals as they implement new practices, increases adoption of practices with fidelity23-26. However, implementation facilitation generally, and virtual facilitation (e.g., video coaching) in particular, has not been systematically studied in community pharmacy settings. The need to examine the effectiveness of virtual facilitation as a means to increase vaccine hesitancy counseling and COVID-19 vaccination is of great importance given the large travel distances to rural areas and social distancing. Our goal is to test if virtual facilitation increases rural pharmacists’ ability to implement COVID-19 vaccine hesitancy counseling when compared to a “standard” implementation approach (e.g., training and dissemination of implementation support tools). Using a rural pharmacy practice-based research network (PBRN) that spans 5 southeastern states, we propose two aims. Aim 1 involves a stepped-wedge trial with 30 rural pharmacies to test whether virtual facilitation outperforms the standard approach in increasing: (a) the fidelity with which pharmacists implement the vaccine hesitancy counseling intervention and (b) the number of vaccine hesitant patients who agree to receive the vaccine. Using a project-sponsored data collection system, we will gather data on implementation outcomes, including fidelity and effectiveness. In Aim 2, we will conduct a cost assessment to explore the sustainability of virtual facilitation. We are uniquely positioned to test these competing implementation approaches and leverage rural community pharmacists to engage in vaccine hesitancy counseling in rural communities that have low vaccination rates.

项目总结

项目成果

Addressing COVID-19 vaccine hesitancy in rural community pharmacies: a protocol for a stepped wedge randomized clinical trial.

• DOI: 10.1186/s13012-023-01327-7
• 发表时间: 2023-12-18
• 期刊: IMPLEMENTATION SCIENCE
• 影响因子: 7.2
• 作者: Curran, Geoffrey;Mosley, Cynthia;Gamble, Abigail;Painter, Jacob;Ounpraseuth, Songthip;Brewer, Noel T.;Teeter, Ben;Smith, Megan;Halladay, Jacquie;Hughes, Tamera;Shepherd, J. Greene;Hastings, Tessa;Simpson, Kit;Carpenter, Delesha
• 通讯作者: Carpenter, Delesha